Attachment 1 – MEPS-HC Section Summary and Changes

MEPS HC section by section review.docx

Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC)

Attachment 1 – MEPS-HC Section Summary and Changes

OMB: 0935-0118

Document [docx]
Download: docx | pdf

Attachment 1–MEPS-HC Section Summary and Changes


Summary of questionnaire sections and changes for the MEPS-HC since the previous OMB clearance.The first section includes all new additions to the MEPS instrument for the Affordable Care Act (ACA). Then, the sections are listed in alphabetical order, not the order which they occur in the instrument.


Questions added to the MEPS instrument related to the ACA

Item

Changes/Reason

Text/Source

Population

HP04A

Item added to support new state exchange names

Is this coverage through {STATE EXCHANGE NAME-A}{, [which may alsobe known as {ALIAS B} {or {ALIAS C}}]}?


Source: Adapted from CPS

All RUs with private coverage that is likely exchange

HP14A

Item added to acknowledge new state SHOP program

In {RU STATE}, {STATE SHOP NAME-A}{, [which may also be knownas {ALIAS B} {or {ALIAS C}}],} is a {new} program where smallbusinesses will be able to shop for health insurance plans fortheir employees. Is {your/{POLICYHOLDER}’s} health insurancecoverage through {ESTABLISHMENT} related at all to a programlike that?


Source: Original question to MEPS based on assessing ACA component.

All establishment-policyholder pairs that is through a small employer

HX11A

Item added to ascertain if Medicaid is purchased through state exchange program

Is the coverage with {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} through {STATE EXCHANGE NAME-A}{, [whichmay also be known as {ALIAS B} {or {ALIAS C}}]}?


Source: Adapted from CPS

All RUs with Medicaid

HX15A

Item added to ascertain if Medicaid is purchased through state exchange program

Is the coverage with a program sponsored by a state or local government agency which provided hospital and physicianbenefits through {STATE EXCHANGE NAME-A}{, [which may also beknown as {ALIAS B} {or {ALIAS C}}]}?


Source: Adapted from CPS

All RUs identifying Medicaid-like coverage

HX45A

Item added to record with family members have a monthly premium for coverage

Which family members have a monthly premium for that coverage?


PROBE: Anyone else?



Source: Adapted from CPS

All RUs with Medicaid or Medicaid-like coverage

HX46B

Item added to ascertain if the cost of the premium is subsidized based on family income

{PLAN NAME: {NAME OF PLAN FROM HX44}}


Is the cost of the premium subsidized based on family income?


Source: Adapted from CPS

All RUs with Medicaid or Medicaid-like coverage

HX47 (number reused)

New item to collect metal plan name for exchange insurance

Is {the {NAME OF PLAN FROM HX44} plan/this plan} a platinum, gold, silver, bronze or catastrophic plan?


Source: Adapted from BLSCEQ

All RUs with Medicaid-like coverage that is through an exchange


HX60A (number reused

New item to collect metal plan name for exchange insurance

Is {your/{PERSON}’s} {INSURER RECORDED AT HX51} plan a platinum, gold, silver, bronze or catastrophic plan?


Source: Adapted from BLSCEQ

All establishment-policyholder pairs with private exchange coverage

HX62A

Item added to ascertain if the cost of the premium is subsidized based on family income

Is the cost of the premium subsidized based on family income?


Source: Adapted from CPS

All establishment-policyholder pairs with private coverage that is likely exchange

HX81

New question regarding medical debt

When answering the next questions, think about money that yourfamily has spent on out of pocket expenses for medical care.We do not want you to count health insurance premiums, over thecounter drugs, or costs that you will be reimbursed for.


In the past 12 months did anyone in the family have problemspaying or were unable to pay any medical bills? Include bills fordoctors, dentists, hospitals, therapists, medication, equipment, nursing home or home care.


Source: NHIS

All RUs in Rounds 2 and 4

HX82

New question regarding medical debt

Does anyone in your family currently have any medical bills that are being paid off over time? This could include medical bills being paid off with a credit card, through personal loans, or bill paying arrangements with hospitals or other providers. The bills can be from earlier years as well as this year.


Source: NHIS

All RUs in Rounds 2 and 4

HX83

New question regarding medical debt

Does anyone in your family currently have any medical bills that you are unable to pay at all?


Source: NHIS

All RUs in Rounds 2 and 4

OE08B

New item added to acknowledge new state SHOP program

In {RU STATE}, {STATE SHOP NAME-A}{, [which may also be knownas {ALIAS B} {or {ALIAS C}}],} is a {new} program where smallbusinesses will be able to shop for health insurance plans for their employees. Is {your/{POLICYHOLDER}’s} health insurancecoverage through {ESTABLISHMENT} related at all to a programlike that?


Source: Source: Original question to MEPS based on assessing ACA component.

All establishment-policyholder pairs from a previous round that is through a small employer

OE35AA2

New item added to collect information on subsidized insurance

Is the cost of the premium subsidized based on familyincome?


Source: Adapted from CPS

All establishment-policyholder pairs from a previous round with private coverage that is likely exchange

OE38B (reused number)

New item to collect metal plan name for exchange insurance

Is {your/{PERSON}’s} {INSURER RECORDED AT OE38} plan a platinum, gold, silver, bronze or catastrophic plan?


Source: Adapted from BLSCEQ

All establishment-policyholder pairs from a previous round with private exchange coverage

PR16A

Item added to record which family members have a monthly premium for coverage

Which family members have a monthly premium for that coverage?


PROBE: Anyone else?


Source: Adapted from CPS

All RUs with Medicaid coverage in a previous round

PR17A

Item added to record if cost of premium is subsidized based on family income

{PLAN NAME: {NAME OF PLAN FROM PR15}}


Is the cost of the premium subsidized based on family income?


Source: Adapted from CPS

All RUs with Medicaid coverage in a previous round

PR32A

Item added to record which family members have a monthly premium for coverage

Which family members have a monthly premium for that coverage?


PROBE: Anyone else?


Source: Adapted from CPS

All RUs with Medicaid-like coverage in a previous round

PR33A

Item added to record if cost of premium is subsidized based on family income

{PLAN NAME: {NAME OF PLAN FROM PR31}}


Is the cost of the premium subsidized based on family income?


Source: Adapted from CPS

All RUs with Medicaid-like coverage in a previous round

PR34 (number reused)

New item to collect metal plan name for exchange insurance

Is {the {NAME OF PLAN FROM PR31} plan/this plan} a platinum, gold, silver, bronze or catastrophic plan?


Source: Adapted from BLSCEQ

All RUs with Medicaid-like coverage in a previous round that is through an exchange




Shape1

The MEPS-HC questionnaires for Rounds 1–5 consist of many individual sections. Listed below is a brief description of each section, including changes that have been made since the last OMB clearance.

Access to Care (AC)

This supplemental section, asked in Rounds 2 and 4, identifies whether each household member has a medical provider who provides the usual source of care (USC), reasons why members without a USC do not have a USC, various aspects of satisfaction with usual care providers, and problems a household may have experienced in obtaining needed health care. It also includes questions on possible language barriers to health care and specific problems any household member may have experienced in obtaining needed health, dental, or prescription medicine care.

Item

Changes/Reason

Text

Population

AC01

Omitted / Version moved to RE (DHHS standards)

What language is spoken in your home most of the time?

All RU members

AC02

Omitted / Version moved to RE (DHHS standards)

Are all members of your household comfortable conversing in 
English?

All RU members

AC02A

Omitted / Version moved to RE (DHHS standards)

Who is not comfortable conversing in English?


All RU members

AC03

Omitted / Version moved to RE

{Were/Was} {you/{PERSON}} born in the United States?


All RU members

AC04

Omitted / Version moved to RE

How long {have/has} {you/{PERSON}} lived in the United States?


All RU members

AC12

Omitted / No longer needed analytically. Already have an objective measure in AC13

How {do/does} {you/{PERSON}} usually get to {PROVIDER}?


All providers selected as a Usual Source of Care

AC14

Omitted / No longer needed analytically. Already have an objective measure in AC13

How difficult is it for {you/{PERSON}} to get to {PROVIDER}?

Would you say it is ...

very difficult, ........................ 1 {BOX_03}
somewhat difficult, .................... 2 {BOX_03}
not too difficult, or .................. 3 {BOX_03}
not at all difficult? .................. 4 {BOX_03}
REF ................................... -7 {BOX_03}
DK .................................... -8 {BOX_03}

All RU members who have selected a Usual Source of Care Provider

AC19OV

Omitted / No longer needed analytically, rarely used

OTHER RACE:

[Enter Other Specify] .................. {AC20}
REF ................................... -7 {AC20}
DK .................................... -8 {AC20}

All providers selected as a Usual Source of Care

AC35

Omitted / No longer needed analytically, not being used in any research internal or external

How much of a problem was it that {you/{PERSON}} did not get medical care, tests, or treatments {you/he/she} or a doctor believed necessary?

Would you say ...

a big problem, ......................... 1 {END_LP03}
a small problem, or .................... 2 {END_LP03}
not a problem? ......................... 3 {END_LP03}
REF ................................... -7 {END_LP03}
DK .................................... -8 {END_LP03}

All current RU members with an unmet need for medical care

AC39

Omitted / No longer needed analytically, not being used in any research internal or external

How much of a problem was it that {you/{PERSON}} {were/was} delayed in getting medical care, tests, or treatments {you/he/she} or a doctor believed necessary?

Would you say ...

a big problem, ......................... 1 {END_LP04}
a small problem, or .................... 2 {END_LP04}
not a problem? ......................... 3 {END_LP04}
REF ................................... -7 {END_LP04}
DK .................................... -8 {END_LP04}

All current RU members with an unmet need for medical care

AC43

Omitted / No longer needed analytically, not being used in any research internal or external

How much of a problem was it that {you/{PERSON}} did not get dental care, tests, or treatments {you/he/she} or a dentist believed necessary?

Would you say ...

a big problem, ......................... 1 {END_LP05}
a small problem, or .................... 2 {END_LP05}
not a problem? ......................... 3 {END_LP05}
REF ................................... -7 {END_LP05}
DK .................................... -8 {END_LP05}

All current RU members with an unmet need for dental care

AC47

Omitted / No longer needed analytically, not being used in any research internal or external

How much of a problem was it that {you/{PERSON}} {were/was} delayed in getting dental care, tests, or treatments {you/he/she} or a dentist believed necessary?

Would you say ...

a big problem, ......................... 1 {END_LP06}
a small problem, or .................... 2 {END_LP06}
not a problem? ......................... 3 {END_LP06}
REF ................................... -7 {END_LP06}
DK .................................... -8 {END_LP06}

All current RU members with an unmet need for dental care

AC51

Omitted / No longer needed analytically, not being used in any research internal or external

How much of a problem was it that {you/{PERSON}} did not get prescription medicines {you/he/she} or a doctor believed necessary?

Would you say ...

a big problem, ......................... 1 {END_LP07}
a small problem, or .................... 2 {END_LP07}
not a problem? ......................... 3 {END_LP07}
REF ................................... -7 {END_LP07}
DK .................................... -8 {END_LP07}

All current RU members with an unmet need for prescription meds

AC55

Omitted/ No longer needed analytically, not being used in any research internal or external

How much of a problem was it that {you/{PERSON}} {were/was} delayed in getting prescription medicines {you/he/she} or a doctor believed necessary?

Would you say ...

a big problem, ......................... 1 {END_LP08}
a small problem, or .................... 2 {END_LP08}
not a problem? ......................... 3 {END_LP08}
REF ................................... -7 {END_LP08}
DK .................................... -8 {END_LP08}

All current RU members with an unmet need for prescription meds



Adult Self-Administered Questionnaire (Adult SAQ)

A brief self-administered questionnaire (SAQ) will be used to collect self-reported (rather than through household proxy) information on health status, health opinions and satisfaction with health care for adults 18 and older. The satisfaction with health care items are a subset of items from the Consumer Assessment of Healthcare Providers and Systems (CAHPS). The health status items are the Short Form 12 Version 2 (SF-12 version 2), which has been widely used as a measure of self-reported health status in the United States, the Kessler Index (K6) of non-specific psychological distress, and the Patient Health Questionnaire (PHQ-2)

Changes: None

Assets (AS)

To supplement financial data collected in the Income section, the Assets supplemental section, asked in Round 5, asks about household members' real estate, businesses, vehicles, investments, other assets, and debts. 

Changes: None

Calendar Section (CA)

This section monitors the use of a health events calendar provided to the respondent during the MEPS pre-contact interview for use in recording visits to medical providers and medical places. This information determines the household's path through the sections of the questionnaire that collect information on medical events. 

Changes: None

Charge Payment (CP)

The Charge Payment section tracks total charges and sources of payment for medical events reported in earlier sections. The section obtains specific information for each medical event reported on total charges, copayments, out-of-pocket payments, insurance payments, reimbursements, discounts, disallowed amounts, balance due, and other sources of payment. Additionally, it clarifies how prescription medicine claims are processed, including questions about third party payers for prescription medicines.

Item

Changes/Reason

Text

Population

CP01C

Omitted / Not needed analytically; higher nonresponse and limited use in Pmed editing

How much did {you/{PERSON}} pay out-of-pocket for {your/his/her} 
last prescription?

All RU members with prescriptions

CP24

Omitted / high burden

At the moment, it appears that {AMOUNT REMAINING} of the total 
charge is still unpaid. Let me be sure I have entered everything 
correctly.

REVIEW CHARGES AND PAYMENTS WITH RESPONDENT. WORK WITH 
RESPONDENT TO CORRECT ERRONEOUS INFORMATION, IF ANY.

All event-provider pairs where charges and payments differed by 3% or $5

CP26

Omitted / high burden

The payments you reported exceed the charge I have recorded by 
{$ DISCREPANCY}. Let me be sure I have all the information 
recorded correctly.

REVIEW CHARGES AND PAYMENTS WITH RESPONDENT. WORK WITH 
RESPONDENT TO CORRECT ERRONEOUS INFORMATION, IF ANY.

All event-provider pairs where charges and payments differed by 3% or $5



Child Preventive Health (CS)

This supplemental section, asked in Rounds 2 and 4, collects information on general health status, special health care needs, potential behavioral problems, accessibility to health care, preventative care, height, and weight of any child in the family.

Item

Changes/Reason

Text

Population

CS01

Omitted / Not needed analytically; not used in NHQR or NHDR

The following are statements about {your/{PERSON}’s} general health status.

How true or false is each of these statements for {you/him/her}?

1 = DEFINITELY TRUE
2 = MOSTLY TRUE
3 = DON’T KNOW
4 = MOSTLY FALSE
5 = DEFINITELY FALSE

All current RU members <=17 years of age.

CS01_01

Omitted / Not needed analytically; not used in NHQR or NHDR

a. {I/He/She} seem{s} to be less healthy than other children that I know.

All current RU members <=17 years of age.

CS02_02

Omitted/ Not needed analytically; not used in NHQR or NHDR

b. {I/He/She} {have/has} has never been seriously ill.

All current RU members <=17 years of age.

CS03_03

Omitted / Not needed analytically; not used in NHQR or NHDR

c. When there is something going around, {I/he/she} usually catch{es} it.

All current RU members <=17 years of age.

CS04_04

Omitted/ Not needed analytically; not used in NHQR or NHDR

d. I expect {I/he/she} will have a very healthy life.

All current RU members <=17 years of age.

CS05_05

Omitted / Not needed analytically; not used in NHQR or NHDR

e. I worry more about {my/his/her} health than otherpeople worry about their children’s health.

All current RU members <=17 years of age.



Closing (CL)

At the end of each rounds interview, participants are asked to provide written authorization for the MEPS to collect additional information from the medical providers, insurance providers, and employers identified throughout each interview. The Closing section facilitates the completion of authorization forms for each unique person-provider pair and each unique person-establishment pair. During subsequent rounds of data collection, the MEPS-MPC on the medical visits directly from medical providers based on the authorization specified in these forms. This section also prompts the distribution of the Self Administered Questionnaire (SAQ) and Diabetes Care Survey (DCS). In addition, this section verifies the contact information for the household for use in the next interview and accounts for memory aids that were used by the household members throughout the current rounds interview. 

Item

Changes/Reason

Text/Source

Population

CL40AA

New item to collect Preventative Care SAQ (developed for AHRQ Center for Primary Care, Prevention, and Clinical Partnerships) / Item needed for operational purposes

(Not long ago), we mailed a short {blue/purple} questionnaire about health choices to (READ PERSON NAMES BELOW).


I want to check if (READ NAMES BELOW) completed that questionnaire already or needs a replacement.


1. COLLECT PREVENTATIVE CARE SAQs, IF AVAILABLE.

2. IF ANY REPORTED AS LOST, RE-DISTRIBUTE APPROPRIATE NUMBER AND TYPE OF PREVENTATIVE CARE SAQs TO THE RESPONDENT.


Source: MEPS SAQ Items

Current RU members in Panel 18 Round 5 only that are =>35 years of age and selected for preventive care sample.

CL40AAA

New item to record Preventative Care SAQ status / Item needed for operational purposes

COLLECT {PERSON}’S COMPLETED YOUR CHOICES ABOUT YOUR HEALTH SAQ.IF {PERSON} NOT AVAILABLE OR NOT ABLE TO COMPLETE THIS SAQ AT THIS TIME, LEAVE {MALE/FEMALE} YOUR CHOICES ABOUT YOUR HEALTH SAQ WITH {HIM/HER} OR RESPONDENT AND EXPLAIN SAQ INSTRUCTIONS.


SELECT THE STATUS OF THE SAQ:


Source: MEPS SAQ Items

Current RU members in Panel 18 Round 5 only that are =>35 years of age and selected for preventive care sample.


CL40AAAOV


New overlay for item CL40AAAOV / Item needed for operational purposes

SPECIFY:


Source: MEPS SAQ Items

Current RU members in Panel 18 Round 5 only that are =>35 years of age and selected for preventive care sample.

CL40AAAA

New item to collect reason for Preventative Care SAQ refusal / Item needed for operational purposes

SELECT MAIN REASON FOR REFUSAL:


Source: MEPS SAQ Items

Current RU members in Panel 18 Round 5 only that are =>35 years of age and selected for preventive care sample.

CL40_40V

New overlay for item CL40AAAA/ Item needed for operational purposes

OTHER REASON FOR REFUSAL:


Source: MEPS SAQ Items

Current RU members in Panel 18 Round 5 only that are =>35 years of age and selected for preventive care sample.

CL42A

New item to confirm respondent email from a previous round/ Item needed for operational purposes

Is this still the best email address to contact you to schedule appointments and send MEPS interview reminders?


Source: Original question for MEPS administrative purpose

All current round respondents and proxies

CL42B

New item added to collect respondent e-mail/ Item needed for operational purposes

Do you send or receive emails?


Source: NHIS

All current round respondents and proxies

CL42C

New item added to collect respondent e-mail/ Item needed for operational purposes

{What is your new email address?/We’d like to contact you by email to help schedule the next interview and send an interview reminder. May I have your email address?}


Source: NHIS

All current round respondents and proxies

CL42D

New item added to collect respondent e-mail/ Item needed for operational purposes

Is that your personal e-mail, work e-mail, a family or shared e-mail address, or some other type of email account?


Source: Original question for MEPS administrative purpose

All current round respondents and proxies

CL42DOV

New overlay for item CL42D/ Item needed for operational purposes

SPECIFY TYPE OF EMAIL ACCOUNT:


Source: Original question for MEPS administrative purpose

All current round respondents and proxies

CL42E

New item added to collect respondent e-mail/ Item needed for operational purposes

How often do you check this email account?


PROBE: How many times per day, per week, per month, per

year do you check this email account?


Source: NHIS

All current round respondents and proxies



Condition Enumeration (CE)

The Condition Enumeration section first obtains a summary assessment of each person's physical and mental health. It then identifies specific physical and mental health conditions, accidents, or injuries affecting each person. Using this information, this section creates a roster of conditions and health problems reported for each family member. Later in the interview, this roster links with health care utilization and disability day information. 

Changes: None

Conditions (CN)

This section collects additional information about physical and mental health conditions identified through medical events or disability days. It obtains further details on each condition on each person's medical condition roster to determine if it was due to an accident or injury and whether it is on a priority list of conditions. If the condition is an accident or injury or a priority condition, subsequent questions ask whether a medical person has been consulted about the condition, when the condition was first noticed, the condition's severity, the current status of the condition, and any treatments received. 

Item

Changes/Reason

Text

Population

CN06

Omitted / Not critical to analyses; most responses are in current year

Let’s talk about {CONDITION}.

When did the accident or injury happen?

{PROBE IF ANY EVENTS LISTED: The dates we have recorded for 
the medical care for {CONDITION} include (READ EVENT DATES 
BELOW).}

[Enter Year-4] ......................... 
REF ................................... -7 {CN06A}
DK .................................... -8 {CN06A}

All RU members with conditions selected as accidents or injuries

CN06A

Omitted / Not critical to analyses; most responses are in current year

Did the {CONDITION} occur before or after January 1, {YEAR}?

BEFORE ................................. 1 {BOX_05}
AFTER .................................. 2 {BOX_05}
REF ................................... -7 {BOX_05}
DK .................................... -8 {BOX_05}

All RU members with conditions selected as accidents or injuries

CN06OV1

Omitted / Not critical to analyses; most responses are in current year

MONTH:

[Enter Month-2] ........................ 
REF ................................... -7 {BOX_05}
DK .................................... -8 {BOX_05}

All RU members with conditions selected as accidents or injuries

CN06OV2

Omitted

CN06OV2

DAY:

[Enter Day-2] ........................... {BOX_05}
REF ................................... -7 {BOX_05}
DK .................................... -8 {BOX_05}

All RU members with conditions selected as accidents or injuries



Dental Care (DN)

The Dental Care section obtains details on the nature of any dental care visit, type of dental care provider, treatments and services performed, and prescribed medicines. 

Changes: None

Diabetes Care Self-Administered Questionnaire (Diabetes SAQ)

A brief self administered paper-and-pencil questionnaire on the quality of diabetes care is administered once a year (during round 3 and 5) to persons identified as having diabetes. Included are questions about the number of times the respondent reported having a hemoglobin A1c blood test, whether the respondent reported having his or her feet checked for sores or irritations, whether the respondent reported having an eye exam in which the pupils were dilated and the last time the respondent had his or her blood cholesterol checked and whether the diabetes has caused kidney or eye problems. Respondents are also asked if their diabetes is being treated with diet, oral medications or insulin.

Changes: None

Disability Days (DD)

The Disability Days section assesses the impact of any physical illness, injury, or mental or emotional problem on household members' attendance at work or school. These questions specify how many days of work or school were missed, for what health condition they were missed, and how many days were missed because of someone else's illness, injury, or health care needs. 

Item

Changes/Reason

Text

Population

DD03

Omitted / Not needed analytically; condition doesn’t align with number of days missed

What are the health problems that caused {you/{PERSON}} to miss workon those days?

All RU members => 16 years of age

DD04

Omitted / Low analytic utility

Of those days, how many did {you/{PERSON}} stay in bed for a half 
day or more?


[Enter Number of Days] ................. 
REF ................................... -7 
DK .................................... -8 

All RU members => 16 years of age

DD04A

Omitted / Low analytic utility

Of those days, how many were in {YEAR}?

[Enter Number of Days] ................. 
REF ................................... -7 
DK .................................... -8

All RU members => 16 years of age

DD06

Omitted / Not needed analytically; condition doesn’t align with number of days missed

What are the health problems that caused {you/{PERSON}} to miss
school on those days?

All RU members 3-22 years of age

DD07

Omitted / Low analytic utility

Of those days, how many did {you/{PERSON}} stay in bed a half day or 
more?

[Enter Number of Days] ................. 
REF ................................... -7 {DD08}
DK .................................... -8 {DD08}

All RU members 3-22 years of age

DD07A

Omitted / Low analytic utility

Of those days, how many were in {YEAR}?

[Enter Number of Days] ................. 
REF ................................... -7 
DK .................................... -8 

All RU members 3-22 years of age

DD08

Omitted / Low analytic utility

{Besides the days in bed you just told me about, how/How} many
{additional} days did {you/{PERSON}} spend a half day or more in bed 
{since {START DATE}/between {START DATE} and {END DATE}} because
of a physical illness or injury, or mental or emotional problem?
{Please include the time {you/he/she} {were/was} in {the hospital}
{and} {the long-term care facility}.}

[Enter Number of Days] ................. {BOX_01E}
NO {ADDITIONAL} BED DAYS ............... 995 {BOX_02}
REF .................................... -7 {BOX_02}
DK ..................................... -8 {BOX_02}

All RU members => 1 year of age

DD08A

Omitted / Low analytic utility

Of those days, how many were in {YEAR}?

[Enter Number of Days] ................. {DD09}
REF ................................... -7 {DD09}
DK .................................... -8 {DD09}

All RU members => 1 year of age

DD09

Omitted / Not needed analytically; condition doesn’t align with number of days missed

What are the health problems that caused {you/{PERSON}} to spend a halfday or more in bed on those days?

All RU members => 1 year of age



Emergency Room (ER)

The Emergency Room section obtains information on the health conditions requiring emergency room care, medical services provided, any surgical procedures performed, prescribed medicines, and the physicians and surgeons providing emergency room care. This section collects physicians and surgeons who are not already on the provider roster. 

Item

Changes/Reason

Text

Population

ER01

Omitted / Not needed analytically; poor reliability

Did {you/{PERSON}} see a medical doctor during this particular visit?

YES .................................... 1 {ER02}
NO ..................................... 2 {ER02}
REF ................................... -7 {ER02}
DK .................................... -8 {ER02}

All ER event-provider pairs



Employment (EM)

The Employment section covers questions about each person's employment or self-employment status. For jobs identified, this section asks questions to obtain contact information for each employer. For several types of jobs, questions are asked about type of business or industry, firm size, how long the person has worked at each job, whether health insurance was offered, hours worked, and job titles or main duties. For persons who are currently employed, questions ask about periods of unpaid leave at their job. For those not currently working, questions ask about previous jobs and the reasons for not working. Questions are asked about whether the person's job was temporary or seasonal, as well as questions about health insurance, including whether it was offered to the person, whether it was offered to any employee, and why the person was not eligible. Informed consent is obtained regarding contacting employers who provide health insurance.

Item

Changes/Reason

Text

Population

EM103

Omitted / Not critical to MEPS purpose or mandate

{Do/Does} {you/{PERSON}} expect to be recalled or return to 
{EMPLOYER} within the next 30 days?

YES .................................... 1 {EM104}
NO ..................................... 2 {EM104}
REF ................................... -7 {EM104}
DK .................................... -8 {EM104}

All RU members 16+ with no current job

EM115B

Omitted / Not critical to MEPS purpose or mandate

{Were/Was} {you/{PERSON}} not eligible for insurance because 
{you/he/she} {{have/has}/had} not worked long enough, because 
{you/he/she} {{don’t/doesn’t}/didn’t} work enough hours, because 
{you/he/she} {{are/is}/{were/was}} on call, because of medical 
problems, or because of some other reason?

HASN’T WORKED LONG ENOUGH .............. 1 {EM116}
DOESN’T WORK ENOUGH HOURS .............. 2 {EM116}
ON CALL ................................ 3 {EM116}
MEDICAL PROBLEM ........................ 4 {EM116}
SOME OTHER REASON ..................... 91 {EM115BOV}
REF ................................... -7 {EM116}
DK .................................... -8 {EM116}

All person-employer pairs created during current round

EM115BOV

Omitted / Not critical to MEPS purpose or mandate; not released to public

[Enter Other Specify] .................. {EM116}
REF ................................... -7 {EM116}
DK .................................... -8 {EM116}

All person-employer pairs created during current round

EM123

Omitted / Not critical to MEPS purpose or mandate; not released to public

How many other household members {now work/worked} regularly 
at this business?

[Enter Number of HH Members] ........... {EM124}
REF ................................... -7 {EM124}
DK .................................... -8 {EM124}

All person-employer pairs created during current round where employer is self-employed

EM125

Omitted / No analytic interest; not released to public

Did {you/{PERSON}} spend any time looking for work {since {START 
DATE}/between {START DATE} and {END DATE}}?

YES .................................... 1 {EM126}
NO ..................................... 2 {EM126}
REF ................................... -7 {EM126}
DK .................................... -8 {EM126}

All RU members 16+ with no jobs during reference period

EM127

Omitted/ Not needed analytically

Were there any other reasons?

CHECK ALL THAT APPLY.

NO OTHER REASONS ....................... 0 
COULD NOT FIND WORK .................... 1 
RETIRED ................................ 2 
UNABLE TO WORK BECAUSE ILL/DISABLED .... 3 
ON TEMPORARY LAYOFF .................... 4 
MATERNITY/PATERNITY LEAVE .............. 5 
GOING TO SCHOOL ........................ 6 
TAKING CARE OF HOME OR FAMILY .......... 7 
WANTED SOME TIME OFF ................... 8 
WAITING TO START NEW JOB ............... 9 
OTHER ................................. 91 {EM127OV}
REF ................................... -7 {BOX_34}
DK .................................... -8 {BOX_34}

All RU members 16+ with no jobs during reference period

EM127OV

Omitted/ Not needed analytically

[Enter Other Specify] .................. {BOX_34}
REF ................................... -7 {BOX_34}
DK .................................... -8 {BOX_34}

All RU members 16+ with no jobs during reference period

EM129

Omitted / Not critical to MEPS purpose or mandate; not released to public

Did {you/{PERSON}} spend any time looking for work {since {START 
DATE}/between {START DATE} and {END DATE}}?

YES .................................... 1 {EM130}
NO ..................................... 2 {EM130}
REF ................................... -7 {EM130}
DK .................................... -8 {EM130}

All RU members 16+ with at least 1 job during reference period

EM130

Omitted / Not critical to MEPS purpose or mandate; not released to public

Did the {# WEEKS NOT WORKED} weeks {since {START DATE}/between
{START DATE} and {END DATE}} when {you/{PERSON}} did not work for
pay occur all at one time or was there more than one period of 
time when {you/he/she} did not work?

ALL AT ONE TIME ........................ 1 {LOOP_04}
MORE THAN ONE PERIOD ................... 2 {EM131}
REF ................................... -7 {LOOP_04}
DK .................................... -8 {LOOP_04

All RU members 16+ with at least 1 job during reference period

EM131

Omitted / Not critical to MEPS purpose or mandate; not released to public

How many different periods of time {were/was} {you/{PERSON}} not 
working {since {START DATE}/between {START DATE} and {END DATE}}?

[Enter Number of Periods] ............. {LOOP_04}
REF ................................... -7 {LOOP_04}
DK .................................... -8 {LOOP_04}

All RU members 16+ with at least 1 job during reference period

EM132

Omitted / Not critical to MEPS purpose or mandate; not released to public

What was the main reason {you/{PERSON}} did not work during {that 
time/the most recent period/the time before that}?

COULD NOT FIND WORK .................... 1 {EM133}
RETIRED ................................ 2 {EM133}
UNABLE TO WORK BECAUSE ILL/DISABLED .... 3 {EM133}
ON TEMPORARY LAYOFF .................... 4 {EM133}
MATERNITY/PATERNITY LEAVE .............. 5 {EM133}
GOING TO SCHOOL ........................ 6 {EM133}
TAKING CARE OF HOME OR FAMILY .......... 7 {EM133}
WANTED SOME TIME OFF ................... 8 {EM133}
WAITING TO START NEW JOB ............... 9 {EM133}
OTHER ................................. 91 {EM132OV}
REF ................................... -7 {END_LP04}
DK .................................... -8 {END_LP04}

All RU members 16+ with at least 1 job during reference period

EM132OV

Omitted / Not critical to MEPS purpose or mandate; not released to public

[Enter Other Specify] .................. {EM133}
REF ................................... -7 {EM133}
DK .................................... -8 {EM133}

All RU members 16+ with at least 1 job during reference period

EM133

Omitted / Not critical to MEPS purpose or mandate; not released to public

Were there any other reasons?

CHECK ALL THAT APPLY.

NO OTHER REASONS ....................... 0 
COULD NOT FIND WORK .................... 1 
RETIRED ................................ 2 
UNABLE TO WORK BECAUSE ILL/DISABLED .... 3 
ON TEMPORARY LAYOFF .................... 4 
MATERNITY/PATERNITY LEAVE .............. 5 
GOING TO SCHOOL ........................ 6 
TAKING CARE OF HOME OR FAMILY .......... 7 
WANTED SOME TIME OFF ................... 8 
WAITING TO START NEW JOB ............... 9 
OTHER ................................. 91 {EM133OV}
REF ................................... -7 {END_LP04}
DK .................................... -8 {END_LP04}

All RU members 16+ with at least 1 job during reference period

EM133OV

Omitted / Not critical to MEPS purpose or mandate; not released to public

[Enter Other Specify] .................. {END_LP04}
REF ................................... -7 {END_LP04}
DK .................................... -8 {END_LP04}

All RU members 16+ with at least 1 job during reference period

EM134

Omitted / Not critical to MEPS purpose or mandate; not released to public

{In addition to the times we have just talked about 
{since/between}/{Since/Between}} {START DATE} {and {END DATE}},
was there any time when {you/{PERSON}} {were/was} on unpaid leave 
from {a job/all jobs} for a period of time of one week or more?

YES .................................... 1 {EM135}
NO ..................................... 2 {BOX_34}
REF ................................... -7 {BOX_34}
DK .................................... -8 {BOX_34}

All RU members 16+ with at least 1 job during reference period

EM135

Omitted / Not critical to MEPS purpose or mandate; not released to public

How many weeks was that?

NUMBER OF WEEKS IN REFERENCE PERIOD: {NUMBER OF WEEKS}

[Enter Number of Weeks] ................
ON UNPAID LEAVE THE WHOLE TIME ........ 96 {LOOP_05}
REF ................................... -7 {LOOP_05}
DK .................................... -8 {LOOP_05}

All RU members 16+ with at least 1 job during reference period

EM136

Omitted / Not critical to MEPS purpose or mandate; not released to public

Did the {# WEEKS UNPAID LEAVE} weeks {since {START DATE}/between
{START DATE} and {END DATE}} when {you/{PERSON}} had unpaid leave 
occur all at one time or was there more than one period of time when
{you/he/she} had unpaid leave?

ALL AT ONE TIME ........................ 1 {LOOP_05}
MORE THAN ONE PERIOD ................... 2 {EM137}
REF ................................... -7 {LOOP_05}
DK .................................... -8 {LOOP_05}

All RU members 16+ with at least 1 job during reference period

EM137

Omitted / Not critical to MEPS purpose or mandate; not released to public

How many different periods of time did {you/{PERSON}} have unpaid 
leave {since {START DATE}/between {START DATE} and {END DATE}}?

[Enter Number of Periods] .............. {LOOP_05}
REF ................................... -7 {LOOP_05}
DK .................................... -8 {LOOP_05}

All RU members 16+ with at least 1 job during reference period

EM138

Omitted / Not critical to MEPS purpose or mandate; not released to public

What was the main reason {you/{PERSON}} had unpaid leave {that 
time/the most recent period/the time before that}?

UNABLE TO WORK BECAUSE ILL/DISABLED .... 1 {EM139}
ON TEMPORARY LAYOFF .................... 2 {EM139}
MATERNITY/PATERNITY LEAVE .............. 3 {EM139}
GOING TO SCHOOL ........................ 4 {EM139}
TAKING CARE OF HOME OR FAMILY .......... 5 {EM139}
WANTED SOME TIME OFF ................... 6 {EM139}
OTHER ................................. 91 {EM138OV}
REF ................................... -7 {END_LP05}
DK .................................... -8 {END_LP05}

All RU members 16+ with at least 1 job during reference period

EM138OV

Omitted / Not critical to MEPS purpose or mandate; not released to public

[Enter Other Specify] .................. {EM139}
REF ................................... -7 {EM139}
DK .................................... -8 {EM139}

All RU members 16+ with at least 1 job during reference period

EM139

Omitted / Not critical to MEPS purpose or mandate; not released to public

PERIOD OF UNPAID LEAVE {NN} OF {NN}

Were there any other reasons?

CHECK ALL THAT APPLY.

NO OTHER REASONS ....................... 0 
UNABLE TO WORK BECAUSE ILL/DISABLED .... 1 
ON TEMPORARY LAYOFF .................... 2 
MATERNITY/PATERNITY LEAVE .............. 3 
GOING TO SCHOOL ........................ 4 
TAKING CARE OF HOME OR FAMILY .......... 5 
WANTED SOME TIME OFF ................... 6 
OTHER ................................. 91 {EM139OV}
REF ................................... -7 {END_LP05}
DK .................................... -8 {END_LP05}

All RU members 16+ with at least 1 job during reference period

EM139OV

Omitted / Not critical to MEPS purpose or mandate; not released to public

[Enter Other Specify] .................. {END_LP05}
REF ................................... -7 {END_LP05}
DK .................................... -8 {END_LP05}

All RU members 16+ with at least 1 job during reference period

EM140

Omitted / Not critical to MEPS purpose or mandate; not released to public

Since {you/{PERSON}} {were/as) 21 years old, {have/has} 
{you/he/she} ever been without a job for more than one year
for any reason?

YES .................................... 1 {EM141}
NO ..................................... 2 {BOX_36A}
REF ................................... -7 {BOX_36A}
DK .................................... -8 {BOX_36A}

All RU members 22 to 64 years of age and ever worked

EM141

Omitted / Not critical to MEPS purpose or mandate; not released to public

Please think about all of the years {you/{PERSON}} {have/has} been
out of work since {you/he/she} {were/was} 21 years old.

For what reasons {were/was} {you/he/she} without a job for more 
than a year?

CHECK ALL THAT APPLY.

COULD NOT FIND WORK .................... 1 
RETIRED ................................ 2 
UNABLE TO WORK BECAUSE ILL/DISABLED .... 3 
ON TEMPORARY LAYOFF .................... 4 
MATERNITY/PATERNITY LEAVE .............. 5 
GOING TO SCHOOL ........................ 6 
TAKING CARE OF HOME OR FAMILY .......... 7 
WANTED SOME TIME OFF ................... 8 
WAITING TO START NEW JOB ............... 9 
OTHER ................................. 91 {EM141OV}
REF ................................... -7 {EM142}
DK .................................... -8 {EM142}

All RU members 22 to 64 years of age and ever worked

EM141OV

Omitted / Not critical to MEPS purpose or mandate; not released to public

[Enter Other Specify] .................. {EM142}
REF ................................... -7 {EM142}
DK .................................... -8 {EM142}

All RU members 22 to 64 years of age and ever worked

EM142

Omitted / Not critical to MEPS purpose or mandate; not released to public

Since {you/{PERSON}} {were/was} 21 years old, what is the total 
number of years {you/he/she} {were/was} without a job because of 
all the reasons you’ve just told me?

[Enter Number of Years] ................ {BOX_36A}
REF ................................... -7 {BOX_36A}
DK .................................... -8 {BOX_36A}

All RU members 22 to 64 years of age and ever worked



Employment Wage (EW)

The Employment Wage section collects detailed information about the wage structure for all non-self employed, current jobs identified in the previous Employment (EM) section. 

Item

Changes/Reason

Text

Population

EW06

Omitted / Not critical to MEPS purpose or mandate

If {you/{PERSON}} worked an extra hour, how much would {you/he/she} earn for that hour?

[Enter $ Per Hour] ..................... {EW23}
REF ................................... -7 {EW23}
DK .................................... -8 {EW23}

All person-employer pairs not paid hourly or salaried

EW19

Omitted / Not critical to MEPS purpose or mandate

What {is/was} {your/{PERSON}'s} hourly rate for overtime?

{DOES/DID} NOT WORK OVERTIME ........... 1 {EW23}
STRAIGHT TIME .......................... 2 {EW23}
TIME AND A HALF ........................ 3 {EW23}
COMP TIME .............................. 4 {EW23}
EXACT AMOUNT ........................... 5 {EW19OV1}
OTHER ................................. 91 {EW19OV2}
REF ................................... -7 {EW23}
DK .................................... -8 {EW23}

All person-employer pairs paid hourly

EW19OV1

Omitted / Not critical to MEPS purpose or mandate

[Enter $ Per Hour] ..................... {EW23}

All person-employer pairs paid hourly

EW190OV2

Omitted / Not critical to MEPS purpose or mandate; not released to public

[Enter Other Specify] .................. {EW23}
REF ................................... -7 {EW23}
DK .................................... -8 {EW23}

All person-employer pairs paid hourly



Event Driver (ED)

The Event Driver verifies and modifies information entered in the Provider Probes, Event Roster, and Provider Roster sections. It also provides an opportunity to add new medical events throughout the interview if the respondent recalls an event after completing the Provider Probes section. 

Changes: None

Event Roster (EV)

Probes continue in this section for additional detail on event dates, type of event, and type of provider. This section creates a roster displaying this information as it is linked to each person. The Event Roster links to further sections that collect more detailed data on each specific type of event and then the charge and payment for each event. 

Changes: None

Flat Fee (FF)

The Flat Fee section functions as a subsection of Charge Payment (CP). It captures information on those types of medical payment arrangements that charge a grouped amount, or flat fee, for multiple visits or services. 

Changes: None

Health Insurance (HX)

The Health Insurance section collects information about private health insurance obtained through an employer, direct purchase private insurance plans, and public health insurance programs. It identifies the household members covered by health insurance, type of plan, name of each plan, nature of coverage under each plan, duration of coverage, and who pays various costs for the policy premiums. It also identifies the household members not covered by health insurance. For employer-sponsored coverage, this section creates a link to job characteristics collected in the Employment (EM) section of the questionnaire. For individuals who are uninsured at the beginning of the year, the section collects information on the length of time they have been uninsured. For private insurance policies, it obtains information on employer-related coverage and non-employer-related coverage (i.e., purchased through a group, association, school, small business group, insurance company, etc.). The Health Insurance section also collects information for public insurance on Medicare, Medicaid/SCHIP, Medicaid waiver programs, CHAMPUS/CHAMPVA (now TRICARE/CHAMPVA), and other government programs.  Questions related to whether the insurance will cover part of the cost of an out-of-network provider are asked.

Item

Changes/Reason

Text

Population

HX31

Omitted / Unnecessary detail and burden

Is the name of {your/{PERSON}’s} insurance plan through Medicare{,
as of {END DATE},} listed on this card?

YES .................................... 1 {HX31OV}
NO ..................................... 2 {HX32}
REF ................................... -7 {HX32}
DK .................................... -8 {HX32}

All establishment-person pairs with Medicare and created during the current round

HX31OV

Omitted / Unnecessary detail and burden

Which insurance plan {is/was} {your/his/her} Medicare managed care
plan {as of {END DATE}}?

CODE LETTER OF PLAN FROM SHOW CARD:

[Enter Plan Letter From Card] ......... {HX33A}

All establishment-person pairs with Medicare and created during the current round

HX41

Omitted / Unnecessary detail and burden

Is the name of the health insurance through {{Medicaid/{STATE 
NAME FOR MEDICAID}} or {STATE CHIP NAME}/the program sponsored 
by a state or local government agency which provides hospital 
and physician benefits}{, between {START DATE} and {END DATE),}} 
listed on this card?

YES .................................... 1 {HX41OV}
NO ..................................... 2 {HX42}
REF ................................... -7 {HX42}
DK .................................... -8 {HX42}

All RUs with Medicaid or Medicaid-like coverage and created during the current round

HX41OV

Omitted / Unnecessary detail and burden

Which plan is the health insurance through {{Medicaid/{STATE NAME 
FOR MEDICAID}} or {STATE CHIP NAME}/that program)}?

LETTER OF PLAN FROM SHOW CARD:

[Enter Plan Letter From Card] ......... 

All RUs with Medicaid or Medicaid-like coverage and created during the current round

HX47

Omitted / Unnecessary detail and burden

Who {else} pays {some of/for} the premium or cost
of this insurance?

FEDERAL GOVERNMENT .................... 1 
STATE GOVERNMENT ...................... 2 
LOCAL GOVERNMENT ...................... 3 
SOME GOVERNMENT ....................... 4 
OTHER ................................. 91 {HX47OV}
REF ................................... -7 {BOX_31C}
DK .................................... -8 {BOX_31C}

All RUs with Medicaid or Medicaid-like coverage and created during the current round

HX47OV

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_31C}
REF ................................... -7 {BOX_31C}
DK .................................... -8 {BOX_31C}

All RUs with Medicaid or Medicaid-like coverage and created during the current round

HX47A

Omitted / Unnecessary detail and burden

[Now, let’s talk about the coverage someone in the family has
through TRICARE or CHAMPVA.]

Does anyone in the family pay anything for the coverage through
TRICARE or CHAMPVA?

[Do not include the cost of any copayments, coinsurance or 
deductibles anyone in the family may have had to pay.]

YES .................................... 1 {HX47B}
NO ..................................... 2 {BOX_32}
REF ................................... -7 {BOX_32}
DK .................................... -8 {BOX_32}

All RUs with Tricare coverage and created during the current round

HX47B

Omitted / Unnecessary detail and burden

How much does anyone in the family pay for the coverage through
TRICARE or CHAMPVA?

[Enter Amount in Dollars] .............. {HX47BOV1}
REF ................................... -7 {BOX_32}
DK .................................... -8 {BOX_32}

All RUs with Tricare coverage and created during the current round

HX47BOV1

Omitted / Unnecessary detail and burden

Is that per year, per month, per week, or what?

UNIT OF COVERAGE:

PER YEAR ............................... 1 {BOX_32}
QUARTERLY/EVERY 3 MONTHS ............... 2 {BOX_32}
BIMONTHLY/EVERY 2 MONTHS ............... 3 {BOX_32}
PER MONTH .............................. 4 {BOX_32}
PER WEEK ............................... 5 {BOX_32}
BIWEEKLY/EVERY 2 WEEKS ................. 6 {BOX_32}
SEMI-ANNUALLY/2 TIMES PER YEAR ......... 7 {BOX_32}
SEMI-MONTHLY/2 TIMES PER MONTH ......... 8 {BOX_32}
OTHER ................................. 91 {HX47BOV2}
REF ................................... -7 {BOX_32}
DK .................................... -8 {BOX_32}

All RUs with Tricare coverage and created during the current round

HX47BOV2

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_32}
REF ................................... -7 {BOX_32}
DK .................................... -8 {BOX_32}

All RUs with Tricare coverage and created during the current round

HX50

Omitted / Unnecessary detail and burden

Is there any other name for the {INSURANCE COMPANY OR HMO 
NAME.} policy, such as Option A, $100 Deductible Plan, 90/80 
Plan, Gold Plan, or High Option Plan?

YES, ANOTHER NAME ...................... 1 {HX50OV}
NO OTHER NAME .......................... 2 {END_LP13}
REF ................................... -7 {END_LP13}
DK .................................... -8 {END_LP13}

All establishment-person pairs with Medigap coverage and created during the current round

HX50OV

Omitted / Unnecessary detail and burden

[Enter Insurance Company or HMO] ....... {END_LP13}
REF ................................... -7 {END_LP13}
DK .................................... -8 {END_LP13}

All establishment-person pairs with Medigap coverage and created during the current round

HX59

Omitted / Unnecessary detail and burden

Is the name of {your/{POLICYHOLDER}’s} insurance plan through
{ESTABLISHMENT} listed on this card?

YES .................................... 1 {HX59OV}
NO ..................................... 2 {BOX_40}
REF ................................... -7 {BOX_40}
DK .................................... -8 {BOX_40}

All establishment-person pairs with coverage from the federal government and created during the current round

HX59OV

Omitted / Unnecessary detail and burden

Which insurance plan is {your/his/her} {ESTABLISHMENT}
insurance?

CODE LETTER OF PLAN FROM SHOW CARD:

[Enter Plan Letter From Card] ......... {BOX_40}

All establishment-person pairs with coverage from the federal government and created during the current round

HX60A

Omitted / Unnecessary detail and burden

Will {your/{POLICYHOLDER}’s} plan pay for any of the costs of 
visits to doctors who are not part of {your/his/her} HMO, even if
{you/he/she} {do/does} not have a referral?

YES .................................... 1 {END_LP17}
NO ..................................... 2 {END_LP17}
REF ................................... -7 {END_LP17}
DK .................................... -8 {END_LP17}

All establishment-person pairs with Medigap or major medical coverage and created during the current round

HX63

Omitted / Unnecessary detail and burden

Who {else} pays {some of/for} the premium or cost
of this insurance?

CHECK ALL THAT APPLY.

FEDERAL GOVERNMENT .................... 1 
STATE GOVERNMENT ...................... 2 
LOCAL GOVERNMENT ...................... 3 
SOME GOVERNMENT ....................... 4 
EMPLOYER .............................. 5 
UNION ................................. 6 
OTHER ................................. 91 {HX63OV}
REF ................................... -7 {BOX_44B}
DK .................................... -8 {BOX_44B}

All establishment-person pairs with Medigap or major medical coverage and created during the current round

HX63OV

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_44B}
REF ................................... -7 {BOX_44B}
DK .................................... -8 {BOX_44B}

All establishment-person pairs with Medigap or major medical coverage and created during the current round



Health Status (HE)

The Health Status section assesses the physical and mental health status for both children and adults. Specific areas assessed include limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), the use of health aids, physical limitations, activity limitations, mental impairments, vision impairments, and hearing difficulties. For children, this section obtains additional information on participation in special education or therapy services, general health status, height, weight and child care.  Also included are questions assessing whether a person has had difficulty with or has required supervision for at least 3 months when performing daily activities.

Item

Changes/Reason

Text

Population

HE03A

Omitted / Not needed analytically; not much variation

Do you expect that {you/{PERSON}} will need help or supervision 
with these activities for at least three more months? 

YES .................................... 1 {END_LP01}
NO ..................................... 2 {END_LP01}
REF ................................... -7 {END_LP01}
DK .................................... -8 {END_LP01}

All RU members =>13 years with IADL

HE06A

Omitted / Not needed analytically; not much variation

Do you expect that {you/{PERSON}} will need help or supervision 
with personal care for at least three more months? 

YES .................................... 1 {END_LP02}
NO ..................................... 2 {END_LP02}
REF ................................... -7 {END_LP02}
DK .................................... -8 {END_LP02}

All RU members =>13 years with ADL

HE18A

Omitted / Not needed analytically; not much variation

{Are/Is} {you/{PERSON}} expected to have difficulty with any 
of these activities for at least three more months? 

YES .................................... 1 {END_LP03}
NO ..................................... 2 {END_LP03}
REF ................................... -7 {END_LP03}
DK .................................... -8 {END_LP03}

All RU members =>13 years with difficulty moving



Home Health (HH)

For those persons using home health care, the Home Health section obtains information on the types of health care workers providing home health services, reasons for home health care, the nature of home health services provided, frequency of visits, length per visits, and duration of visits. 

Changes: None

Hospital Stay (HS)

The Hospital Stay section obtains details on the length of stay, reasons or conditions requiring hospitalization, surgical procedures performed, medicines prescribed at discharge, and the physicians and surgeons providing hospital care. This section collects physicians and surgeons who are not already on the provider roster. 

Item

Changes/Reason

Text

Population

HS06B

Omitted / Limited utility; low frequency

Did {you/{PERSON}} receive an epidural or a 'spinal' for pain? 

YES .................................... 1 {HS08}
NO ..................................... 2 {HS08}
REF ................................... -7 {HS08}
DK .................................... -8 {HS08}

All HS event-provider pairs where giving birth is reason for stay



Income (IN)

This supplemental section, asked in Rounds 3 and 5, collects information about the household members' income and Federal income tax filing status, specifically about itemized deductions for health insurance premiums, tax credits, wages, other private income sources, and public assistance income. 

Item

Changes

Text

Population

IN10

Omitted / Not used in income editing

{Did/Will} {you/{PERSON}} itemize deductions or take the standard 
deduction? 

Itemized Deductions .................... 1 {IN14}
Standard Deduction ..................... 2 {END_LP01}
REF .................................... -7 {END_LP01}
DK ..................................... -8 {END_LP01}

All RU members filing or planning to file tax return

IN14

Omitted/ Not used in income editing

About how much {was/will be} the total of all the itemized 
deduction expenses?

[Enter $ Amount] ....................... {IN15}
REF .................................... -7 {IN15}
DK ..................................... -8 {IN15}

All RU members filing or planning to file tax return

IN21

Omitted / Not used to calculate total income or poverty levels

During {YEAR}, how much money did {you/{PERSON}} {and {you/{NAME OF SECONDARY FILER}}} receive from refunds of state or local income taxes?

{IF NECESSARY, SAY: If any money from a joint return, include 
only the amount that would be {your/his/her} portion.}

[Enter $ Amount] ....................... {IN22}
REF .................................... -7 {IN22}
DK ..................................... -8 {IN21A}

All RU members 16+ or those filing or planning to file tax return

IN21A

Omitted / Not used to calculate total income or poverty levels

Which of the ranges on this card is the best estimate of how much 
money was received [from refunds of state or local taxes in {YEAR}]?

1 - 100 ................................. 1 {IN22}
101 - 500 ............................... 2 {IN22}
501 - 1,000 ............................. 3 {IN22}
1,001 - 5,000 ........................... 4 {IN22}
5,001 - 15,000 .......................... 5 {IN22}
15,001 OR MORE .......................... 6 {IN22}
REF .................................... -7 {IN22}
DK ..................................... -8 {IN22}

All RU members 16+ or those filing or planning to file tax return

IN39

Omitted/ Not used in income editing

Did {you/{PERSON}} receive money from Supplemental Security Income
because of {your/his/her} own disability or for some other reason?

DISABILITY .............................. 1 {IN40A}
SOME OTHER REASON ....................... 2 {IN40A}
REF .................................... -7 {IN40A}
DK ..................................... -8 {IN40A}

All RUs receiving Supplemental Security income (SSI)



Managed Care (MC)

This section determines whether household members are covered under a private managed care plan. The section groups the types of coverage as either HMO, other type of managed care plan, or non-managed care plan based on questions about the characteristics of the insurance plan. 

Item

Changes/Reason

Text

Population

MC02

Omitted / No longer needed analytically; not used for expenditure editing or imputation; R difficulty answering in validation study

{Does/As of {END DATE}, did} {your/{POLICYHOLDER}’s} insurance plan require {you/him/her} to sign up with a certain primarycare doctor, group of doctors, or a certain clinic which {you/he/she} must go to for all of {your/his/her} routinecare?

PROBE: Do not include emergency care or care from a specialist 
you were referred to. 

YES .................................... 1 {MC04}
NO ..................................... 2 {MC03}
REF ................................... -7 {MC03}
DK .................................... -8 {MC03}

All establishment-person-insurer triplets

MC03

Omitted / No longer needed analytically; not used for expenditure editing or imputation; R difficulty answering in validation study

{Is/As of {END DATE}, was} there a book or list of doctorsassociated with the plan?

YES .................................... 1 {MC04}
NO ..................................... 2 {BOX_01}
REF ................................... -7 {BOX_01}
DK .................................... -8 {BOX_01}

All establishment-person-insurer triplets

MC04

Omitted / No longer needed analytically; not used for expenditure editing or imputation; R difficulty answering in validation study

{Will/As of {END DATE}, would} {your/{POLICYHOLDER}’s} plan pay for anyof the costs of visits to doctors who are not associated with {your/his/her} plan, even if {you/he/she} {{do/does}/did}not have a referral?

YES .................................... 1 {BOX_01}
NO ..................................... 2 {BOX_01}
REF ................................... -7 {BOX_01}
DK .................................... -8 {BOX_01}

All establishment-person-insurer triplets

MC05

Omitted / No longer needed analytically; not used for expenditure editing or imputation; R difficulty answering in validation study

{Will/As of {END DATE}, would} {your/{POLICYHOLDER}’s} plan pay for any of the costs of visits to doctors who are not part of {your/his/her} HMO, even if {you/he/she} {{do/does}/did} not havea referral?

YES .................................... 1 {BOX_01}
NO ..................................... 2 {BOX_01}
REF ................................... -7 {BOX_01}
DK .................................... -8 {BOX_01}

All establishment-person-insurer triplets



Medical Provider Visits (MV)

The Medical Provider Visits section obtains details on the nature of any contacts or visits, the type of provider, health conditions requiring medical provider services, treatments and services performed, surgical procedures, and prescribed medicines. This section also probes for any follow up or repeat visits that cost the same amount as the original visit.  Questions are asked about the medical provider's specialty and the medical provider's place type (e.g., managed care plan center or doctor's office).

Item

Changes/Reason

Text

Population

MV02A

Omitted / poor reliability; high burden

What kind of place is that -- a managed care plan center or 
HMO, a clinic, a doctor’s office, or some other place?

DOCTOR’S OFFICE OR GROUP PRACTICE ..... 1 {MV03}
MANAGED CARE PLAN CENTER/HMO .......... 3 {MV03}
MEDICAL CLINIC ........................ 2 {MV03}
RURAL HEALTH CLINIC ................... 7 {MV03}
COMPANY CLINIC ........................ 8 {MV03}
SCHOOL CLINIC ......................... 9 {MV03}
OTHER CLINIC .......................... 10 {MV03}
NEIGHBORHOOD/FAMILY HEALTH CENTER ..... 4 {MV03}
COMMUNITY HEALTH CENTER ............... 13 {MV03}
BIRTHING CENTER ....................... 15 {MV03}
WALK-IN URGENT CARE ................... 11 {MV03}
LABORATORY/X-RAY FACILITY ............. 14 {MV03}
LASER EYE SURGERY CENTER .............. 5 {MV03}
OTHER FREESTANDING SURGICAL CENTER .... 6 {MV03}
VA FACILITY ........................... 12 {MV03}
INDIAN HEALTH SERVICE (IHS) FACILITY .. 16 {MV03}
SOME OTHER PLACE ...................... 91 {MV03}
REF ................................... -7 {MV03}
DK .................................... -8 {MV03}

All MV event-provider pairs

MV10

Omitted / poor reliability; high burden

Looking at this card, which of these treatments, if any, did 
{you/{PERSON}} receive during this visit?

CHECK ALL THAT APPLY.

PHYSICAL THERAPY ....................... 1 {MV11}
OCCUPATIONAL THERAPY ................... 2 {MV11}
SPEECH THERAPY ......................... 3 {MV11}
CHEMOTHERAPY ........................... 4 {MV11}
RADIATION THERAPY ...................... 5 {MV11}
KIDNEY DIALYSIS ........................ 6 {MV11}
IV THERAPY ............................. 7 {MV11}
DRUG OR ALCOHOL TREATMENT .............. 8 {MV11}
ALLERGY SHOT ........................... 9 {MV11}
PSYCHOTHERAPY/COUNSELING .............. 10 {MV11}
SHOTS, OTHER THAN ALLERGY ............. 11 {MV11}
NO TREATMENTS RECEIVED ................ 95 {MV11}
REF ................................... -7 {MV11}
DK .................................... -8 {MV11}

All MV event-provider pairs



Old Employment/ Private Related Insurance (OE)

For RU members that still hold the same job in Rounds 2 through 5 that was reported during the previous round as providing health insurance, this section collects information about the continuation of insurance coverage. Included are questions about whether the policyholder was responsible for any amount of the charge, whether there was an additional name for the insurance, and payments to out-of-network providers were added.

Item

Changes/Reason

Text

Population

OE09AAA

Omitted / Unnecessary detail and burden

Who {else} pays {some of/for} the premium or cost
of this insurance?

CHECK ALL THAT APPLY.

FEDERAL GOVERNMENT .................... 1 
STATE GOVERNMENT ...................... 2 
LOCAL GOVERNMENT ...................... 3 
SOME GOVERNMENT ....................... 4 
EMPLOYER .............................. 5 
UNION ................................. 6 
OTHER ................................. 91 {OE09AAAOV}
REF ................................... -7 {BOX_08AA}
DK .................................... -8 {BOX_08AA}

All establishment-person pairs with insurance from a still current job created during the previous round

OE09AAAOV

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_08AA}
REF ................................... -7 {BOX_08AA}
DK .................................... -8 {BOX_08AA}

All establishment-person pairs with insurance from a still current job created during the previous round

OE11A

Omitted / Unnecessary detail and burden

Is there any other name for the {INSURANCE COMPANY OR HMO 
NAME} policy, such as Option A, $100 Deductible Plan, 90/80 
Plan, Gold Plan, or High Option Plan?

YES, ANOTHER NAME ...................... 1 {OE11AOV}
NO OTHER NAME .......................... 2 {BOX_09A}
REF ................................... -7 {BOX_09A}
DK .................................... -8 {BOX_09A}

All establishment-person pairs with insurance from a still current job created during the previous round

0E11AOV

Omitted / Unnecessary detail and burden

[Enter Policy Name] .................... {BOX_09A}
REF ................................... -7 {BOX_09A}
DK .................................... -8 {BOX_09A}

All establishment-person pairs with insurance from a still current job created during the previous round

OE11B

Omitted / Unnecessary detail and burden

Will {your/{POLICYHOLDER}’s} plan pay for any of the costs of 
visits to doctors who are not part of {your/his/her} 
HMO, even if {you/he/she} {do/does} not have a referral?

YES .................................... 1 {END_LP04}
NO ..................................... 2 {END_LP04}
REF ................................... -7 {END_LP04}
DK .................................... -8 {END_LP04}

All establishment-person pairs with insurance from a still current job created during the previous round

OE23AAA

Omitted / Unnecessary detail and burden

Who {else} pays {some of/for} the premium or cost
of this insurance?

CHECK ALL THAT APPLY.

FEDERAL GOVERNMENT .................... 1 
STATE GOVERNMENT ...................... 2 
LOCAL GOVERNMENT ...................... 3 
SOME GOVERNMENT ....................... 4 
EMPLOYER .............................. 5 
UNION ................................. 6 
OTHER ................................. 91 
REF ................................... -7 {BOX_17AA}
DK .................................... -8 {BOX_17AA}

All establishment-person pairs with insurance from a non-current job created during the previous round

OE23AAAOV

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_17AA}
REF ................................... -7 {BOX_17AA}
DK .................................... -8 {BOX_17AA}

All establishment-person pairs with insurance from a non-current job created during the previous round

OE25AA

Omitted / Unnecessary detail and burden

Is there any other name for the {INSURANCE COMPANY OR HMO 
NAME} policy, such as Option A, $100 Deductible Plan, 90/80 
Plan, Gold Plan, or High Option Plan?

YES, ANOTHER NAME ...................... 1 {OE25AAOV}
NO OTHER NAME .......................... 2 {BOX_18A}
REF ................................... -7 {BOX_18A}
DK .................................... -8 {BOX_18A}

All establishment-person pairs with insurance from a non-current job created during the previous round

OE25AAOV

Omitted / Unnecessary detail and burden

[Enter Policy Name] .................... {BOX_18A}
REF ................................... -7 {BOX_18A}
DK .................................... -8 {BOX_18A}

All establishment-person pairs with insurance from a non-current job created during the previous round

OE25B

Omitted / Unnecessary detail and burden

Will {your/{POLICYHOLDER}’s} plan pay for any of the costs of 
visits to doctors who are not part of {your/his/her} HMO, even
if {you/he/she} {do/does} not have a referral?

YES .................................... 1 {END_LP08}
NO ..................................... 2 {END_LP08}
REF ................................... -7 {END_LP08}
DK .................................... -8 {END_LP08}

All establishment-person pairs with insurance from a non-current job created during the previous round

OE35AAA

Omitted / Unnecessary detail and burden

Who {else} pays {some of/for} the premium or cost of this
insurance?

CHECK ALL THAT APPLY. 

FEDERAL GOVERNMENT .................... 1
STATE GOVERNMENT ...................... 2
LOCAL GOVERNMENT ...................... 3
SOME GOVERNMENT ....................... 4
EMPLOYER .............................. 5
UNION ................................. 6
OTHER ................................. 91 {OE35AAAOV}
REF ................................... -7 {BOX_26AA}
DK .................................... -8 {BOX_26AA}

All establishment-person pairs with insurance from other private sources created during the previous round

OE35AAAOV

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_26AA}
REF ................................... -7 {BOX_26AA}
DK .................................... -8 {BOX_26AA}

All establishment-person pairs with insurance from other private sources created during the previous round

OE38A

Omitted / Unnecessary detail and burden

Is there any other name for the {INSURANCE COMPANY OR HMO 
NAME} policy, such as Option A, $100 Deductible Plan, 90/80 
Plan, Gold Plan, or High Option Plan?

YES, ANOTHER NAME ...................... 1 {OE38AOV}
NO OTHER NAME .......................... 2 {BOX_28A}
REF ................................... -7 {BOX_28A}
DK .................................... -8 {BOX_28A}

All establishment-person pairs with insurance from other private sources created during the previous round

OE38AOV

Omitted / Unnecessary detail and burden

[Enter Policy Name] .................... {BOX_28A}
REF ................................... -7 {BOX_28A}
DK .................................... -8 {BOX_28A}

All establishment-person pairs with insurance from other private sources created during the previous round

OE38B

Omitted / Unnecessary detail and burden

Will {your/{POLICYHOLDER}’s} plan pay for any of the costs of 
visits to doctors who are not part of {your/his/her} HMO, even
if {you/he/she} {do/does} not have a referral?

YES .................................... 1 {END_LP12}
NO ..................................... 2 {END_LP12}
REF ................................... -7 {END_LP12}
DK .................................... -8 {END_LP12}

All establishment-person pairs with insurance from other private sources created during the previous round



Old Public Related Insurance (PR)

For RU members who were covered during the previous round by Medicare, Medicaid/SCHIP, CHAMPUS/CHAMPVA (now TRICARE/CHAMPVA), or other state or local government sponsored programs, this section collects information about the continuation of coverage provided through these public programs. 

Item

Changes/Reason

Text

Population

PR02

Omitted / Unnecessary detail and burden

During the last interview, it was recorded that {you/{PERSON}}
{were/was} enrolled in Medicare. We would like to update information 
about {your/his/her} Medicare coverage.

Is the name of {your/{PERSON}’s} insurance plan through Medicare{, as of{END DATE},} listed on this card?

YES .................................... 1 {PR02OV}
NO ..................................... 2 {PR03}
REF ................................... -7 {PR03}
DK .................................... -8 {PR03}

All establishment-person pairs with Medicare and created during the previous round

PR02OV

Omitted / Unnecessary detail and burden

Which insurance plan {is/was} {your/his/her} Medicare managed care plan{as of {END DATE}}?

CODE LETTER OF PLAN FROM SHOW CARD.

[Enter Plan Letter From Card] ......... {PR05}

All establishment-person pairs with Medicare and created during the previous round

PR12

Omitted / Unnecessary detail and burden

Is the name of the health insurance through {Medicaid/{STATE
NAME FOR MEDICAID}} or {STATE CHIP NAME} {, between {START DATE} and {END DATE},} listed on this card?

YES .................................... 1 {PR12OV}
NO ..................................... 2 {PR13}
REF ................................... -7 {PR13}
DK .................................... -8 {PR13}

All RUs with Medicaid coverage and created during the previous round

PR12OV

Omitted / Unnecessary detail and burden

Which plan is the health insurance through {Medicaid/{STATE
NAME FOR MEDICAID}} or {STATE CHIP NAME}?

CODE LETTER OF PLAN FROM SHOW CARD.

[Enter Plan Letter From Card] ......... {BOX_04A}

All RUs with Medicaid coverage and created during the previous round

PR18

Omitted / Unnecessary detail and burden

Who {else} pays {some of/for} the premium or cost of this
insurance?

CHECK ALL THAT APPLY.

FEDERAL GOVERNMENT .................... 1
STATE GOVERNMENT ...................... 2
LOCAL GOVERNMENT ...................... 3
SOME GOVERNMENT ....................... 4
OTHER ................................. 91 {PR18OV}
REF ................................... -7 {BOX_05}
DK .................................... -8 {BOX_05}

All RUs with Medicaid coverage and created during the previous round

PR18OV

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_05}
REF ................................... -7 {BOX_05}
DK .................................... -8 {BOX_05}

All RUs with Medicaid coverage and created during the previous round

PR22A

Omitted / Unnecessary detail and burden

Does anyone in the family pay anything for the coverage through
TRICARE or CHAMPVA?

[Do not include the cost of any copayments, coinsurance or 
deductibles anyone in the family may have had to pay.]

YES .................................... 1 {PR22B}
NO ..................................... 2 {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

All RUs with Tricare coverage and created during the previous round

PR22B

Omitted / Unnecessary detail and burden

How much does anyone in the family pay for the coverage through
TRICARE or CHAMPVA?

[Enter Amount in Dollars] .............. {PR22BOV1}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

All RUs with Tricare coverage and created during the previous round

PR22BOV1

Omitted / Unnecessary detail and burden

Is that per year, per month, per week, or what?

UNIT OF COVERAGE:

PER YEAR ............................... 1 {BOX_08}
QUARTERLY/EVERY 3 MONTHS ............... 2 {BOX_08}
BIMONTHLY/EVERY 2 MONTHS ............... 3 {BOX_08}
PER MONTH .............................. 4 {BOX_08}
PER WEEK ............................... 5 {BOX_08}
BIWEEKLY/EVERY 2 WEEKS ................. 6 {BOX_08}
SEMI-ANNUALLY/2 TIMES PER YEAR ......... 7 {BOX_08}
SEMI-MONTHLY/2 TIMES PER MONTH ......... 8 {BOX_08}
OTHER ................................. 91 {PR22BOV2}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08

All RUs with Tricare coverage and created during the previous round

PR22BOV2

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

All RUs with Tricare coverage and created during the previous round

PR28

Omitted / Unnecessary detail and burden

Is the name of the health insurance through the program
sponsored by a state or local government agency which provides
hospital and physician benefits{, between {START DATE} and 
{END DATE},} listed on this card?

YES .................................... 1 {PR28OV}
NO ..................................... 2 {PR29}
REF ................................... -7 {PR29}
DK .................................... -8 {PR29}

All RUs with Medicaid-like coverage and created during the previous round

PR28OV

Omitted / Unnecessary detail and burden

Which plan is the health insurance through this program?

CODE LETTER OF PLAN FROM SHOW CARD.

[Enter Plan Letter From Card] ......... {PR32}

All RUs with Medicaid-like coverage and created during the previous round

PR34OV

Omitted / Unnecessary detail and burden

[Enter Other Specify] .................. {BOX_11}
REF ................................... -7 {BOX_11}
DK .................................... -8 {BOX_11}

All RUs with Medicaid-like coverage and created during the previous round



Other Medical Expenses (OM)

This section serves to direct the CAPI program to other sections in cases where respondents report expenses for glasses or contact lenses or for insulin and other diabetic equipment or supplies. 

Changes: None

Outpatient Department (OP)

If any outpatient visits were made during the reference period, this section obtains details on the nature of the contact, type of care received, health conditions requiring outpatient services, treatments and services performed, surgical procedures, prescribed medicines, and the physicians and surgeons providing outpatient services. This section collects physicians and surgeons who are not already on the provider roster. It also probes for any follow up or repeat visits that cost the same amount as the original outpatient visit. 

Item

Changes/Reason

Text

Population

OP10

Omitted / poor reliability; high burden

Looking at this card, which of these treatments, if any, did 
{you/{PERSON}} receive during this visit?

CHECK ALL THAT APPLY.

PHYSICAL THERAPY ....................... 1 {OP11}
OCCUPATIONAL THERAPY ................... 2 {OP11}
SPEECH THERAPY ......................... 3 {OP11}
CHEMOTHERAPY ........................... 4 {OP11}
RADIATION THERAPY ...................... 5 {OP11}
KIDNEY DIALYSIS ........................ 6 {OP11}
IV THERAPY ............................. 7 {OP11}
DRUG OR ALCOHOL TREATMENT .............. 8 {OP11}
ALLERGY SHOT ........................... 9 {OP11}
PSYCHOTHERAPY/COUNSELING .............. 10 {OP11}
SHOTS, OTHER THAN ALLERGY ............. 11 {OP11}
NO TREATMENTS RECEIVED ................ 95 {OP11}
REF ................................... -7 {OP11}
DK .................................... -8 {OP11}

All OP event-provider pairs

Overall Structure of Employment (EM-O)

Because most private health insurance is provided through employment, the MEPS interview collects detailed information on jobs held by each person in the household aged 16 or older. This section functions to direct the CAPI program through the loop of employment-related questions for each person 16 or older.

Changes: None

Prescribed Medicines (PM)

The Prescribed Medicines section obtains details on prescribed medicines reported in earlier medical events sections as well as additional prescriptions reported in this section. Questions determine whether free pharmaceutical samples were obtained, the specific health problems for which the medicine was prescribed, the number of refills obtained during the reference period, the first date of use of each medicine, and the name and address of the pharmacy that filled each prescription. 

Changes: None

Preventive Care (AP)

The Preventive Care supplemental section, asked in Round 3 and 5, gathers information on any preventive care received. Questions ask about frequency of dental and physical check-ups, flu shots, and other preventative health exams. 

Item

Changes

Text

Population

AP15OV

Omitted / Not needed analytically; not used in NHQR or NHDR

About how long ago in months has it been (blood pressure checked by a doctor, nurse or other health professional)?

IF LESS THAN ONE MONTH AGO, ENTER 0.

NUMBER:

[Enter Small Number] ................... {AP16}
REF ................................... -7 {AP16}
DK .................................... -8 {AP16}

All RU members 18+



Priority Conditions (Quality Supplement) (PC)

The Priority Conditions section collects information about diabetes andasthma. This is a supplemental section asked in Rounds 3 and 5.

Changes: None

Priority Conditions Enumeration (PE)

The Priority Conditions Enumeration section includes questions which obtain a summary assessment of each person's physical and mental health. Additionally, information is collected about a select group of medical conditions including attention deficit hyperactivity disorder, attention deficit disorder, diabetes, asthma, high cholesterol, hypertension, coronary heart disease, angina, heart attacks, other heart disorders, strokes, emphysema, chronic bronchitis, cancer, joint pain, and arthritis. Using this information, this section creates a roster of conditions and health problems reported for each family member. Later in the interview, this roster links with health care utilization and disability day information.  

Changes: None


Private Health Insurance Detail (HP)

This section collects additional detail on each private health insurance policy, including the name of the insurance company, the policyholder of each plan identified, and the household members covered by each policy. Informed consent information regarding contacting employers who provide health insurance is obtained.

Changes: See change in ACA section


Provider Directory (PD)

The Provider Directory section compiles a directory of all medical persons and medical facilities reported by MEPS respondents. It clarifies the relationship of each medical provider to the person's insurance plan and verifies the name, address, and telephone number of the provider. 

Changes: None

Provider Probes (PP)

The Provider Probes section collects the information required to create a medical event in the database, i.e., the type of event, the person incurring the event, the health care provider, and the date(s) of the event. This section links with the Event Roster, Provider Roster, and Event Driver sections.  Included are questions about independent labs/testing facilities and alternative care.

Item

Changes

Text

Population

PP10

New item to collect health care received in an overnight facility / needed to further differentiate institutional care from hospital stays

{Since {START DATE}/Between {START DATE} and {END DATE}}, has anyone in the family received health care in a place like those listed on this card, where they stayed overnight?


IF NECESSARY, SAY: Do not include assisted living or other permanent residences.


Source: Original question to MEPS based on evaluation of estimates

All RUs using records for event reporting

PP11

New item to collect health care received in an overnight facility / needed to further differentiate institutional care from hospital stays

{Have/Has} {you/{PERSON’S FIRST MIDDLE AND LAST NAME}} received any other health care where {you/he/she} stayed overnight? Or has anyone in the family received health care in a place like those listed on this card where they stayed overnight? [Please include any health car we have not yet talked about.]


Source: Original question to MEPS based on evaluation of estimates

All RUs using records for event reporting


Provider Roster (PV)

This section creates a roster to display the name and street address of each provider and/or facility associated with each person's medical events detailed in the Event Roster. This information is strictly confidential. 

Changes: None

RU Information Screen (RS)

To assist in conducting subsequent interviews, the interviewer records helpful information in this section, such as special instructions, special problems, locating directions, difficulties with the CAPI administration, and whether the household moved. 

Item

Changes

Text

Population

RS01A

Question added to ascertain if the interview was completed on travel / needed for operational purposes

WAS THIS INTERVIEW COMPLETED WHILE ON TRAVEL?

Source: Original question for MEPS administrative purpose

All RUs

RS04A

New item added to collect RU specific information on data collecting and record keeping tips / needed for operational purposes

DO YOU HAVE ANY TIPS ABOUT THE RU OR THE RESPONDENT THAT CAN HELP WITH COLLECTING BETTER DATA IN THE NEXT ROUND? INCLUDE NOTES ABOUTADDITIONAL HELPFUL RECORDS THAT YOU DIDN’T HAVE THIS ROUND, THINGS YOU DID OR SAID TO MOTIVATE THE RESPONDENT TO GET RECORDS, ETC.

Source: Original question for MEPS administrative purpose

All RUs


RS04B

New item added to collect RU specific information on data collecting and record keeping tips / needed for operational purposes

ENTER RECORD KEEPING AND OTHER DATA QUALITY TIPS:

Source: Original question for MEPS administrative purpose

All RUs

RS04AA

New item added to collect Data Quality Risk information / needed for operational purposes

HOW CONFIDENT ARE YOU THAT THE RESPONDENT GAVE YOU ALL HEALTH CARE FOR ALL RU MEMBERS?

Source: Original question for MEPS administrative purpose

All RUs

RS04BB

New item added to collect Data Quality Risk information / needed for operational purposes

ENTER COMMENTS OR DESCRIBE THE SITUATION THAT LED YOU TOBELIEVE THIS.

Source: Original question for MEPS administrative purpose

All RUs

RS17OV (number reused)

Item added to collect specific information on converting a refusal / needed for operational purposes

WHICH OF THE FOLLOWING STRATEGIES, IF ANY, HELPED YOU CONVERTTHIS REFUSAL?

Source: Original question for MEPS administrative purpose

All RUs



Reenumeration-A (RE-A)

Reenumeration refers to the process of collecting eligibility and demographic data on each person associated with a household participating in MEPS. The Reenumeration section has two parts, Reenumeration-A and Reenumeration-B. RE-A -- Reenumeration-A Part A includes questions RE01 through RE75, which identify and define the eligibility status for each person and family unit living within each MEPS sampled household, as well as any family members who are temporarily living away from the household. Part A identifies the reference period for each family unit and the person that serves as the primary respondent for the family is identified. It also obtains age, gender, and marital status for each person. 



Item

Changes/Reason

Text

Population

RE11

Item added to obtain respondent consent for CARI recording / needed for operational purposes

Some of this interview will be recorded for quality controlpurposes. I’d like to continue now, unless you have anyquestions.

IF THE RESPONDENT HAS QUESTIONS, PLEASE PRESS F1 TO REFER TO THE FAQS IN THE HELP SCREEN.

Source: Westat corporate standard used across many surveys.

All RUs

RE35A

Item added to confirm that RU member meets the definition of institutionalized / needed for operational purposes

Is {PERSON} expected to stay in the institution 100 days or less or more than 100 days?

Source: Original question to MEPS

All RU members coded as institutionalized


Reenumeration-B (RE-B)

Reenumeration-B Part B of the Reenumeration section includes questions RE76 through RE112. This section details how family members are related to one another and the size of the family unit. Race, ethnicity, educational attainment, and military status for each person are specified. 

Item

Changes/Reason

Text

Population

RE104

Item added to follow-up on high school diploma/GED status

{{Do/Does/Did}/As of December 31, {YEAR} did}{you/{PERSON}} have a high school diploma or {{have/has/had}/had} {you/{PERSON}} passed the GED equivalency test?


Source:Original question to MEPS used from 1996 to 2011

All RU members 16+

RE105

Item added to follow-up on highest degree received

What is the highest educational degree {you/{PERSON}} obtained{as of December 31, {YEAR}}?


Source: Original question to MEPS used from 1996 to 2011

All RU members 16+



Review of Employment Information (RJ)

In Rounds 2 through 5, the Review of Employment Information reviews employment information for any current job identified during the previous round. It collects updated information on job status, salary where changes in wages occur, full- or part-time work, health insurance benefits, and size of employment establishment if the jobholder is self employed. Questions are asked about whether the person's job was temporary or seasonal, and additional questions are asked about health insurance, including whether it was offered to the person, whether it was offered to any employee, and why the person was not eligible.

Item

Changes/Reason

Text

Population

RJ01AA

Omitted / Not needed analytically

Some people are in temporary jobs that last only for a limited 
time or until the completion of a project. {Is/Was} {your/{PERSON}’s}
job at {EMPLOYER} temporary?

YES ................................... 1 {RJ01AAA}
NO .................................... 2 {RJ01AAA}
REF ................................... -7 {RJ01AAA}
DK .................................... -8 {RJ01AAA}

All person-employer pairs created during a previous round where employer is a current-main job.

RJ01AAA

Omitted / Not needed analytically

{Is/Was} {your/{PERSON}’s} job at {EMPLOYER} a year round job or 
{is/was} it only available during certain times of the year?

[Teachers and other school personnel who work only during the
school year should consider themselves to have a year round job.]

YEAR ROUND ............................ 1 {BOX_03A}
NOT YEAR ROUND ........................ 2 {BOX_03A}
REF ................................... -7 {BOX_03A}
DK .................................... -8 {BOX_03A}

All person-employer pairs created during a previous round where employer is a current-main job.

RJ03

Omitted / Not critical to MEPS purpose or mandate

Wages can change for many reasons. What is the main reason
there has been a change in the amount {you/{PERSON}} {make/makes}
through {ESTABLISHMENT}?

PROMOTION OR DEMOTION ................. 1 {BOX_04}
CHANGE IN RESPONSIBILITIES ............ 2 {BOX_04}
PAY RAISE OR PAY DECREASE ............. 3 {BOX_04}
ANNUAL COST OF LIVING INCREASE ........ 4 {BOX_04}
NEW CONTRACT .......................... 5 {BOX_04}
CHANGE IN NUMBER OF HOURS WORKED ...... 6 {BOX_04}
CHANGE IN SHIFT TIME .................. 7 {BOX_04}
RECEIVED AN EDUCATIONAL DEGREE ........ 8 {BOX_04}
TOOK SPECIAL CLASSES .................. 9 {BOX_04}
OTHER ................................. 91 {RJ03OV}
REF ................................... -7 {BOX_04}
DK .................................... -8 {BOX_04}

All person-employer pairs created during a previous round where employer is a current-main job.

RJ03OV

Omitted / Never edited or released to public

[Enter Other Specify] ................. {BOX_04}
REF ................................... -7 {BOX_04}
DK .................................... -8 {BOX_04}

All person-employer pairs created during a previous round where employer is a current-main job.

RJ06A

Omitted / Not needed analytically

Some people are in temporary jobs that last only for a limited 
time or until the completion of a project. {Is/Was} {your/{PERSON}’s}
job at {EMPLOYER} temporary?

YES ................................... 1 {RJ06AA}
NO .................................... 2 {RJ06AA}
REF ................................... -7 {RJ06AA}
DK .................................... -8 {RJ06AA}

All person-employer pairs created during a previous round where employer is a current-miscellaneous job.

RJ06AA

Omitted / Not needed analytically

{Is/Was} {your/{PERSON}’s} job at {EMPLOYER} a year round job or 
{is/was} it only available during certain times of the year?

[Teachers and other school personnel who work only during the
school year should consider themselves to have a year round job.]

YEAR ROUND ............................ 1 {BOX_05AA}
NOT YEAR ROUND ........................ 2 {BOX_05AA}
REF ................................... -7 {BOX_05AA}
DK .................................... -8 {BOX_05AA}

All person-employer pairs created during a previous round where employer is a current-miscellaneous job.

RJ08AAAA

Omitted / Not critical to MEPS purpose or mandate

{Were/Was} {you/{PERSON}} not eligible for insurance because 
{you/he/she} {have/has} not worked long enough, because {you/he/she} 
{don’t/doesn’t} work enough hours, because {you/he/she} {are/is} on 
call, because of medical problems, or because of some other reason?

IF MORE THAN ONE REASON, PROBE FOR MAIN REASON.

HASN’T WORKED LONG ENOUGH ............. 1 {BOX_05A}
DOESN’T WORK ENOUGH HOURS ............. 2 {BOX_05A}
ON CALL ............................... 3 {BOX_05A}
MEDICAL PROBLEM ....................... 4 {BOX_05A}
SOME OTHER REASON ..................... 91 {RJ08AAOV}
REF ................................... -7 {BOX_05A}
DK .................................... -8 {BOX_05A}

All person-employer pairs created during a previous round where employer is a current job.

RJ08AAOV

Omitted / Never edited or released to public

[Enter Other Specify] ................. {BOX_05A}
REF ................................... –7 {BOX_05A}
DK .................................... –8 {BOX_05A}

All person-employer pairs created during a previous round where employer is a current job.

Satisfaction with Health Plan (SP)

The Satisfaction with Health Plan section collects satisfaction information for private insurance, Medigap, Medicare managed care programs, Medicaid/SCHIP, and TRICARE insurance. The information collected includes ease of access to medical care, need to seek approval for medical treatments and delays in care experienced while waiting for approval, ease of access to understandable plan information and repercussions of poor access, need to complete paperwork and problems filling out paperwork, and an overall rating of the health plan. 

Item

Changes

Text

Population

Entire Section

Omitted / Not needed analytically


All RUs


Time Period Covered Detail (HQ)

This section clarifies the timeframe for which each person was covered by each reported health insurance policy. It links to the Health Insurance (HX), Private Health Insurance Detail (HP), and Old Public Related Insurance (PR) sections. 

Changes: None



Method of Collection:

There are no changes to the current data collection methods.

Estimated Annual Respondent Burden:

There are no changes to the current burden estimates.

Estimated Annual Costs to the Federal Government:

There are no changes to the current cost estimates.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorDHHS
File Modified0000-00-00
File Created2021-01-24

© 2024 OMB.report | Privacy Policy