Policy – Add File Name(s) to First Page
Assess_CMS-HOS_18060502_Results I
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Lead Image [BND 2018 STARS]
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Blogger Title
Medicare (CMS) - Health Outcomes Survey (HOS) Report I for
Keith E Torkelson
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Google Plus Information
NCQA – CMS - HOS – SPH-Analytics – Brand New Day (BND) - KE
Torkelson 2018
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Figures - Partners
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Abstract & Cast of Characters
We discuss the CMS SPH Health
Outcomes Survey (HOS) process followed by our results. We first applied the HOS about ourselves in
Real Time back in 2014. We wrote and
published a report about this experience last year (2017). Our first Real Time score estimate was for
2014. We scored ourselves a 60.2%
Health (Care) Status Value with 100% being best. For 2016 we scored ourselves a 52.8%. For 2018 (now) we scored ourselves a 67.8%. In 2016 we applied the HOS assessment
retroactively for 2012, a year we suffered catastrophic losses. For 2012 we scored ourselves a 44.5%. In 2018 (now) we applied the HOS assessment
retroactively for one of our better years 1985. For 1985 we scored ourselves a 95.9%. We compared the CMS SPH HOS process to that of Sharecare
online. Both the HOS and Sharecare
(RealAge) Assessment have a comparable number of questions (Items). The difference is that none of the systems
(CMS, SPH, NCQA, etc) managing the HOS are positioned to return meaningful and
strategic results back to the Test Taker (Consumer). After one completes Sharecare’s online RealAge Assessment
Sharecare returns meaningful results as well as recommendations. We find there is little incentive for HOS
Test Takers to allocate time to take the Survey. In terms of process RealAge is far superior to the HOS process in
value. Our motivation here at MSG to
keep submitting our work is that we have hope it may be helping others in some
shape – way - form. Lastly, a reason we
would like our HOS results back is so we can evaluate our MSG HOS Algorithms.
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Cast of Characters
Keith E Torkelson (AKA Buster) is
the consumer for which this report is centered. This report pertains to the biennial Health Outcomes Survey or
HOS. It appears that the National
Committee for Quality Assurance (NCQA) was involved with authoring the version
we received by mail. For the survey
HCQA associates with the Centers for Medicare & Medicaid Services
(CMS). Symphony Performance Health
(SPH) Analytics circulates and scores the HOS.
The majority of the questions address the performance and our
relationship with our Primary Care Physician (PCP). Our PCP appears to contract with our insurance provider Brand New
Day (BND). In addition, our Behavioral
Health Doctor (BHD) appears to contract with BND. Our records show we first recorded working on our biennial HOS
during mid-year 2014. In attempting to
get our HOS Results we have worked with the following people or colleagues:
Jaqueline Zamora (SPH), “Your colleagues at NCQA”, Debbie A Vereb (SPH) &
Amy K Larrick (SPH).
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List of Tables – Matrices – Figures
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Figures - Partners
Table – Acronyms (AcroCodes) – Health Outcomes Study 2018
Evidence Up Front (EUF) - HOS Related Images
Table – Satisfaction with Measurement – HOS Management
Process
[IMAGE OF BND CMS STARS - DITTO]
Matrix – Health Related Engagement (HRE) Summary – 2012 Till
Present
Table – Legend - Sharecare RealAge
Matrix – Sharecare RealAge Online Assessment Results
Table – Acronyms & Abbreviations for HOS Scoring
Matrix – CMS HOS Results – Retroactive (MSG)
Matrix – CMS HOS Results – Real Time - 2014 (MSG)
Matrix – CMS HOS Results – Real Time – 2015 – A Skip Year
(MSG)
Matrix – CMS HOS Results – Real Time – 2016 (MSG)
Matrix – Comparative Longitudinal HOS Scores Coded &
Calculated by MSG
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Table – Acronyms (AcroCodes) – Health Outcomes Study 2018
Health Status Value - Table Key
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AcroCode
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Description
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HEDIS
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The Healthcare Effectiveness Data and Information Set
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BND
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Brand New Day
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GBDP
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Graduate By DEATH Program
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CAHPS
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Consumer Assessment of Health Plan Study
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HOS
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Health Outcomes Survey
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HSV
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Health (Care) Status Value
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KPIs
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Key Performance Indicators
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TMG
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The Myers Group
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MIPS
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Merit-Based Incentive Payment System
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NCQA
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National Committee for Quality Assurance
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CMS
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Centers for Medicare & Medicaid Services
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MSG
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Mentalation Solutions Group
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QSM
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Quick Score Method
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SPH
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Symphony Performance Health
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SPH-Analytics
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TMG_HOSS
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The Myers Group Health Outcomes Survey Support
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SR-CMS
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Star Ratings - Centers for Medicare & Medicaid
Services
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SR-Online
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Stars Ratings-Online Objective
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SR-MSG
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Stars Rating-Mentalation Solutions Group
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Table of Acronyms (Acrocodes) – Last Update: 20180711-W:
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Special Topic – HOS Related
Experiences
This report is centered about our
third (3rd) CMS Health Outcomes Survey (HOS). We first were solicited back in 2014 for our
first (1st) HOS. Next we
received our second (2nd) HOS in 2016. It would appear that HOS Assessments are distributed in a
biennial rhythm. After filling out our
second HOS we formally asked SPH for our results from 2014. We now think they did not understand nor
were prepared to help us the Test Taker out.
In 2016 we filled out our HOS and submitted it. Then we get a call from a phone Rep who
stated they had not received it. They
sent us out a second. Yet we did not
get any results from 2014. There are
many reasons we desire our HOS results.
One reason is that the student in us wants our test results. Returning test results is usual and
customary in an education setting why not a public health setting.
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Special Topic – Confidentiality –
Transparency – Evidence
We decided to share our 2018
Health Outcomes Survey intact and in totality.
To the best of our knowledge none of the members in the supply line such
as CMS or SPH can do this due to confidentiality issues. We here at MSG for Buster are pursuing an
effort about guarded transparency. We
call this effort “Triple Blood”.
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Evidence Up Front (EUF) - HOS
Related Images
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Introduction - Definition
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What is a CMS Health Outcome
Survey?
This paper pertains to the
biennial CMS Health Outcomes Survey.
“The Medicare Health Outcomes Survey (HOS) was launched in 1998 as a
part of the Health Plan Employer Data and Information Set (HEDIS®). The
Medicare HOS is the first outcomes measure used in Medicare managed care and
the largest survey effort ever undertaken by the Centers for Medicare &
Medicaid Services (CMS).”
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Table – Satisfaction with Measurement
– HOS Management Process
Measuring Agencies About Biennial HOS
Quick Score Method (QSM)
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Method
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Process
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Agency
Results
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Our Results
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20160526-TH: NCQA Customer Support
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Failed
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Failed
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Surrender
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BND
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Remote
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Average
3.5 MSG Stars
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OK
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CAHPS
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Complex
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Poor
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Pending
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HEDIS
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Complex
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Poor
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Excellent
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HEDIS (HOS)
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Complex
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Poor
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Maturing
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HOS
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OK
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Poor
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OK
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MSG
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Maturing
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Excellent
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[DITTO]
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Myers
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OK
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Poor
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OK
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NCQA
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Poor
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Poor
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Poor
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NCQA - Portal
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Poor
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Poor
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Poor
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Sharecare
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Exemplary
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Good
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Satisfied
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SPH Analytics
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Poor
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Poor
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Poor
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Table – Satisfaction with Measurement and Measuring Agencies
- Last Reviewed 20180711-W:
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BND Stars
FYI - [PDF] - 2018 Medicare Star
Ratings - Brand New Day
“The Medicare Program rates all
health and prescription drug plans each year, based on a plan's quality and
performance."
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[INSERT IMAGE OF BND CMS STARS -
DITTO]
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Purpose
This report is part of MSG’s
(our) effort to help our insurer, Brand New Day (BND), improve their CMS Stars
Scores. We have previously compared
various insurers such as Kaiser Permanente to BND. As you can see BND is in the range of 3.5 Stars. We would like to see BND earn their Quality
Bonus Payments (QBP) as a plan with a Medicare Star Rating > 4 Stars. We discovered this year rather than the CMS
HOS being a standalone valuation it is part of HEDIS. We probably will not arrive at an exact CMS Stars equation ever
on our own. Our equation for CMS Stars
has been modified as follows:
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Was >
HEDIS + CAHPS + HOS = CMS Stars
HOS now as a Subset of HEDIS
HEDIS = CAHPS + HOS
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We are uncertain how HEDIS feeds
into CMS Stars. In addition, CAHPS may
include or actually be the HOS. In our
upcoming yearly HEDIS report we will work to refine our CMS assessment
knowledge even further.
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FYI - What is HEDIS?
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HEDIS® and Quality Compass®
“HEDIS is a tool used by more
than 90 percent of America's health plans to measure performance on important
dimensions of care and service. Because so many plans collect HEDIS data, and
because the measures are so specifically defined, HEDIS makes it possible to
compare the performance of health plans on an "apples-to-apples"
basis. Health plans also use HEDIS results themselves to see where they need to
focus their improvement efforts.”
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Company Man and Perfect
Performance
Even though historically we have
received nothing in return for our Health Outcome Survey (HOS) efforts we have
decided to submit one for this year (2018).
We do this for a few reasons. First,
we liken ourselves to a company person (Brand New Day) and if it is good for
the company we help out. Second our
input contributes to the companies (Brand New Day) CMS Stars performance
score. Last time we checked BND earned
for 2018 3.5 Stars out of 5.0 Stars from CMS.
We have been contributing for BND here and there that their CMS Stars
Score will improve for 2019. Even
though we have received a reminder card from the provider that CMS contracts
(SPH) to manage our particular HOS there is really no hurry. In the pages that follow we summarize some
of our experiences with the Health Outcome Survey process. We have been at it long enough to specialize
about our HOS’s.
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Table - Evaluation Breakdown –
Provider/Consumer/Impact
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Assessment
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Measures
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Trend
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Note
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HOS
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Provider Part
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Improving
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HRE
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Consumer (Our) Part
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Increasing
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RealAge
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Impact of Health Mediation
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Improving
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Table – Evaluation Breakdown – Provider/Consumer/Impact –
Last Reviewed: 20180712-TH:
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20180711-W: Defining a Health
Related Engagement (HRE)
The first note in our database
regarding HREs is February 28, 2016.
Our planners indicate we have been tracking our HREs since 2014. Since then we have worked on a standard
definition for our HRE (MSG) Product.
The definition includes requirements and specifications. As of today, July 11, 2018, our Beta
Definition is as follows. For us the
HRE method looks like a promising practice.
We have applied it more than 100 times.
HREs require preparing in advance for and attending an engagement. HREs are assessment driven. HREs might be likened to dosage. Dosages have been linked to better
outcomes. We track the impact about our
HREs. We also focus on Satisfaction. When it comes to in house engagements we do
not count an HRE. We strive to maximize
the value of others’ and our time. We
take measurements at an HRE. We apply
Para-health worker principles while at an HRE.
Our role in an engagement is that of a ProSumer (MSG). Our behavior at an HRE is that of
ProSumption (MSG). In most case we
share the results from our findings. Google (Blogger) is our partner in ProSumption. In general HREs are either medical or social
in nature. ProSumption about HREs
addresses arriving at standards. In
general, an HRE has therapeutic value as measured by assessment. We prefer Commercial-Of-The-Shelf (COTS)
assessment to the ones we here at MSG write.
To balance things out we schedule HREs to be with healthy people. As a practicing ProSumer we attempt to
maximize transparency. Naturally we
score ourselves high as a ProSumer applying HRE principles. Finally, our HRE time is Voluntary. At times we receive non-monetary
compensation for our HRE efforts.
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Special Topic - Health Related Engagements (HREs)
Metadata: 2016022801 HREs Step-03 V2018
Matrix – Health Related
Engagement (HRE) Summary – 2012 Till Present
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Calendar
Year
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Track
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HRE
Total
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HRE
In Network
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Perfect
In Network
Attendance
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Note
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2012
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DNT
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Ã
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Ã
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Yes
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2013
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DNT
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Ã
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Ã
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Yes
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2014
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Partial
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82
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DNT
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Yes
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2015
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Full
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80
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33
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Yes
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2016
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Full
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88
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45
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Yes
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2017
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Full
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120
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78
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Yes
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20180710-TU
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YTD
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66
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34
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So Far
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Matrix – Health Related
Engagement (HRE) Summary – 2012 Till Present - Last Update: 20180711-W:
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DNT=Did Not Track
HRE=Health Related Engagement
YTD=Year To Date
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Table – Legend - Sharecare RealAge
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Acro
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Meaning
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RAOA
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RealAge Online Assessment
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RA
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RealAge
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CA
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Calendar Age
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Table – Legend - Sharecare RealAge - Last Reviewed:
20180711-W:
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How is it RealAge?
We have several assessments that indicate the impact of
our Individualized Health Management Program (IHMP). For this study we chose the online assessment called RealAge by
Sharecare. The RealAge test assesses a
broad spectrum of health elements including: Eating, exercising, sleeping
habits, lab work results, etc. Since we
first familiarized ourselves with the format Sharecare has changed the nature
of the online test. We signed on to
update our responses only to find that they request more precise answers. For now we will skip updating our RealAge
file. We will update our RealAge file
after we have the results from our 2018 (Annual) physical exam. We project that our RealAge has improved
over 2017. The behavioral change that
would have the most impact on our Quality Of Life would be quitting
smoking. Note: In order to use the
RealAge system you have to set up an account.
Next you will find a Matrix containing our RealAge results over time.
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FYI - Find Out Your RealAge –
Sharecare
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[INSERT REALAGE PROMO IMAGE]
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Matrix – Sharecare RealAge Online Assessment Results
Last Reviewed: 20170802-TH: RealAge Online Assessment (RAOA)
Results
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Date
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Details - Assessment
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Real-Age Score
(RAS)
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20060614-W
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Laura Davis suggests RAOA
Can’t find legacy findings
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Found It!
RA = 63.0 - CA =
47.2
Diff + 15.8
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20141220-SA
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Plan to take 1-4 Assessments
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Took 1
RA = 63.9 - CA =
55.8
Diff + 8.1
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20150402-TH
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Retake Real-Age (RAOA)
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RA = 62.7 - CA =
56.0
Diff + 6.7
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20170418-TU
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Retake Real-Age (RAOA)
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RA = 60.4 - CA =
58.0
Diff + 2.4
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20180710-TU
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RAOA – Major Format Change
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Set aside because
to cumbersome
Expect Improvement
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Matrix – Sharecare RealAge Online Assessment Results - Last
Update: 20180711-W: Table For Buster & AVEY - AKA Keith Edward Torkelson,
M.Sc.
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MSG In Scope Quality Measurement
Legacy Publication
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Brand New Day HMO: Assessment
Evaluation for Brand New Day (KE Torkelson, 2017)
Aug 4, 2017 - Assessment
Evaluation for Brand New Day
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20170727-TH: Purpose (MSG)
“The purpose of this report is to
apply what we have learned from Lived Experience, including lessons learned by
attending the 2015 California Institute for Behavioral Health Solutions (CIBHS)
National Behavioral Health Information Conference (NBHIC), and the 2017 CIBHS
NBHIC. We hope to relate our knowledge
for solving Performance issues for Brand New Day (BND) a real non-profit health
service provider in need of help. In
this paper we inventory and address some of BND’s measurement instruments. We use the Orange County Health Care Agency
(OCHCA) as our model program. Here we
discuss two conference presentations.
We find the material as relevant about the subject under consideration.”
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Table – Acronyms & Abbreviations for HOS Scoring
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Acro or Abbrev
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Meaning
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Alg_HOS_2016
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In House HOS Scoring Algorithm
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Alg_HOS_2018
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In House HOS Scoring Algorithm
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BND
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Health Outcomes Group
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ENRP
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ENRP=Expect No Results Provided
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HSScore
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Health Outcomes Score
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HSV
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Health Status Value
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NRP
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No Results Provided
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Retro
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Retroactive
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RT
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Real Time
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Table – Acronyms & Abbreviations for HOS Scoring
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Matrix – CMS HOS Results – Retroactive (MSG)
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Timestamp
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Assessment Scoring
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HSV Result
% (Items)
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Note
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20160530-M
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1985 Retro by MSG
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95.9 (60)
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Alg_HOS_2016
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20160530-M
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2012 Retro by MSG
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44.5 (60)
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Alg_HOS_2016
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Matrix – CMS HOS Results – Retroactive - 2016 (MSG) - Health
Status Value (HSV) – Last Reviewed: 20180711-W:
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Alg_HOS_2016
Our scoring algorithm 2016 was
written and devised applying the CMS HOS 2016 instrument. The HOS we find tricky to score
consistently. Our scoring framework was
written using Microsoft Excel. Yet
actually scoring due to large variability in numbers of choices per question
lends us to tweak each value we record in the Spreadsheet. For our 2016 version we apply 60 Items. With over 50-Items we would consider the HOS
a full assessment. For SPH Analytics it
would be a huge savings in time if they could get as many consumers as possible
to take the HOS online. When the
consumer submits their online assessment it might best return an immediate
score and interpretation page.
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Matrix – CMS HOS Results – Real Time - 2014 (MSG)
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Timestamp
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Assessment Scoring
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HSV Result
% (Items)
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Note
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-
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20140515-TH
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2014 by MSG
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60.2 (61)
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Alg_HOS_2014
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2014 by TMG via SPH
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NRP
|
Referred to NCQA
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20160526-TH
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2014 via SPH by NCQA
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NRP
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2014 via TMG
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NRP
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Result(s) Never Came
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Matrix – CMS HOS Results – Real Time - 2014 (MSG) - Health
Status Value (HSV) – Last Reviewed: 20180711-W:
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Matrix – CMS HOS Results – Real Time – 2015 – A Skip Year
(MSG)
|
-
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Timestamp
|
Assessment Scoring
|
HSV Result
% (Items)
|
Note
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-
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20151111
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2015 on Own by MSG
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58.5 (60)
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Alg_HOS_2014
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20160101
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2015 Skipped by NCQA
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-
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Matrix – CMS HOS Results – Real Time – 2015 – A Skip Year
(MSG) - Health Status Value (HSV) – Last Reviewed: 20180711-W:
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Matrix – CMS HOS Results – Real Time – 2016 (MSG)
|
-
|
|
|
|
|
|
Timestamp
|
Assessment Scoring
|
HSV Result
% (Items)
|
Note
|
|
|
-
|
|
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20160531-TU
|
2016 by MSG
|
52.8 (64)
|
Alg_HOS_2016
|
|
|
20160602-TH
|
2016 by SPH
|
NRP
|
Mailed
|
|
|
|
2016 via NCQA
|
NRP
|
|
|
|
-
|
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|
Matrix – CMS HOS Results – Real Time – 2016 (MSG)
Table as of June 1, 2016 – Health Status Value (HSV) – Last
Reviewed: 20180711-W:
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Matrix – Comparative Longitudinal HOS Scores Coded &
Calculated by MSG
|
-
|
|
|
|
|
|
Timestamp
|
Assessment Scoring
|
HSV Result
% (Items)
|
Note
|
|
|
-
|
|
|
|
|
|
20180606-W
|
1985 Retro by MSG
|
95.9 (60)
|
Alg_HOS_2016
|
|
|
-
|
|
|
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|
20160530-M
|
2012 Retro by MSG
|
44.5 (60)
|
Alg_HOS_2016
|
|
|
-
|
|
|
|
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20140515-TH
|
2014 RT by MSG
|
60.2 (61)
|
Alg_HOS_2014
|
|
|
-
|
|
|
|
|
|
20160531-TU
|
2016 RT by MSG
|
52.8 (64)
|
Alg_HOS_2016
|
|
|
-
|
|
|
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|
|
20180704-W
|
FY 2017/18 RT by MSG
|
67.8 (73)
|
Alg_HOS_2018
73 - Items
|
|
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-
|
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|
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Matrix – Comparative HOS Scores Coded & Calculated by
MSG - Health Status Value (HSV) – Last Reviewed: 20180711-W: Longitudinal
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Alg_HOS_2018
We had to tweak our Alg_HOS_2016
scoring algorithm to accommodate a few new questions. For the most part our Alg_HOS_2018 is a build off of our Alg_HOS_2016
framework scoring algorithm. We still
have yet to receive any results back from SPH.
On the HOS the number of answers per question ranges from approximately
2 to about 7. It is a moderately
challenging Assessment Tool to score.
-
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HOS 2014 – Outcomes – Request –
May 26, 2016 (SPH Analytics)
It looks like CMS solicits for us
to fill out and submit their Health Outcome Survey (HOS) every other year. When we received by mail our 2018 HOS we
thought again: Hey we have not received any scores back from our 2014 HOS! In 2018 we contacted SPH Analytics. SPH informed us we needed to contact
NCQA. In the end we never received our
2014 results. Being the company people
we are we went ahead and submitted by mail our 2016 HOS).
-
Conclusion - Who is the HOS
Really for?
It looks like the HOS Assessment
is not for the end user – consumer. How
it is that the agencies involved not feel the one who fills out the HOS should
not get results is beyond us. The test
taker here, Keith Torkelson (AKA Buster) is now approaching sixty (60) years
old. The only area of health that he
might gain substantially is with COPD Management. We hope you found this report useful to you on your Individualized
Journeys About Health (IJAHs).
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End of Report
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