1. Medical Expenditure Panel Survey SURVEY OVERVIEW

2. MEPS History 1977 National Medical Care Expenditure Survey 1977 National Medical Care Expenditure Survey 1987 National Medical Expenditure Survey 1987 National Medical Expenditure Survey 1996 Medical Expenditure Panel Survey 1996 Medical Expenditure Panel Survey

3. MEPS Survey Components The MEPS has two major components: MEPS-HC -- Household Component MEPS-HC -- Household Component MEPS-IC -- Insurance Component MEPS-IC -- Insurance Component

4. MEPS-HC Purpose & Uses Estimates annual health care use, expenditures and insurance coverage, and tracks changes in these over time Estimates annual health care use, expenditures and insurance coverage, and tracks changes in these over time Provides estimates of expenditures and sources of payment by selected demographic variables Provides estimates of expenditures and sources of payment by selected demographic variables Used for policy-related and behavioral research on the determinants of health care use, spending, and insurance coverage Used for policy-related and behavioral research on the determinants of health care use, spending, and insurance coverage Used in micro simulation models to analyze alternative health care delivery proposals. Used in micro simulation models to analyze alternative health care delivery proposals.

5. MEPS-HC Survey Design Sub-sample of respondents from the previous year’s NHIS Sub-sample of respondents from the previous year’s NHIS Representative of the civilian non- institutionalized population of the US Representative of the civilian non- institutionalized population of the US Five in-person interviews over 2 ½ year period using CAPI. Five in-person interviews over 2 ½ year period using CAPI. Interviews average 90 minutes with a range of one to four hours Interviews average 90 minutes with a range of one to four hours

6. 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

7. MEPS-HC Sample Sizes Year FamiliesPersons 1996 8,655 21,571 1997 13,087 32,636 1998 9,023 22,953 1999 9,354 23,565 2000 9,515 23,839 2001 12,852 32,122 2002 14,828 37,418 2003 12,860 32,681 2004 13,018 32,737 2005 12,810 32,320

8. MEPS Panel Design: Data Reference Periods 200420052006 Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4 Panel 8 Round 3 Round 3 Round 4 Round 4 Round 5 Round 5 Panel 9 Round 1 Round 1 Round 2 Round 2 Round 3 Round 3 Round 4 Round 4 Round 5 Round 5 Panel 10 Round 1 Round 1 Round 2 Round 2 Round 3 Round 3 Round 4 Round 4 Round 5 Round 5 Panel 11 Round 1 Round 1 Round 2 Round 2 Round 3 Round 3 Sample Size Sample Size N = 32,737 N = 32,320 N = 32,577 N is equal to the number of people with a positive person weight on the file.

9. MEPS-HC Core Interview Content Demographics Demographics Charges and Payments Charges and Payments Health Status Health Status Conditions Conditions Utilization Utilization Employment Employment Health Insurance Health Insurance

10. MEPS- HC Supplemental CAPI Sections Sections asked in rounds 2 and 4: Access to care Access to care Child preventive health Child preventive health Satisfaction with health plans & providers Satisfaction with health plans & providers Sections asked in rounds 3 and 5: Assets (round 5 only) Assets (round 5 only) Income Income Preventive Care Preventive Care Priority conditions Priority conditions

11. MEPS-HC Supplemental Paper Questionnaires Diabetes Care SAQ Diabetes Care SAQ Given once a year to each person identified as having diabetes Given once a year to each person identified as having diabetes Includes questions about diabetes related tests and managing diabetes Includes questions about diabetes related tests and managing diabetes Adult SAQ Adult SAQ Given once a year to each adult 18 years old and older Given once a year to each adult 18 years old and older Focus is on information that needs to be self reported such as self assessments, height/weight, opinions about health care issues and quality of care measures Focus is on information that needs to be self reported such as self assessments, height/weight, opinions about health care issues and quality of care measures

12. Types of MEPS-HC Files Full-year Files - calendar year data Full-year Files - calendar year data Point-in-time Files - snap shot first part of year Point-in-time Files - snap shot first part of year MEPS/NHIS Link File MEPS/NHIS Link File Longitudinal Data File Longitudinal Data File MEPS HC-036: 1996-2005 Pooled Estimation File MEPS HC-036: 1996-2005 Pooled Estimation File

13. Levels of MEPS-HC Public Use Files Person Level - detailed person information Person Level - detailed person information Event Level - detailed event level information Event Level - detailed event level information Condition Level - detailed condition information Condition Level - detailed condition information Job Level - detailed job information Job Level - detailed job information

14. MEPS-HC Caveats and Limitations Sample size limitations preclude some analyses Sample size limitations preclude some analyses Typically, one respondent provides data for the entire household Typically, one respondent provides data for the entire household Household respondents may not be able to report accurately certain types of information Household respondents may not be able to report accurately certain types of information – type of health plan – detailed event information – diagnoses

15. MEPS-IC (Insurance Component) An independent survey of employers and unions not linked to the household survey An independent survey of employers and unions not linked to the household survey The sample contains information from about 45,000 establishments and supports national and state-level estimates for all 50 states. The sample contains information from about 45,000 establishments and supports national and state-level estimates for all 50 states. Employer-sponsored health insurance measures: Employer-sponsored health insurance measures: – Availability – Enrollment – Benefit and payment provisions – Cost

17. MEPS Publications Statistical Briefs: Easy-to-read, concise graphical summaries of MEPS data Statistical Briefs: Easy-to-read, concise graphical summaries of MEPS data Research Findings and Highlights: Tables and summaries of descriptive statistics Research Findings and Highlights: Tables and summaries of descriptive statistics Methodology Reports: Detailed information on MEPS sample design and survey methods Methodology Reports: Detailed information on MEPS sample design and survey methods Chartbooks: Policy-sensitive topics in an accessible question-and-answer format Chartbooks: Policy-sensitive topics in an accessible question-and-answer format Working Papers: Preliminary analyses of methodological and technical issues by AHRQ staff Working Papers: Preliminary analyses of methodological and technical issues by AHRQ staff Research in Action: Analyses using research results from AHRQ-sponsored studies, including MEPS data Research in Action: Analyses using research results from AHRQ-sponsored studies, including MEPS data

18. AHRQ Data Center (ADC) Provides researchers access to non- public use MEPS data (except directly identifiable information); Provides researchers access to non- public use MEPS data (except directly identifiable information); Mode of data analysis Mode of data analysis – on secure LAN at AHRQ – task order agreement with data contractor – combinations of both

19. Examples of Confidential Data Available for ADC Projects Linked MEPS-HC and Secondary Data Linked MEPS-HC and Secondary Data Full geo-coding for 1996, 1997 and 2000- 2005. FIPS codes for other years Full geo-coding for 1996, 1997 and 2000- 2005. FIPS codes for other years Fully specified industry/occupation and condition codes Fully specified industry/occupation and condition codes Selected State and MSA identifiers and estimation variables Selected State and MSA identifiers and estimation variables – 30 largest states and 10 largest MSAs