Crosswalk

Attachment A. Crosswalk of Changes
This attachment crosswalks the changes to the HOS Questionnaire from the last OMB clearance to the HOS Questionnaire submitted for this
clearance.
2018 Survey Question
Has a doctor ever told you that you had:

2021 Survey Question
N/A

Type of Change
Removal

28. Arthritis of the hip or knee
1
2

Additionally, this condition is so common that
it does not serve to distinguish respondent
groups.

Yes
No

Has a doctor ever told you that you had:

Removal

N/A

29. Arthritis of the hand or wrist
1
2

No
Removal

N/A

31. Sciatica (pain or numbness that travels
down your leg to below your knee)
1
2

Item is not used in CMS Star Ratings or other
programs.
Additionally, this condition is so common that
it does not serve to distinguish respondent
groups.

Yes

Has a doctor ever told you that you had:

Reason for Change
Item is not used in CMS Star Ratings or other
programs.

Yes
No

1

Item is not used in CMS Star Ratings or other
programs.

2018 Survey Question
38. In the past 7 days, how would you rate
your pain on average?
01
02
03
04
05
06
07
08
09
10

1 No pain

2
3
4

00

2

01

3

02

4

03

5

04

6

05

7

06

8

07

9

08

10 Worst imaginable pain

41. Do you now smoke every day, some days,
or not at all?
1

2021 Survey Question
38. In the past 7 days, how would you rate
your pain on average?

09

N/A

10

Type of Change
Response scale
adjustment

Reason for Change
To align with best practices in survey
methodology.

Removal

This HOS item is not used in CMS Star
Ratings or other programs; this information is
collected by Medicare Advantage CAHPS
health surveys.

No pain
1
2
3
4
5
6
7
8
9
10 Worst imaginable pain

Every day
Some days

The National Cancer Institutes (NCI)
Surveillance, Epidemiology, and End Results
(SEER) Program uses other data sources for
this information. HOS responses historically
align closely with information that the
Centers for Disease Control (CDC) collects
through National Health and Nutrition
Examination Survey (NHANES).

Not at all
Don’t know

2

2018 Survey Question
52. Have you ever had a bone density test to
check for osteoporosis, sometimes thought
of as “brittle bones”? This test would have
been done to your back or hip.
1
2

2021 Survey Question
N/A

Type of Change
Removal

Reason for Change
In 2019, NCQA retired the Osteoporosis
Testing in Older Women (OTO) from the
Healthcare Effectiveness Data and
Information Set (HEDIS) for HEDIS 2021 in
response to a change in the U.S. Preventive
Services Task Force (USPSTF)
recommendations for osteoporosis screening.

N/A

Removal

This item is burdensome from a telephone
administration point of view: it takes a good
deal of time for the interviewer to administer.
It has the most missingness in both phone and
mail modes.

Yes
No

68. Which of the following categories best
represents the combined income for all
family members in your household for the
past 12 months?
01

Less than $5,000

02

$5,000–$9,999

03

$10,000–$19,999

04

$20,000–$29,999

05

$30,000–$39,999

06

$40,000–$49,999

07

$50,000–$79,999

08

$80,000–$99,999

09

$100,000 or more

10

Don’t know

It is redundant in the sense that CMS has
access to three other measures that are
considered as proxies for income: Medicaid
status, home ownership, and Supplemental
Security Income (SSI) claim status.

3