Presentation
„ AHRQ new mission and emphasis on
MEPS: A National Information Resource to
Support Health Care Research and Inform
Policy and Practice
Steven B. Cohen PhD
Joel W. Cohen PhD & Karen Beauregard MHA
„
„
„
„
New AHRQ Mission
Statement
To improve the quality, safety,
efficiency, and effectiveness
of health care for all
Americans
Medical Expenditure Panel
Survey (MEPS)
Annual Survey of 15,000 households:
provides national estimates of health care
use, expenditures, insurance coverage,
sources of payment, access to care and
health care quality
Permits studies of:
„ Distribution of expenditures and sources of
payment
„ Role of demographics, family structure,
insurance
„ Expenditures for specific conditions
„ Trends over time
information and research efforts that
translate into policy and practice
MEPS overview and design
enhancements
Program outreach and impact
Research Update
MEPS Data Products and Dissemination
Center for Financing, Access
and Cost Trends
Conducts, supports and manages studies of the
cost and financing of health care, the access
to health care services and related trends.
Develops data sets to support policy and
behavioral research and analyses.
These studies and data development activities
are designed to provide health care leaders
and policymakers with the information and
tools they need to improve decisions on health
care financing, access, coverage and cost.
MEPS Components
„ Household Component (HC)
„ Medical Provider Component (MPC)
„ Insurance Component (IC)
1
MEPS Household Component
Sample Design
Oversampling of policy relevant domains
Minorities (Blacks & Hispanics)
Minorities
Low income
Children with activity limitations
Adults with functional limitations
Predicted high expenditure cases
Elderly
1998Minorities
1998-2001
2002+
Minorities, Asians, Low Income
15,000 households; ~35,000 persons
1996
1997
MPC - Purpose
„ Compensate for household
„
„
„
nonresponse
Accuracy and detail
Imputation source
Methodological studies
MEPS: Pharmacy Component
„ 8000 pharmacies sampled
– data on prescribed medicines
purchased by households
„ Data obtained:
– Medication Name
– National Drug Code (NDC)
– Quantity Dispensed
– Strength and Form
– Sources of Payment
– Amount Paid by Each Source
HC - Purpose
„ Estimates annual health care use and
„
„
„
„
expenditures
Provides distributional estimates
Supports person and family level
analysis
Tracks changes in insurance coverage
and employment
Longitudinal design; linkage to NHIS
MPC - Targeted Sample
„ All hospitals and associated physicians
„ All officeoffice-based physicians
„ All home health agencies
„ All pharmacies
IC - Purpose
„ Availability of health insurance
„ Access to health insurance
„ Cost of health insurance
„ Benefit and payment provisions of
private health insurance
2
IC - Sample
„ 30,000 establishments: derived from
Census Bureau frame
„ Supports national and state estimates
„ Employers linked to HC sample
„ Data released in tabular form on MEPS
website
Recent MEPS Enhancements
„ Supports state estimates: Direct state level
estimates of cost, coverage and use for the
largest states.
„ Supports metro area estimates: Direct MSA
level estimates of cost, coverage and use for
the largest metropolitan areas.
„ MEPS CAPI upgrade: Movement to Windows
Based Computer Assisted Personal Interview System
(CAPI).
Recent Collaborations
CDC, Chronic Disease Directors and Nat’
Nat’l
Pharmaceutical Council
„ Effort focused on the burden and costs of chronic
disease.
„ Consortium recommended adoption of the MEPS
to quantify medical costs for high prevalence
chronic diseases.
CMS
„ National Health Care Expenditure Estimates and
Sources of Payment Reconciliation: MEPS and
the National Health Accounts
Recent Collaborations
„ Fast turn-around estimates of expenditures for
selected conditions for Report to Congress
„ Technical assistance to Congressional
Research Service on insurance issues
„ Collaboration with Treasury Department on
analyses of Health Savings Accounts
„ Serve on HHS Research Coordinating Council
work group on estimating the number of
uninsured
DHHS Data Council
AHRQ DHHS Data Council CoCo-Chair
„ Options for improving Departmental data capacity
for analyses for racial and ethnic minority
populations
„ Enhancements to the analytic capacity and policy
relevance of national, state and local health
insurance data
„ Assessment of current HHS data capabilities for
prescription drug information;
information; plans for future
MMA related enhancements for systematic data
on prescription drug utilization, costs,
expenditures and efficacy
MEPS Impact
„ Informs GDP Estimates: MEPS data on
premium costs are used to produce estimates of
the GDP for the nation.
„ Medicare Modernization Act (MMA):
MEPS used to estimate future costs of Rx
benefit, detailed estimates of Rx use and
expenses for near elderly
„ CDCCDC-NPCNPC-CDDCDD-AHRQ Collaboration:
Collaboration:
MEPS used to estimate the cost of specific
chronic diseases.
3
MEPS Impact
„ State Reports on Coverage:
Coverage: MEPS has
been used by numerous States in annual reports
and evaluations of their population’
population’s eligibility
and enrollment decisions.
„ HRSA state planning grant initiative
program: Numerous states have participated in
program, using MEPS data to provide reports to their
legislatures and governors.
• Obesity Cost Calculator: Sponsored by
NBGH. MEPS used for cost estimates and now includes
a module for estimating return on investment to firms for
providing bariatric surgery benefits.
Maryland Health Care Commission
Report using the MEPS IC
MEPS Informs Consumers’
Consumers’
Checkbook Guide to Health Plans
„ Annual
Approximate Yearly Cost to You ($)
publication
Plan
Yearly
If Your Health If Your Health If Your Health
„ Rates every plan Code Plan Name Premium($) Care Usage Care Usage Care Usage
were Low were Average were High
available to
federal
Local HMOs and Point of Service
employees and
Kaiser Midretirees
E32
1510
1650
2350
3890
Atlantic
„ Compares likely JP2 M.D. IPA
1530
1690
2460
4160
cost of various
Aetna Health1070
1270
2620
5390
plan options to JN5 St
employee
Aetna HealthJN2
1570
1760
2880
5330
Hi
Estimated 2004 cost
Aetna
to average family
222 Consumer
1290
1290
3450
7340
of 3 with head
Driven
under 55
2G2 CareFirst
2280
2480
3530
5850
Knowledge Transfer Efforts:
Statistical Methods
Yearly
Limit on
Cost to
You
Excluding
Dental($)
5480
7330
5530
6030
16950
Provide support for statistical and
methodological research to improve the
quality, efficiency, timeliness of health care
surveys
Sponsor of Conferences on Health Survey
Research Methods
OMB’
OMB’s Statistical Policy Conference on Achieving
Statistical Quality in a Diverse and Changing
Environment
OMB’
OMB’s Federal Committee on Statistical
Methodology
9530
4
Knowledge Transfer Efforts:
Recent Enhancements
„ Continued to speed up the production of
estimates
„ In process of redesigning MEPS web site.
„ Expanded the content of the MEPS web site
„ Enhanced MEPS outreach activities
Research Uses of the
Medical Expenditure Panel Survey
Areas of Research Using MEPS
Data
Outline
„ Access, use, and quality
„ Expenditures
„ Descriptive data
„ Private and public health insurance
„ Health status and health behaviors
„ Illustrative research findings
„ Microsimulation modeling
„ Statistics and methods
„ Current research
– Insurance and expenditures
Number of uninsured under age 65
1996–
1996–2004
Number in millions
62.0
62.2
44.5
44.2
31.6
32.1
59.1
60
50
58.5
First half of year
Full year
61.7
61.9
61.7
45.7
45.9
31.3
32.0
42.0
42.6
43.8
31.0
28.7
31.5
insurance status, 1996–
1996–2003
Private
62.9
47.0
48.1
40
30
33.7
20
10
Number in millions
Any time in year
70
Number of children under age 18, by allall-year
40
39.8
39.7
41.4
42.0
40.4
11.6
11.3
12.4
1996
1997
1998
1999
2000
2001
2002
2003
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household
Component of the Medical Expenditure Panel Survey, 1996–2003 Full-Year and
1996–2004 Point-in-Time Files
2004
Uninsured
38.6
39.4
38.9
14.1
16.1
30
20
10.9
11.8
16.5
10
7.0
7.1
6.5
5.3
6.3
5.6
5.1
1996
1997
1998
1999
2000
2001
2002
0
0
Public only
4.6
2003
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household
Component of the Medical Expenditure Panel Survey, 1996–200 Full-Year Files
5
Percent uninsured by age,
population under age 65,
2001 to 2002
Uninsured at least one month
60
Percent uninsured by race/ethnicity,
population under age 65,
2001 to 2002
Uninsured at least one month
Uninsured 24 months
52.6
51.8
50
50
40
40
33.8
31.9
30
Percent
Percent
Uninsured 24 months
60
56.7
27.0
26.7
21.1
20
16.8
11.4
10
27.6
27.2
23.8
20
15.8
9.9
34.7
34.4
30
10.3
8.2
5.4
13.5
9.4
10
8.1
6.9
0
0
Total
Under 18
18-24
25-29
30-34
35-54
Hispanic
55-64
Rhoades, J. A. The LongLong-Term Uninsured in America, 2001 to 2002: Estimates for the U.S. Population under Age 65.
Statistical Brief #67. January 2005. Agency for Healthcare Research
Research and Quality, Rockville, MD.
http://www.meps.ahrq.gov/papers/st67/stat67.pdf
Health Insurance Premiums Employee/Employer Contributions for
Single Coverage 1996 - 2002
2002
$565
2001
$498
2000 $450
1999 $420
1998 $383
$2,624
$2,391
$2,205
$1,905
$1,791
1997 $320
$1,731
1996 $342
$1,650
$0
$1,000
Employee
Contribution
Employer
Contribution
$2,000
$3,000
$4,000
Premiums
increased
10.4% &
employee
contributions
increased
13.5% over
2001,
continuing the
trend from
previous years.
AHRQ MEPS Insurance Component Index to Tables
www.meps.ahrq.gov/Data_Pub/IC_Tables.htm
Non-Hispanic Black
Non-Hispanic White
Non-Hispanic Asian,
Pacific Islanders
Non-Hispanic Other
Rhoades, J. A. The LongLong-Term Uninsured in America, 2001 to 2002: Estimates for the U.S. Population under Age 65.
Statistical Brief #67. January 2005. Agency for Healthcare Research
Research and Quality, Rockville, MD.
http://www.meps.ahrq.gov/papers/st67/stat67.pdf
Health Insurance Premiums Employee/Employer Contributions for
Family Coverage 1996 - 2002
2002
$6,482
$1,987
$5,768
2001 $1,741
2000 $1,614
1999 $1,438
1998 $1,382
1997 $1,305
1996 $1,275
$0
$5,158
Employee
Contribution
Employer
Contribution
$4,620
$4,208
$4,027
$3,679
$2,000 $4,000 $6,000 $8,000 $10,000
Premiums
increased
12.8% and
employee
contributions
increased
14.1% over
2001,
continuing the
trend from
previous years.
AHRQ MEPS Insurance Component Index to Tables
www.meps.ahrq.gov/Data_Pub/IC_Tables.htm
Distribution of Health Expenses by Source of
Payment, 2002
Total = $810.7 Billion
8%
11%
40%
19%
Private
Medicare
Out-of-pocket
Medicaid
Other
22%
Source: Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2002.
6
Distribution of Health Expenses by Type of
Service, 2002
4% 2%
Median and average medical expenses per
person, 2002
$3,302
$3,500
8%
32%
19%
Inpatient
Ambulatory
Prescribed Meds
Dental
Home Health
Other
$2,813
$3,000
$2,500
$2,000
Median
Average
$1,500
$960
$1,000
$663
$500
$0
Persons with expenditures
Per capita expenditures
35%
Source: Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2002.
Source: Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2002
Concentration of Medical Expenditures
1987, 1996, and 2002
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
1987
1996
2002
Top Top Top Top
1% 5% 10% 50%
„ 1% of the population
accounts for around
25% of expenses
„ 50% of the population
accounts for only 3% of
expenses
„ This degree of
concentration has been
consistent over time
Concentration of Expenditures, 2002
97
100
80
80
Percent of Total
Expenditures
64
60
49
40
22
20
3
0
Top 1%
(>=$35,543)
Top 5%
(>=$11,487)
Top 10%
(>=$6,444)
Top 20%
(>=$3,219)
Top 50%
(>=$664)
Bottom 50%
(<$664)
Percent of Population
Source: Berk and Monheit, “Concentration of Expenditures Revisited,”
Health Affairs, March/April 2001, and 2002 MEPS.
Conditional Distributions by
Percentile for Persistence of
Expenditures
Persistence of Level of Health Care Expenditures: 1999-2000
60.0
55.0
50.0
45.0
40.0
35.0
Percent (%) 30.0
25.0
20.0
15.0
90-100%
80-90%
70-80%
60-70%
50-60%
40-50%
Expenditure Group
30-40%
2000
20-30%
10-20%
0-10%
10.0
5.0
10
-2
0%
010
%
30
-4
0%
Expenditure Group
1999
20
-3
0%
50
-6
0%
40
-5
0%
70
-8
0%
60
-7
0%
90
-1
00
%
80
-9
0%
0.0
Conwell, L. J. and Cohen, J. W. Characteristics of Persons with High Medical Expenditures in
the U.S.
Civilian Noninstitutionalized Population, 2002. Statistical Brief #73. March 2005. Agency for
Healthcare
Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/papers/st73/stat73.pdf
http://www.meps.ahrq.gov/papers/st73/stat73.pdf
Factors for Models
„ Demographic characteristics: Age; sex;
race/ethnicity; marital status; region; MSA
classification
„ Health status measures: health status; limitations
in activity
„ Health insurance coverage: full year insured; part
year insured; uninsured
„ Health conditions: Diagnosis of arthritis; cancer;
cerebrovascular disease; diabetes; heart disease;
high blood pressure
„ Accidental events: poisoning; trauma
„ Utilization measures: inpatient events; ambulatory
visits; number of prescribed medicine purchases
„ Expenditure measures: total health care spending
7
Factors Associated With the Prediction of
High Levels of Medical Expenditures
Predictive Models
Prior Year Characteristics
„ High level of prior year medical expenditures
„ Age (elderly)
„ Family size (single)
„ Health status (poor)
„ Family income (high)
„ Activity limitation
„ High use of Rx and office based Dr. visits
„ Presence of either COPD or infectious
disease
„ Model 1: Logistic Model with prior year’
year’s
medical expenditures and precursor
information (t(t-1).
(Y=1 top 10% in $s; 0 otherwise)
„ Model 2: Logistic Model with prior year’
year’s
medical expenditures (t(t-1) and precursor
information (t(t-1 and tt-2).
Sensitivity and Specificity of
Model 1
Actual High
Expenditure
Classification in
2001
High
Expenditure in
20012001-top decile
Not High
Expenditure in
2001
Sensitivity and Specificity of
Model 2
Predicted as
High
ExpenditureExpenditure2000
Top Decile
Not Predicted
as High
Total
ExpenditureExpenditureNot in Top
Decile
Actual High
Expenditure
Classification in
2001
Predicted as
High
ExpenditureExpenditure2000
Top Decile
Not Predicted
as High
ExpenditureExpenditureNot in Top
Decile
49.9%
True +
50.1%
False --
1,013
(10.0 %)
49.3%
True +
50.7%
False --
1,013
(10.0 %)
5.6%
False +
94.4%
True --
9,116
(90.0 %)
High
Expenditure in
20012001-top decile
Not High
Expenditure in
2001
5.6%
False +
94.4%
True --
9,116
(90.0 %)
Total
10,129
Total
OutOut-ofof-pocket Expenses as a Percent
of Family Income, 2002
Total
10,129
Changes in Percent Uninsured for Children, 197719772001
35
34
30
Percent
25
18
20
Top 5%
Bottom 50%
15
10
5
Percent Uninsured
25
20
15
10
5
3
5
0
0
>10%
>20%
Conwell, L. J. and Cohen, J. W. Characteristics of Persons with High Medical Expenditures in the
U.S.
Civilian Noninstitutionalized Population, 2002. Statistical Brief #73. March 2005. Agency for
Healthcare
Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/papers/st73/stat73.pdf
http://www.meps.ahrq.gov/papers/st73/stat73.pdf
1977
1987
First part of year
1997
Entire year
2001
Any time during year
P. Cunningham and J. Kirby, “Children’s Health Coverage: A Quarter-Century Of Change,”
Health Affairs, Sept/Oct 2004
8
TakeTake-Up Rates among Children Eligible for
Public Coverage, 19961996-2002
100
80
60
40
20
0
80
80
77
61
60
44
Mcd-welfare elig
Mcd-poverty expans
1996 (1998 SCHIP)
SCHIP
2002
Between 1996 (1998 for SCHIP) and 2002, there was a dramatic
increase in enrollment among children eligible for Medicaid and
SCHIP.
TSelden, JHudson, JBanthin, “Tracking Changes in Eligibility and Coverage among
Children, 1996-2002,” Health Affairs 23(5):39-50, September/October 2004.
Take Up of Dependent Coverage
„ Logit analysis of taketake-up of any coverage and family
coverage:
– Cost of coverage matters.
– So does Medicaid eligibility of family members.
– Income also a factor, but not a large effect.
„ Results suggest declining dependent coverage related to:
– OutOut-ofof-pocket premium costs for such coverage
– Medicaid eligibility of family members
Source: Monheit and Vistness,
Vistness, The Demand for Dependent Health Insurance:
How Important is the Cost of Family Coverage? Journal of Health Economics,
forthcoming.
MEPS: Prescription Drugs Increase as
Percent of Total Health Expenses,
1996 -2002
EmployerEmployer-Sponsored
Health Insurance Offers
80
% of Estabs that Offer Health
Insurance
Percent of Establishments
70
% of Estabs with Health
Insurance that Offer 1 Plan
60
6% 3%
4% 2%
32%
% of Estabs with Health
Insurance that Offer >1 Plan
50
8%
8%
38%
40
19%
13%
30
20
Inpatient
Ambulatory
Prescribed Meds
Dental
Home Health
Other
10
33%
0
1997
1998
1999
2000
2001
35%
2002
Year
Zawacki and Taylor, “Fully Paid Employer Provided Health Insurance: Trends in Benefits
Benefits Over Time,”
Time,”
Agency for Healthcare Research and Quality, 2005.
1996
2002
Source: Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey,
1996 and 2002
Recent Publications
„ CFACT staff
– More than 50 publications in 20042004-05
– Dedicated journal issues
„ External users
–
–
–
–
Identified more than 70 articles in 20042004-05
Prescription drug costs and use
Expenditures and obesity
Costs of covering the uninsured
9
Forthcoming AHRQ Sponsored
Medical Care Supplement
Knowledge Transfer Efforts:
Health Services Research
Forthcoming AHRQ Sponsored Medical Care Supplement
on “Trends in Medical Care Costs, Coverage, Use
and Access: Research Findings from the MEPS”
“Trends in Medical Care Costs, Coverage, Use and
Access: Research Findings from the MEPS”
z
z
z
z
z
z
What Happens When Workers Fail to Take up EmploymentEmploymentRelated Health Insurance?
What Drives Health Insurance Options at the Workplace?
Evidence from 19971997-2002 MEPS Employer Data
Access to Care and Utilization among Children, the Effect of
Public and Private Coverage
Trends in Medicaid Prescription Drug Expenditures
Children and Antibiotics: Analysis of Reduced Use
z
z
z
The Utility of Extended Longitudinal Profiles in Predicting Future
Future
Health Care Expenditures
Using the SFSF-12 Health Status Measure to Predict Medical
Expenditures
Explaining Racial and Ethnic Disparities in Health Care
Reports of Fewer Activity Limitations: Recovery, Survey
Fatigue, or Switching Respondent?
Examples of Current InInHouse Research
AHRQ Working Paper Series
„ Changes in treatment for mental health
services
„ The effects of direct to consumer advertising
on prescription drug use and expenses
„ Health status and persistence of expenditures
„ Identifying factors accounting for disparities in
access and use
MEPS Public Use Data
Methods of Dissemination
„ MEPS web site
– www.meps.ahrq.gov
„ AHRQ clearinghouse
MEPS Data Products and
Dissemination
– CDCD-ROM
– 800800-358358-9295
„ Questions?
– MEPSPD@ahrq.gov
10
MEPS Mailing List/List
Server
WWW.MEPS.AHRQ.GOV
„ Mailing List/List Server
z click on “Mail List/List Server”
Server” from
Web site
z both receive ee-mail notices of data and
publications released on the Web
z List Server allows for interactive
exchange of ideas and information
MEPS Data Product
Information
MEPS Data Products
„ Types of Products
„ Publications (Findings, Methods,
„ Upcoming Data Releases
„
„
„
„
„ MEPS Data Center
Chartbooks)
Stat Briefs
OnOn-line tables
MEPSMEPS-NET
MicroMicro-data files
– Public use
– Data Center
Percentage of adults age 18 and older receiving
urgent care when needed, 2000–
2000–2002
Recent Statistical Briefs
always
usually
sometimes/never
100%
„ Access to Urgent Medical Care Among Adults
18 and Older 20002000-2002, Janet Greenblatt and
Michelle Roberts
80%
„
40%
Antidepressant Use Trends 19971997-2002, Marie
Stagnitti
16.7
14.9
15.4
29.2
28.0
27.1
54.1
57.1
57.5
2000
2001
2002
60%
20%
„ Five Most Costly Medical Conditions 19971997-2002,
Gary Olin and Jeffrey Rhoades
0%
11
Percent of U.S. civilian noninstitutionalized population
with at least one antidepressant prescribed medicine
purchase, by sex, 1997 and 2002
2002
Percent
11.4
10
7.4
5.4
5
3.8
0
Expenditures (in thousands of 2002 dollars)
1997
15
Expenditures for the five most expensive
conditions, 1997 and 2002
1997
$70,002
$67,621
$60,000
$55,423
$53,748
$55,834
$48,425
$47,508
$40,000
$45,263
$36,195
$35,272
$20,000
$0
Heart conditions
Male
2002
$80,000
Cancer
Trauma
Mental disorders
Pulmonary
conditions
Female
An Example of a Recent
Chart book
Average number of ambulatory care visits
by type of metro area
Average number of ambulatory care visits by age group
12
10.9
10.3
10
„ Health Care in Urban and Rural Areas
Combined Years 19981998-2000, Sharon Larson
and Amy Taylor
9.9
8
6.3
6
6.3
Metro
Near-metro
Near-rural
Rural
6.0
5.5
5.1
4
2
0
Under age 65
Age 65 and over
Source: pooled 1998-2000 MEPS HC Data
Example of Recent
Findings
„ Trends in Children’
Children’s Antibiotic Use:
19961996-2001, Ed Miller and Bill Carroll
Antibiotic Use of Children 14 and Under
19961996-2001
„
„
1996
1997
„ Population size
59.2
59.8
39.0
33.7
„
59.8
2001
61.0
60.6
60.6
28.9
28.6
29.0
0.6
2.0
0.5
1.9
0.5
1.9
Percent
„ Percent of kids
„ w/antibiotics
„ Avg number of antibiotic
„ prescriptions:
„
„
„
1998
1999
2000
Number in millions
All kids
Kids w/ any
antibiotic use
0.9
2.4
30.6
Number
0.7
2.1
0.6
1.9
12
Recent and Upcoming MEPS
Data Releases
„ 2003 Use File - Including Quality
Variables (May 2005)
„ 2003 Jobs file (May 2005)
„ 2003 NHIS Link file (May 2005)
More Upcoming Data
Releases
„ 2003 Event files (September(September-November
2005)
„ Panel 7 Longitudinal Weight ( January
2006)
„ 2003 Conditions (December 2005)
„ 2003 Use and Expenditures (December
2005)
„ 2004 Insurance File (July 2005)
„ 2004 IC Tables (July 2005)
MEPS Tables Compendia
MEPSMEPS-HC Tables
Compendia
„ Sets of Static tables with flexibility to
redefine categories
„ Full year tables for expenditures
„ First part of year tables for insurance
coverage
„ Expenditure by Condition Tables (people,
events, and total expenditures by site of
service)
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MEPSMEPS-net
MEPSnet
„ An onon-line interactive statistical
computer system
„ Provides immediate access to data in
a nonnon-programming environment
„ MEPSnet is a set of statistical tools
– MEPSnet/HC
– MEPSnet/IC
MEPSMEPS-net HC
MEPSnet/IC
„ Currently has the capacity to produce
use, expenditure, source of payment and
health insurance estimates for all years
(including standard errors)
„ Plans to add Access data in 2005
„ Interactive WebWeb-based tool provides
national, and StateState-byby-State, and public
sector insurance data in tabular format
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MEPSnet IC Interactive
Data Tool
„
„
„
StepStep-byby-Step search for estimates.
Estimates shown for all years available.
Graphical display of yearyear-toto-year trend
with twotwo-standard deviation error bars
displayed.
„ Links back to table from which data
derived.
ADC Facilities
„ Secure room
„ Terminal connected to secure LAN
„ SAS, STATA, GAUSS, Stat Transfer,
SUDAAN, Limdep, EQS software
available, and others upon request
„ Limited staff support by people who
know:
– the data
– the confidentiality issues
– the software
Data Center Fees
„ User fee of $150.00 for approved
projects to cover technical
assistance, simple file construction,
and/or up 2 hours of programming
support from data contractor
„ (additional programming support
available at cost of 80.00/hr)
„ User fee waived for fullfull-time students
AHRQ Data Center
„ Provides researchers access to nonnon-
public use MEPS data (except directly
identifiable information);
„ Mode of data analysis
– on a secure LAN at AHRQ, Rockville
– task order agreement with data
contractor
– combinations of both.
Application And Review
Process
„ Application procedures are on the MEPS
web site
„ Submit proposal to data center
coordinator
„ Review within 1 week for feasibility, and
data availability
„ Internal review board (IRB) review required
ADC Procedures
„ May bring data in, but not out
„ Access only to data needed for approved
project
„ Tabular data will be reviewed for
confidentiality
„ Only approved tables can leave the
Center
„ Center will store data files, foreign merge
files, and all outputs needed for
replication
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Limited Remote Access
„ Once you have an established data
center project, and have worked on
site to develop and debug programs,
jobs may be submitted to our Data
Center Supervisor to run. OutOut-put
will be reviewed for confidentiality
and mailed to you.
Available for Data Center
Projects
„ 1996 Nursing Home Data
„ Linked HC - Secondary Data (full geogeo-
coding for 1996, 1997 , 20002000- 2002;
FIPS codes for other years)
„ NonNon-identifiable MPC data
Confidential Data
Available for Data Projects
„ Fully specified industry/occupation
codes
„ Imputed NDC codes
„ Continuous poverty measure
„ Linked HCHC-IC Data
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