As Health Outcomes Survey (HOS) measures gain weight in Medicare Stars Ratings, prioritizing member-perceived health is more critical than ever. Recently, mPulse and Rex Wallace Consulting hosted an in-depth webinar exploring how health plans can refine their HOS strategies to drive meaningful, member-centric outcomes. Below, we summarize the key insights and takeaways to support your organization’s HOS performance and member experience goals.
Why should HOS be front of mind?
HOS assesses members’ perceptions of their physical and mental health, capturing dimensions such as fall risk, bladder control, and physical activity. Historically representing a small portion of Star Ratings, HOS measures are poised to jump from 5% in 2026 to 11% of overall Star Ratings in 2027, underscoring the urgent need for a strong, proactive strategy today.
Key Blind Spots in HOS Strategies
X Lack of Member-Level Risk Identification: Many plans take a broad approach, missing personalized opportunities. Identifying which members are most at risk for declining health perceptions is essential to targeted outreach.
X Disconnected Data: HOS-related data often sits across HRAs, AWVs, care management, and vendor programs without integration, leaving plans unable to see the full picture.
X Absence of Governance: Unlike CAHPS, HOS governance structures are often absent, leading to missed accountability, coordination, and strategic execution.
X No Pre-Assessment or Mock Survey Strategy: Without baseline insights or early assessments, plans are flying blind, unable to tailor interventions before survey administration.
Strategic Levers to Improve HOS Performance
✓ Stratify by Tenure and Risk: Prioritize members eligible for upcoming follow-ups (2023 baseline cohort) and segment by likelihood of decline using predictive analytics and clinical indicators.
✓ Leverage Predictive Tools for Personalized Outreach: Use platforms like mPulse Decision Point Insights (DPI) to identify high-risk members and tailor interventions ranging from care management to targeted digital programs and campaigns.
✓ Integrate HOS into Frontline Workflows: Train care managers, in-home vendors, and customer service teams to reinforce positive health perceptions and identify at-risk members for timely support.
✓ Engage Providers: Educate providers on how their conversations influence HOS responses. Support them with EHR prompts, scripting, performance dashboards, and incentives.
To drive meaningful HOS outcomes, health plans should consistently use predictive risk tiers throughout the year, integrate clinical and perception-based data, embed HOS strategies across care teams and digital channels, and monitor KPIs monthly to adapt as needed. However, they must avoid siloing HOS efforts from other initiatives, ignoring social determinants of health, relying solely on clinical teams, using generic outreach that misses high-risk members, and operating without clear governance and accountability.
Tiered Engagement: One Size Does Not Fit All
To ensure each member receives the right support, plans should adopt a tiered engagement approach tailored to their level of risk.
High Risk: Personalized clinical outreach, care management, in-home visits, and community-based support to stabilize health.
Rising Risk: Early interventions, health coaching, and digital engagement to prevent decline.
Low Risk: Preventive communication, healthy behavior campaigns, and digital self-service tools to sustain wellness.
Turn Your Data into Actionable HOS Strategies
mPulse data-driven engagement solutions help health plans turn their data into meaningful action by identifying members who are most likely to influence HOS outcomes and targeting them with greater precision. It supports plans in designing personalized engagement strategies across channels such as SMS, IVR, email, and care management referrals while also equipping providers with insights that can shape member perceptions of their health. Additionally, our solutions make it easier to drive coordinated interventions by producing prioritized member lists with integrated provider details, enabling teams to act efficiently and effectively.
Nest Steps
HOS is no longer optional; it is a strategic imperative for Stars success. Whether your plan is building its first HOS strategy or refining an existing one, taking even small steps now can yield outsized future returns. Members’ health perceptions shape not only your ratings but their trust in your organization.
Start driving meaningful, member-centric outcomes today. Connect with mPulse to design a tailored HOS improvement strategy.
HOS: Strategies to Drive Member-Centric Outcomes
Wed, May 21 10:30 AM – 11:30 AM CDT
