Medical Expenditure Panel SurveyMedical Expenditure Panel Survey

SURVEY OVERVIEWSURVEY OVERVIEW

MEPS HistoryMEPS History

1977 National Medical Care Expenditure 1977 National Medical Care Expenditure SurveySurvey

1987 National Medical Expenditure Survey1987 National Medical Expenditure Survey

1996 Medical Expenditure Panel Survey1996 Medical Expenditure Panel Survey

MEPS Survey ComponentsMEPS Survey Components

The MEPS has two major components:The MEPS has two major components:

MEPS-HC -- Household ComponentMEPS-HC -- Household Component

MEPS-IC -- Insurance ComponentMEPS-IC -- Insurance Component

MEPS-HC Purpose & UsesMEPS-HC Purpose & Uses

Estimates annual health care use, Estimates annual health care use, expenditures and insurance coverage, and expenditures and insurance coverage, and tracks changes in these over timetracks changes in these over time

Provides estimates of expenditures and Provides estimates of expenditures and sources of payment by selected demographic sources of payment by selected demographic variablesvariables

Used for policy-related and behavioral Used for policy-related and behavioral research on the determinants of health care research on the determinants of health care use, spending, and insurance coverageuse, spending, and insurance coverage

Used in micro simulation models to analyze Used in micro simulation models to analyze alternative health care delivery proposals.alternative health care delivery proposals.

MEPS-HC Survey Design

Sub-sample of respondents from the Sub-sample of respondents from the previous year’s NHISprevious year’s NHIS

Representative of the civilian non-Representative of the civilian non-institutionalized population of the USinstitutionalized population of the US

Five in-person interviews over 2 ½ year Five in-person interviews over 2 ½ year period using CAPI.period using CAPI.

Interviews average 90 minutes with a Interviews average 90 minutes with a range of one to four hoursrange of one to four hours

MEPS-HC Survey Design -- Oversampling

Oversampling improves the precision of estimates for specific subgroups

Blacks and Hispanics have been oversampled every year with an additional over sampling of blacks in 2004

Low income and Asians oversampled in 2002 and beyond

MEPS-HC Sample SizesMEPS-HC Sample Sizes

YearYear Families Families PersonsPersons1996 8,6551996 8,655 21,571 21,5711997 13,087 32,6361997 13,087 32,6361998 9,023 22,9531998 9,023 22,9531999 9,354 23,5651999 9,354 23,5652000 9,515 23,8392000 9,515 23,8392001 12,852 32,1222001 12,852 32,1222002 14,828 37,4182002 14,828 37,4182003 12,860 32,6812003 12,860 32,6812004 13,018 32,7372004 13,018 32,7372005 12,810 32,3202005 12,810 32,320

MEPS Panel Design: Data Reference PeriodsMEPS Panel Design: Data Reference Periods

20042004 20052005 20062006

Q1Q1 Q2Q2 Q3Q3 Q4Q4 Q1Q1 Q2Q2 Q3Q3 Q4Q4 Q1Q1 Q2Q2 Q3Q3 Q4Q4

Panel 8Panel 8 Round 3Round 3

Round 4Round 4

Round 5Round 5

Panel 9Panel 9 Round 1Round 1

Round 2Round 2

Round 3Round 3

Round 4Round 4

Round 5Round 5

Panel 10Panel 10 Round 1Round 1

Round 2Round 2

Round 3Round 3

Round 4Round 4

Round 5Round 5

Panel 11Panel 11 Round 1Round 1

Round 2Round 2

Round 3Round 3

Sample SizeSample Size N = 32,737N = 32,737 N = 32,320N = 32,320 N = 32,577N = 32,577

N is equal to the number of people with a positive person weight on the file.

MEPS-HC MEPS-HC Core Interview ContentCore Interview Content

DemographicsDemographics Charges and PaymentsCharges and Payments Health StatusHealth Status ConditionsConditions Utilization Utilization EmploymentEmployment Health InsuranceHealth Insurance

MEPS- HC Supplemental CAPI MEPS- HC Supplemental CAPI SectionsSections

Sections asked in rounds 2 and 4:Sections asked in rounds 2 and 4: Access to careAccess to care Child preventive healthChild preventive health Satisfaction with health plans & Satisfaction with health plans &

providersprovidersSections asked in rounds 3 and 5:Sections asked in rounds 3 and 5: Assets Assets (round 5 only)(round 5 only) IncomeIncome Preventive CarePreventive Care Priority conditionsPriority conditions

MEPS-HC Supplemental Paper MEPS-HC Supplemental Paper QuestionnairesQuestionnaires

Diabetes Care SAQDiabetes Care SAQ• Given once a year to each person identified as Given once a year to each person identified as

having diabeteshaving diabetes• Includes questions about diabetes related tests Includes questions about diabetes related tests

and managing diabetesand managing diabetes

Adult SAQAdult SAQ• Given once a year to each adult 18 years old and Given once a year to each adult 18 years old and

olderolder• Focus is on information that needs to be self Focus is on information that needs to be self

reported such as self assessments, height/weight, reported such as self assessments, height/weight, opinions about health care issues and quality of opinions about health care issues and quality of care measurescare measures

Types of MEPS-HC FilesTypes of MEPS-HC Files

Full-year Files - calendar year dataFull-year Files - calendar year data

Point-in-time Files - snap shot first part of yearPoint-in-time Files - snap shot first part of year

MEPS/NHIS Link FileMEPS/NHIS Link File

Longitudinal Data FileLongitudinal Data File

MEPS HC-036: 1996-2005 Pooled Estimation FileMEPS HC-036: 1996-2005 Pooled Estimation File

Levels of MEPS-HC Public Levels of MEPS-HC Public Use FilesUse Files

Person Level - detailed person Person Level - detailed person informationinformation

Event Level - detailed event level Event Level - detailed event level informationinformation

Condition Level - detailed condition Condition Level - detailed condition informationinformation

Job Level - detailed job informationJob Level - detailed job information

MEPS-HC Caveats and MEPS-HC Caveats and LimitationsLimitations

Sample size limitations preclude some Sample size limitations preclude some analysesanalyses

Typically, one respondent provides data for Typically, one respondent provides data for the entire householdthe entire household

Household respondents may not be able to Household respondents may not be able to report accurately certain types of report accurately certain types of informationinformation– type of health plantype of health plan– detailed event informationdetailed event information– diagnosesdiagnoses

MEPS-IC (Insurance Component)MEPS-IC (Insurance Component)

An independent survey of employers and unions not An independent survey of employers and unions not linked to the household surveylinked to the household survey

The sample contains information from about 45,000 The sample contains information from about 45,000 establishments and supports national and state-level establishments and supports national and state-level estimates for all 50 states. estimates for all 50 states.

Employer-sponsored health insurance measures:Employer-sponsored health insurance measures:

– AvailabilityAvailability

– EnrollmentEnrollment

– Benefit and payment provisionsBenefit and payment provisions

– CostCost

MEPS PublicationsMEPS Publications Statistical Briefs:Statistical Briefs: Easy-to-read, concise graphical Easy-to-read, concise graphical

summaries of MEPS datasummaries of MEPS data

Research Findings and Highlights: Research Findings and Highlights: Tables and Tables and summaries of descriptive statisticssummaries of descriptive statistics

Methodology Reports:Methodology Reports: Detailed information on MEPS Detailed information on MEPS sample design and survey methodssample design and survey methods

Chartbooks:Chartbooks: Policy-sensitive topics in an accessible Policy-sensitive topics in an accessible question-and-answer format question-and-answer format

Working Papers:Working Papers: Preliminary analyses of methodological Preliminary analyses of methodological and technical issues by AHRQ staff and technical issues by AHRQ staff

Research in Action:Research in Action: Analyses using research results from Analyses using research results from AHRQ-sponsored studies, including MEPS dataAHRQ-sponsored studies, including MEPS data

AHRQ Data Center (ADC)AHRQ Data Center (ADC)

Provides researchers access to non-Provides researchers access to non-public use MEPS data (except directly public use MEPS data (except directly identifiable information);identifiable information);

Mode of data analysis Mode of data analysis

– on secure LAN at AHRQ on secure LAN at AHRQ

– task order agreement with data task order agreement with data contractor contractor

– combinations of bothcombinations of both

Examples of Confidential Data Examples of Confidential Data Available for ADC ProjectsAvailable for ADC Projects

Linked MEPS-HC and Secondary DataLinked MEPS-HC and Secondary Data

Full geo-coding for 1996, 1997 and 2000-Full geo-coding for 1996, 1997 and 2000-2005. FIPS codes for other years2005. FIPS codes for other years

Fully specified industry/occupation and Fully specified industry/occupation and condition codescondition codes

Selected State and MSA identifiers and Selected State and MSA identifiers and estimation variablesestimation variables– 30 largest states and 10 largest MSAs30 largest states and 10 largest MSAs