OMB control number

Medicare Health Outcomes Survey (HOS) (CMS-10203)

OMB 0938-0701 ยท HHS/CMS.

OMB 0938-0701

The Centers for Medicare & Medicaid Services collects quality performance measures in order to hold the Medicare managed care industry accountable for the care being delivered, to enable quality improvement, and to provide quality information to Medicare beneficiaries in order to promote an informed choice. It is critical to CMS's mission that we collect and disseminate information that can be used to help beneficiaries choose among health plans, contribute to improved quality of care through identification of improvement opportunities, and assist CMS in carrying out its oversight and purchasing responsibilities.

The latest form for Medicare Health Outcomes Survey (HOS) (CMS-10203) expires 2027-06-30 and is listed under ICR 202501-0938-006.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-10203 Medicare Health Outcomes Survey-Modified (Spanish)Form
Form CMS-10203 Medicare Health Outcomes Survey-Modified (Russian)Form
Form CMS-10203 Medicare Health Outcomes Survey-Modified (Chinese)Form
Form CMS-10203 Medicare Health Outcome Survey (Spanish)Form
Form CMS-10203 Medicare Health Outcome Survey (Russian)Form
Form CMS-10203 Medicare Health Outcome Survey (Chinese)Form
Form CMS-10203 Medicare Health Outcomes Survey-Modified (HOS-M)Form
Form CMS-10203 Medicare Health Outcomes SurveyForm
Form CMS-10203 Medicare Health Outcomes Survey (HOS)Form
draft response to comments_02272025.docx (document unavailable)Supplementary Document
UHC Comments - Medicare Health Outcomes Survey 2.13.2025.pdf (document unavailable)Public Comments
SNPA PRA HOS February 13, 2025.pdf (document unavailable)Public Comments
PC_202501-0938-006_021225_104632_1.pdf (document unavailable)Public Comments
CMS-10203 Supporting Statement A_30day_final.docx (document unavailable)Supporting Statement A
1. CMS-10203 Supporting Statement A_.docxSupporting Statement A
UnitedHealthcare.pdf (document unavailable)Public Comments
Special Needs Plan Alliance.pdf (document unavailable)Public Comments
Commonwealth Care Alliance.pdf (document unavailable)Public Comments
CMS-10203 Supporting Statement B_.docxSupporting Statement B
Attachment A. Crosswalk of Changes.docxSupplementary Document
CMS Response to Public Comments Received for CMS-10203 updated.docxSupplementary Document
Medicare Health Outcomes Survey (HOS) Form
Medicare Health Outcomes Survey (HOS) Form
Medicare Health Outcomes Survey (HOS) Form
Medicare Health Outcomes Survey (HOS) Form
Medicare Health Outcomes Survey (HOS) Form
Medicare Health Outcomes Survey (HOS) Form
Medicare Health Outcomes Survey (HOS) Form
Medicare Health Outcomes Survey (HOS) Form
Medicare Health Outcomes Survey (HOS) Form

All Historical Document Collections