MEPS: A National Information Resource to
Support Health Care Research & Policy
AcademyHealth Meetings
June 6, 2004
Steven B. Cohen PhD
Joel W. Cohen PhD & Karen Beauregard MHA
.
Presentation
 AHRQ new mission and emphasis on




information and research effort that translate
into policy and practice
MEPS overview and design enhancements
Program outreach and impact
Research Update
MEPS Data Products and Dissemination
New AHRQ Mission Statement
To improve the quality, safety,
efficiency, and effectiveness of
health care for all Americans
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.
WWW.MEPS.AHRQ.GOV
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
Measurement of expenditures in managed care
Expenditures for specific conditions
Trends over time
MEPS Components
 Household Component (HC)
 Medical Provider Component (MPC)
 Insurance Component (IC)
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
MEPS Household Component
Sample Design
Oversampling of policy relevant domains
1996
1997
1998-2001
2002+
Minorities (Blacks & Hispanics)
Minorities
Low income
Children with activity limitations
Adults with functional limitations
Predicted high expenditure cases
Elderly
Minorities
Minorities, Asians, Low Income
HC - Sample Sizes
Year
Households
1996
1997
1998-2000
2001
2002 to present
9,400
13,500
10,000
13,500
15,000
Persons
23,500
33,000
25,000
33,000
37,000
MPC - Purpose
 Compensate for household nonresponse
 Accuracy and detail
 Imputation source
 Methodological studies
MPC - Targeted Sample
 All hospitals and associated physicians
 All office-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
IC - Samples
 30,000 establishments: derived from Census
Bureau frame
 Employers linked to HC sample
 Data released in tabular form on MEPS website
Uninsured Status for the
Non-elderly, 1996-2002
Number of Uninsured in Millions
Any Time in Year
70
60
50
62.2
59.1
44.5
44.2
42.0
31.6
32.1
31.0
1996
1997
1998
62.0
1st 1/2 of Year
58.5
42.6
61.7
Full Year
61.9
43.8
45.7
31.5
31.3
2000
2001
45.9
40
30
20
28.7
10
0
1999
2002
Concentration of Medical Expenditures
1987 and 1996
 1% of the population
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
1987
1996
Top Top Top Top
1% 5% 10% 50%
accounts for almost 30% of
expenses
 50% of the population
accounts for only 3% of
expenses
 This degree of
concentration has been
consistent over time
Source: Berk and Monheit, “Concentration of Expenditures Revisited,”
Health Affairs, March/April 2001.
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
0-
10
%
0%
-2
-3
0%
10
Expenditure Group
1999
20
30
-4
0%
0%
-5
40
50
-6
0%
0%
-7
60
-8
0%
0%
70
-9
80
90
-1
00
%
0.0
Targeted Research Efforts
 Trends in Cost, Coverage and Access
 microsimulations of generic versions of health
care reforms on coverage and expenditures
 PA on IMPACT OF PAYMENT AND
ORGANIZATION ON COST, QUALITY AND
EQUITY
 Co-ordination of DHHS LTC Research and
Data Development Plan
Recent MEPS Impact

MEPS used to derive estimates of additional aggregate cost to
nation of covering the uninsured: IOM Report “Hidden Costs,
Value Lost” (June 2003).

IOM report on “Health Insurance is a Family Matter” indicates
“the most comprehensive data on who uses what health care
services and how much is paid for those services comes from the
Medical Expenditure Panel Survey” (Fall 2002).

MEPS data used to estimate the costs of "uncompensated care”.
The study revealed that in 2001, uninsured Americans received
~$35 billion worth of uncompensated care (Health Affairs,
March/April 2003: J. Hadley and J. Holahan).
AHRQ-Sponsored Research on Temporary Health
Insurance Gaps Improves Estimates of the Uninsured
and the Cost of the Provision of Coverage
MEPS, 1996-1999
Uninsured Status, Non-elderly
62.0
1996
62.2
1997
59.1
1998
59.2
1999
Number of Uninsured In Millions Any Time in Year
J.A. Rhoades, J.P. Vistnes, J.W. Cohen, The uninsured
in America:1996-2000, MEPS Chartbook No. 9, 2002
USA Today
Bridge Temporary Insurance Gaps,
9/26/02
“…the focus should shift to measures
of the number of Americans each
year who have any gap in their
coverage.
From 1996 to 1999, between 59
million and 62 million Americans
were uninsured at some point each
year, according to a large- scale
survey conducted by the federal
Agency for Healthcare Research and
Quality.”
Example of Use of MEPS Data
Consumers’ Checkbook Guide to Health
Plans
Consumers’ Checkbook Guide to
Health Plans
 Annual publication
 Rates every plan available to federal
employees and retirees
 Compares likely cost of various plan options to
employee
Estimated 2004 cost to average
family of 3 with head under 55
Approximate Yearly Cost to You ($)
Plan
Code
Plan Name
Yearly
Premium ($)
If Your Health
Care Usage
were Low
If Your Health
Care Usage
were Average
If Your Health
Care Usage
were High
Yearly
Limit on
Cost to
You
Excluding
Dental($)
Local HMOs and Point of Service
E32
JP2
JN5
JN2
222
2G2
Kaiser MidAtlantic
M.D. IPA
Aetna HealthSt
Aetna HealthHi
Aetna
Consumer
Driven
CareFirst
1510
1650
2350
3890
5480
1530
1690
2460
4160
7330
1070
1270
2620
5390
5530
1570
1760
2880
5330
6030
1290
1290
3450
7340
16950
2280
2480
3530
5850
9530
Pharmaceutical Costs
 Significance
– Recent spending on prescription drugs were over
10% of all health care expenditures
– Recent annual growth rates exceed 15%
– Insurance coverage an important policy issue
 AHRQ research can clarify:
– Effects of new drugs on overall health care costs
– How prices vary by insurance status & type of drug
– Effects of different coverage and payment options
– Outcomes and effectiveness of pharmaceuticals
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
Types of Analyses Supported by
MEPS Prescribed Medicine Data
 Trends in out of pocket burdens across all
major population subgroups
 Examine burden on individuals and families
 Prevalence of potentially inappropriate
prescribing patterns
 Trends in use and expenditures by therapeutic
category: e.g. statins, anti-depressants,
analgesics, proton pump inhibitors
Recent AHRQ Sponsored Medical
Care Supplement
“Health Care Costs, Coverage, and Access in
the United States: Research Findings from the
Medical Expenditure Panel Survey”
This volume is dedicated to the memory of
Dr. John M. Eisenberg in honor of his
commitment to ensuring that health care is based
on a strong foundation of research
Recent Conference on Policy Impact
MEPS: Informing Policy on Health Insurance
Coverage and Health Care Costs
 Highlight recent research efforts from the survey
focused on healthcare costs and coverage that help
inform consumer and purchaser decisions.
 Facilitate discussion of utility of MEPS to inform
policy and decisions by consumers and purchasers
Conference Agenda
 Patterns in Prescription Drug Expenditures
Moderator: Joel Cohen, AHRQ
 Private Insurance Markets
Moderator: Gail Shearer, Consumers Union
 Disabled, Rural, and Racial/Ethnic Minorities
Moderator: Alan Monheit, Univ. of Medicine, NJ
 Children’s Health Insurance Coverage
Moderator: Linda Bilheimer, RWJF
The National Healthcare
Quality Report
Background
 Mandated by Congress in the Healthcare
Research and Quality Act (PL. 106-129)
– “Beginning in fiscal year 2003, the Secretary,
acting through the Director, shall submit to
Congress an annual report on national trends in
the quality of health care provided to the
American people.”
Conceptual Framework
COMPONENTS OF HEALTH CARE QUALITY 1/
CONSUMER PERSPECTIVES ON
HEALTH CARE NEEDS 2/
EFFECTIVENESS
SAFETY
TIMELINESS
PATIENT
CENTEREDNESS
STAYING HEALTHY
GETTING BETTER
LIVING WITH ILLNESS OR DISABILITY
COPING WITH THE END OF LIFE
1/ These are the health care aims defined by the Institute of Medicine in Crossing the Quality Chasm .
2/ Adapted from the Foundation for Accountability's Consumer Information Framework.
NOTE: EQUITY IS ANOTHER COMPONENT OF HEALTH CARE QUALITY AND APPLIES TO EACH CELL
OF THE MATRIX.
MEPS Enhancements to Measure
Healthcare Quality
Data to Support Quality of Care Analyses at
the National Level
 Data currently collected on: access to care,
patient/customer satisfaction, health insurance
coverage, health status, health services
utilization and expenditures.
MEPS Enhancements to Measure
Healthcare Quality
Content
 CAHPS: Patient satisfaction and accountability
measures
 SF-12
 Attitude Items
Research Uses of the
Medical Expenditure Panel Survey
Areas of Research Using MEPS Data
 Access, use, and quality
 Expenditures
 Private and public health insurance
 Health status and health behaviors
 Microsimulation modeling
 Statistics and methods
Outline
 Descriptive data
– Insurance and expenditures
 Illustrative research findings
 Current research
Percent Uninsured First Half of Year for
Persons < 65 by Age, 2003
40%
35%
30%
25%
20%
15%
10%
5%
0%
36.4%
31.1%
20.6%
16.6%
11.9%
All Under
Ages
18
22.2%
17.6%
14.1%
18
19-24 25-29 30-34 35-54 55-64
Source: 2003 Medical Expenditure Panel Survey
Insurance Status of Children for First Half
of Year, 1996-2003
Percent
Private
Public
Uninsured
70%
60%
50%
63.0% 63.7% 64.9% 64.8% 63.8% 62.0% 60.8%
60.6%
40%
30%
21.3% 21.4%
26.3%
23.5%
22.4%
21.7%
20.4%
15.7% 14.9%
14.7% 13.4% 13.9% 14.5% 12.9%
1996
1998
20%
10%
27.5%
11.9%
0%
1997
1999
2000
2001
2002
Source: 1996-2003 Medical Expenditure Panel Survey
2003
Insurance Status of Children for First Half
of Year, 1996-2003
Number in Millions
Private
Public
Uninsured
50
40
40.9
40.6
43.1
41.8
43.0
41.5
44.2
44.1
19.2
20.0
30
20
13.8
13.6
13.6
14.0
15.1
15.7
10
10.2
9.5
9.8
8.7
9.4
9.7
9.4
1996
1997
1998
1999
2000
2001
2002
0
Source: 1996-2003 Medical Expenditure Panel Survey
8.7
2003
Health Insurance Premiums - Employee/Employer
Contributions for Single Coverage 1996 - 2001
2001 $498
2000 $450
1999 $420
1998 $383
$2,391
$2,205
$1,905
$1,791
1997 $320
$1,731
1996 $342
$1,650
$0
Employee
Contribution
$1,000
Employer
Contribution
$2,000
$3,000
$4,000
AHRQ MEPS Insurance Component Index to Tables,
www.meps.ahrq.gov/data pub/ic tables.htm
Average
premiums
increased 8.8% &
employee
contributions
increased 10.8%
over 2000,
continuing the
trend from
previous years.
Health Insurance Premiums -Employee/Employer
Contributions for Family Coverage 1996 - 2000
2001
$1,741
2000
$1,614
1999
$1,438
$5,768
$5,158
$4,620
1998 $1,382
1997 $1,305
1996 $1,275
$0
Employee
Contribution
Employer
Contribution
$4,208
$4,027
$3,679
$2,000
$4,000
$6,000
$8,000
AHRQ MEPS Insurance Component Index to Tables
www.meps.ahrq.gov/data pub/ic tables.htm
Average
premiums
increased 10.9%
and employee
contributions
increased 7.8%
over 2000,
continuing the
trend from
previous years.
Distribution of Health Expenses by Source
of Payment, 2001
Total = $726.4 Billion
8%
9%
42%
20%
22%
Source: Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2001.
Private
Medicare
Out-of-pocket
Medicaid
Other
Distribution of Health Expenses by Type of
Service, 2001
4% 2%
8%
32%
19%
Inpatient
Ambulatory
Prescribed Meds
Dental
Home Health
Other
35%
Source: Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2001.
Median and average medical
expenses per person, 2001
$3,500
$2,994
$3,000
$2,555
$2,500
$2,000
Median
Average
$1,500
$1,000
$856
$595
$500
$0
Persons with expenditures
Per capita expenditures
Source: Center for Financing, Access and Cost Trends,
Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2001
Concentration of Expenditures
Total Expenditures
100%
90%
80%
70%
Panel 1 Year 1
60%
Panel 1 Year 2
50%
40%
Panel 2 Year 1
30%
Panel 2 Year 2
20%
10%
Panel 3 Year 1
0%
Panel 3 Year 2
Top
5%
Top
10%
Population
Top
50%
Recent Publications
 CFACT staff
– More than 50 publications in 2003-04
– Dedicated journal issues
 External users
– Identified more than 70 articles in 2003-04
– Prescription drug costs and use
– Expenditures by condition
– Coverage of the uninsured
Ten Highest Cost Conditions
 Heart Disease ($58B)
 Diabetes ($20B)
 Cancer ($46B)
 Hypertension ($18B)
 Trauma ($44B)
 Cerebrovascular
Disease ($16B)
 Mental Disorders
($30B)
 Pulmonary Conditions
($29B)
 Osteoarthritis ($16B)
 Pneumonia ($16B)
Source: J. Cohen and N. Krauss, “Spending and Service Use
Among People with the Fifteen Most Costly Medical Conditions,
1997,” Health Affairs, March/April 2003.
30%
25%
20%
15%
10%
5%
0%
Hypertension
Diabetes
Pulmonary
Conditions
Mental
Disorder
Trauma
Cancer
% of Population
% of Expenditures
Heart
Disease
Percent
Percent of Population and Expenditures for
Persons with Top 7 Conditions, 1997-98
Condition
Source: J. Cohen, “The Persistence of Expenditures for Persons With High
Cost Conditions,” Center for Financing, Access and Cost Trends, AHRQ, 2003.
Rural-Urban Differences in Access and Use
of Ambulatory Care
 Using a 9-category rural-urban scale, the most rural
residents were more likely than metro residents to
report a usual source of care.
 However, the most rural residents also had fewer
ambulatory visits than metro residents.
 Intermediate areas on the rural-urban scale did not
differ from metro areas in number of visits.
 The metropolitan-nonmetropolitan dichotomy may be
too gross to capture geographic differences in health
service use.
Source: Larson and Fleishman, “Rural-urban differences in usual
sources of care and ambulatory service use: analyses of National data
using urban influence codes, Medical Care, July 2003.
Percent with Employer-Sponsored
Health Insurance
80
60
40
20
70
67
60
57
Urban
Adjacent
Not Adjacent-Large
Not Adjacent-Small
0
Source: Rural-Urban Differences in Employment-Related Health Insurance Sharon L. Larson, Ph.D.
Steven C. Hill, Ph.D., Center for Financing, Access and Cost Trends, AHRQ. 1996-1998 MEPS
Round 1(pooled).
Offer and Take-up of Employer
Sponsored Insurance
Offer
Take-up
100
80
84
68
63
60
60
86
83
82
57
40
20
0
Urban
Adjacent
Not Adjacent-Large
Not adjacent-Small
Source: Rural-Urban Differences in Employment-Related Health Insurance
Sharon L. Larson, Ph.D., Steven C. Hill, Ph.D., Center for Financing, Access
and Cost Trends, AHRQ 1996-1998 MEPS Round 1(pooled).
Employer-Sponsored
Health Insurance Offers
% of Estabs that
Offer Insurance
% of Estabs with
Health Insurance that
Offer 1 Plan
% of Estabs with
Health Insurance that
Offer >1 Plan
1997
1998
1999
2000
2001
52
55
58
59
58
72
68
70
71
70
28
32
30
29
30
Source: “Contributions to Health Insurance Premiums When Does the Employer Pay 100 Percent?”
Alice M. Zawacki, Ph.D.,U.S. Census Bureau and Amy K. Taylor, Ph.D.,Agency for Healthcare Research and Quality
Percent of Establishments that Pay
100% of Premium for at Least One Plan
% of Estabs Offering 1 Plan
that Pay 100% for Family
Coverage
% of Estabs Offering >1 Plan
that Pay 100% for Single
Coverage for at Least 1 Plan
% of Estabs Offering >1 Plan
that Pay 100% for Family
Coverage for at Least 1 Plan
70
60
50
Percent of Establishments
% of Estabs Offering 1 Plan
that Pay 100% for Single
Coverage
40
30
20
10
0
1997
1998
1999
2000
2001
Source: “Contributions to Health Insurance Premiums When Does the Employer Pay 100 Percent?”
Alice M. Zawacki, Ph.D.,U.S. Census Bureau and Amy K. Taylor, Ph.D.,Agency for Healthcare Research and Quality
Enrollment Rates by Wage Distribution and
Single Employee Contribution Levels
1999
 Enrollment rates at
90
80
70
60
50
Low Wage >=50%
Low Wage <50%
High Wage >=50%
0 contributions + contributions
establishments with zero
employee contributions
were higher than at those
with positive employee
contributions.
 Low-wage
establishments had lower
enrollment rates than
other establishments
under either contribution
scenario.
Source: Cooper and Vistnes,” Workers’ Decisions to Take-Up Offered Health
Insurance Coverage: Assessing the Importance of Out-of-Pocket Premiums Costs,”
Medical Care, July 2003.
Insurance Take-Up Decisions are
Sensitive to Tax Subsidies
Tax responsiveness is greater among three
groups of great policy interest:
 workers in small firms
 workers with low incomes
 workers with low health risks
Source: D. Bernard and T. Selden, ”Private Health Coverage and the Tax
Subsidy for Insurance: 1987 and 1996,” 2003, International Journal of
Health Care Finance and Economics
Medicaid expansions reduced financial burdens
for health care among eligible children and their
families between 1987 and 1996
30
20
10
0
1987
1996
MCD- expansions
low income control grp
The percent of children
eligible for the Medicaid
expansions who lived in
families spending 10% or
more of family income on
health care dropped from
30% to 24% between 1987
and 1996, compared to
the control group where
this measure increased
from 20% to 21%.
Source: JBanthin and TSelden, “The ABC’s of Children’s Health
Care…” Inquiry 40:73-85 (Summer 2003)
Marginal Cost of SCHIP
(Savings from cuts to program)
State
Fed
Total
Budget
$282
$596
$878
Rev Crowd
$5
$48
$54
Med Need
$128
$149
$277
Uncomp
$51
$0
$51
Net Saving
$98
$399
$496
“How Much Can States Really Save by Rolling Back SCHIP?” T. Selden and
J. Hudson, Center for Financing, Access and Cost Trends, AHRQ.
Examples of Current Research
 SCHIP and employer crowd out
 Factors associated with persistence of
expenditures
 Use of capitation and effects on provider
behavior
 Prescription drugs and mental health treatment
MEPS Data Products and
Dissemination
MEPS Public Use Data
Methods of Dissemination
 MEPS web site
– www.meps.ahrq.gov
 AHRQ clearinghouse
– CD-ROM
– 800-358-9295
 Questions?
– MEPSPD@ahrq.gov
WWW.MEPS.AHRQ.GOV
New Workshops
 September 20-21 - Hands-on Workshop in
Rockville- Using the MEPS Prescribed Drug and
Condition Files
 November 30-Dec 1 - Hands-on Workshop in
Rockville – MEPS Linking Issues (NHIS,
Conditions, Jobs, PRPL, Events, Pooling,
Longitudinal Analysis)
 Cyber Seminars- 2005
MEPS Mailing List/List Server
 Mailing List/List Server
 click on “Mail List/List Server” from Web site
 both receive e-mail notices of data and
publications released on the Web
 List Server allows for interactive exchange of
ideas and information
MEPS Data Product Information
 Types of Products
 Upcoming Data Releases
 MEPS Data Center
MEPS Data Products
 Publications (Findings, Methods,




Chartbooks)
Stat Briefs
On-line tables
MEPS-NET
Micro-data files
– Public use
– Data Center
Recent Statistical Briefs
 Health Care Expenditures and Percentage
Uninsured 10 Large MSA’s, 2000
 Estimates of Uninsured in Working Families,
2002
 Health Insurance Coverage and Income Levels,
2001
 Out-patient Prescribed Medicines: A comparison
of Use and Expenditures, 1987 and 2001
Figure 2. Average total and out-of-pocket costs for
prescribed medicines for those with a prescribed
medicine purchase, 1987 and 2001
800
730
Dollars
600
400
321
253
200
144
0
Average total cost
Average out-of-pocket cost
1987
2001
Note: Estimates for 1987 were adjusted for inflation to 2001 dollars using data from the
1987 and 2001 Consumer Price Index for All Urban Consumers.
Brand New Insurance Stat Briefs
 Uninsured in America, 2003
 Trends in Health Insurance, 96-03
 Uninsured Children, 2003
Figure 5: Percent Uninsured by Marital Status
People Under Age 65, First Half of 2003
Marital status
Percent
30
29.7
29.4
Separated
Never married
27.6
24.3
15
15.0
0
Married
Widowed
Divorced
Source: Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure
Panel Survey
Figure 2: MEPS, 1996-2003
Uninsured Status, Non-elderly
Number of uninsured in millions
Any time in year
Number in Millions
70
62.0
62.2
44.5
44.2
First half of year
59.1
60
50
58.5
Full year
61.7
42.0
42.6
43.8
61.9
61.7
45.7
45.9
47.0
40
30
31.6
32.1
31.0
28.7
31.5
31.3
32.0
1996
1997
1998
1999
2000
2001
2002
20
10
0
Source: Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure
Panel Survey
2003
Figure 3: Percent of Children Under 18 years with
Public Only Health Insurance by Age, 1996-2003
Public Health Insurance Only
Age 0-3
Age 4-6
29.9
Percent
30
28.2
26.2
24.3
20
Age 7-12
20.8
25.8
24.4
19.0
18.9
15.7
14.5
13.8
1996
1997
1998
10
28.1
23.4
19.7
Age 13-17
29.2
34.0
29.3
32.1
31.1
26.5
27.9
25.6
23.7
20.5
18.2
16.6
1999
2000
20.4
30.9
25.9
22.6
16.0
0
2001
2002
Source: Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure
Panel Survey
2003
Statistical Briefs Planned for 2004




P-med Expenditures by Condition
Hypertension
PSA Screening
Children’s Usual Sources of Care
Recent Chartbooks
 Outpatient Prescribed Drug Expenses, 1999
 Health Care Expenses in the Community
Population, 1999
Chartbooks Planned for 2004
 Health Care in Urban and Rural Areas (1998-2000
combined)
 Race and Ethnic Differences in Health:1996-2001
Recent Findings
 Health Care Expenses for Injuries 1997
 Dental Services, Use, Expenses, and
Sources of Payment 1996-2000
Findings Reports Planned
for 2004





Restricted Activity Days: 97-2001
Health Care Expenditures: 2000
Medical Expenditures for Women: 2000
Children with Special Health Care Needs: 2000
Trends in Antibiotic Use 96-2001
Upcoming MEPS Data Releases
 2002 Use File - Including Quality Variables (June
2004)
 2002 Jobs file (June 2004)
 2002 NHIS Link file (June 2004
 2003 Insurance File (July 2004)
 2003 IC Tables (August 2004)
Upcoming Data Releases
 2002 Event files (September-November 2004)
 Panel 5 Longitudinal Weight ( October 2004)
 2002 Conditions (December 2004)
 2002 Use and Expenditures (December 2004)
 Multim P-med Data (TBD )
MEPS Tables Compendia
MEPS-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)
National-level
MEPS-IC Tables (Table I)
 Firm Size by:
– Industry Groups
– Ownership type (Profit / Non-Profit)
– Age of firm
– % full-time employees
– % low-wage employees
– Union presence
MEPS-IC State Tables
(II, V, VI, VII, and VIII)
 State by:
– Size of firm (Table II)
– Industry groupings (Table V)
– Ownership type (Table VI)
– Age of firm (Table VI)
MEPS-IC State Tables
(II, V, VI, VII, and VIII)
 State by:
– Proportion of Employees who are Full-time
(Table VII)
– Proportion of Employees who are Low-wage
(Table VII)
– Average Wage Quartiles (Table VIII)
MEPS-IC
Public-Sector Tables (Table III)
 State and local governments by:
– Size of government
– Census division
Table Structure
 Establishments
 Employees
 Single Premiums and Employee
Contributions
 Family Premiums and Employee
Contributions
 Employee-Plus-One Premiums and
Employee Contributions
National Totals of Enrollees and
Cost of Health Insurance (Table IV)
 Public and private sectors
 Private-sector by:
– Industry
– Purchased/self-insured plans
– Optional coverage (single service plans)
 Public-sector by:
– Purchased/self-insured plans
– Optional coverage (single service plans)
MEPS-net
MEPSnet
 An on-line interactive statistical computer
system
 Provides immediate access to data in a
non-programming environment
 MEPSnet is a set of statistical tools
– MEPSnet/HC
– MEPSnet/IC
MEPS-net HC
 Currently has the capacity to produce use,
expenditure, source of payment and health
insurance estimates for all years (including
standard errors)
 Plans to add quality data in 2004, and Access
data in 2005
MEPSnet IC Interactive Data Tool
 Step-by-Step search for estimates.
 Estimates shown for all years available.
 Graphical display of year-to-year trend with twostandard deviation error bars displayed.
 Links back to table from which data derived.
AHRQ Data Center
 Provides researchers access to non-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.
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
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
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 full-time students
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
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. Out-put will be reviewed for
confidentiality and mailed to you.
Confidential Data Available for
Data Center Projects
 1996 Nursing Home Data
 Linked HC - Secondary Data (full geo-coding
for 1996, 1997 and 2000, FIPS codes for other
years)
 MPC data
Confidential Data Available for
Data Projects
 Fully specified industry/occupation codes
 Imputed NDC codes
 Continuous poverty measure
 Linked HC-IC Data
Summary
 MEPS overview and design enhancements
 Patient satisfaction and healthcare quality
measurement: NHQR, NHDR
 Program outreach and impact
 Research Update
 MEPS Data Products and Dissemination
 Greater emphasis on program initiatives that
enhance analytic utility of data and research efforts
that inform health care policy and practice