Information Collection

MEPS-HC Core Interview

IC 37877 under ICR 201509-0935-001 · OMB 0935-0118.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0118 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 MEPS-HC Core Interview	Form
1 Attachment 1 -- MEPS-HC Section Summary and Changes Attachment 1 -- MEPS-HC Section Summary and Changes since last OMB clearance 02182015.docx meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp	Form
02-HC Why is Participation in MEPS so Important.pdf Attachment 2 - HC Why is Participation in MEPS so Important	IC Document
Attachment 4 -- HC Policy Impact Award.doc Attachment 4 -- HC Policy Impact Award	IC Document
03-HC MEPS A Survey of Health Care Use and Spending.pdf Attachment 3 -- HC MEPS A Survey of Health Care Use and Spending	IC Document
08-HC Important Information About Your Participatio in MEPS.doc Attachment 8 – HC Important Information About Your Participation in MEPS	IC Document
09-HC MEPS Data Example&FAQs.docx Attachment 9 – HC MEPS Data Example & FAQs	IC Document
10-HC Respondent Letters, Postcards and Notes.docx Attachment 10 – HC Respondent Letters, Postcards and Notes	IC Document
11-HC MEPS FAQs Brochure.docx Attachment 11 – HC MEPS FAQs Brochure	IC Document
12-HC MEPS Monthly Planner.pdf Attachment 12 – HC MEPS Monthly Planner	IC Document
13-HC MEPS Record Keeper.pdf Attachment 13 – HC MEPS Record Keeper	IC Document
14-HC Showcards.docx Attachment 14 – HC Showcards	IC Document
16-HC Certificate of Appreciation.pdf Attachment 16 – HC Certificate of Appreciation	IC Document
17-HC Who Uses MEPS Data.docx Attachment 17 – HC Who Uses MEPS Data	IC Document
24-MEPS Tip Sheet.docx Attachment 24 – HC MEPS Tip Sheet	IC Document
25-HC Tips for Making Your MEPS Interview Easier.docx Attachment 25 – HC Tips for Making Your MEPS Interview Easier	IC Document
05-HC About the MEPS-MPC Authorization Form.docx Attachment 5 – HC About the MEPS-MPC Authorization Form	IC Document
06-HC Data protection is word ONE with MEPS.doc Attachment 6 – HC Data protection is word ONE with MEPS	IC Document
15-HC Validation Letter.doc Attachment 15 – HC Validation Letter	IC Document
04-HC What MEPS tells us about...Charts.docx Attachment 4 – HC What MEPS tells us about…Charts	IC Document
Attachment 7 HC Respondent Recruitment Video Link.msg Attachment 7 – HC Respondent Recruitment Video	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

MEPS-HC Core Interview

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Attachment 1 -- MEPS-HC Section Summary and Changes	Attachment 1 -- MEPS-HC Section Summary and Changes since last OMB clearance 02182015.docx	http://meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15,093

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	37,733	0	37,733
Annual IC Time Burden (Hours)	57,857	3,773	54,084
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 2 - HC Why is Participation in MEPS so Important	02-HC Why is Participation in MEPS so Important.pdf	09/10/2015
Attachment 4 -- HC Policy Impact Award	Attachment 4 -- HC Policy Impact Award.doc	09/24/2012
Attachment 3 -- HC MEPS A Survey of Health Care Use and Spending	03-HC MEPS A Survey of Health Care Use and Spending.pdf	09/10/2015
Attachment 8 â HC Important Information About Your Participation in MEPS	08-HC Important Information About Your Participatio in MEPS.doc	09/11/2015
Attachment 9 â HC MEPS Data Example & FAQs	09-HC MEPS Data Example&FAQs.docx	09/11/2015
Attachment 10 â HC Respondent Letters, Postcards and Notes	10-HC Respondent Letters, Postcards and Notes.docx	09/11/2015
Attachment 11 â HC MEPS FAQs Brochure	11-HC MEPS FAQs Brochure.docx	09/11/2015
Attachment 12 â HC MEPS Monthly Planner	12-HC MEPS Monthly Planner.pdf	09/11/2015
Attachment 13 â HC MEPS Record Keeper	13-HC MEPS Record Keeper.pdf	09/11/2015
Attachment 14 â HC Showcards	14-HC Showcards.docx	09/11/2015
Attachment 16 â HC Certificate of Appreciation	16-HC Certificate of Appreciation.pdf	09/11/2015
Attachment 17 â HC Who Uses MEPS Data	17-HC Who Uses MEPS Data.docx	09/11/2015
Attachment 24 â HC MEPS Tip Sheet	24-MEPS Tip Sheet.docx	09/11/2015
Attachment 25 â HC Tips for Making Your MEPS Interview Easier	25-HC Tips for Making Your MEPS Interview Easier.docx	09/11/2015
Attachment 5 â HC About the MEPS-MPC Authorization Form	05-HC About the MEPS-MPC Authorization Form.docx	09/10/2015
Attachment 6 â HC Data protection is word ONE with MEPS	06-HC Data protection is word ONE with MEPS.doc	09/11/2015
Attachment 15 â HC Validation Letter	15-HC Validation Letter.doc	09/11/2015
Attachment 4 â HC What MEPS tells us aboutâ¦Charts	04-HC What MEPS tells us about...Charts.docx	09/10/2015
Attachment 7 â HC Respondent Recruitment Video	Attachment 7 HC Respondent Recruitment Video Link.msg	09/11/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.