Attachment 3 -- HC MEPS A Survey of Health Care Use and Spending

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A Survey of Health
Care Use and
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Agency for Healthcare Research and Quality
Advancing Excellence in Health Care • www.ah rq.gov

What Is MEPS?
The Medical Expenditure Panel Survey (MEPS) is a family of
surveys on the financing and use of medical care in the United
States. It is conducted by the Agency for Healthcare Research
and Quality (AHRQ). MEPS collects data on:
•

The health services that Americans use and how frequently
they use them.

•

The cost of these services and how they are paid for.

•

Health insurance coverage.

•

Household income and employment.

•

The quality of health care.

The survey features five rounds of interviewing covering two full
calendar years of information. This panel design makes it
possible to determine how changes in respondents' health
status, income, employment, eligibility for public and private
insurance coverage, use of services, and payment for care are
related.
All data for a household are reported by a single household
respondent. At each interview, information is collected about
each household member, and the survey builds on this
information from interview to interview.
A new MEPS panel is initiated each year. MEPS data collection
started in 1996. However, because the data are comparable to
those from earlier medical expenditure surveys conducted in
1977 and 1987, it is possible to analyze long-term trends. Each
annual sample size is about 15,000 households. Data must be
weighted to produce national estimates. Data can be analyzed at
either the person, family, or event level.

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MEPS: A Family of Surveys
MEPS consists of three separate but related surveys.

Household Component (HC):
The MEPS HC uses the sampling frame from the National Health
Interview Survey (NHIS), conducted by the National Center for
Health Statistics. This sampling frame provides a nationally
representative sample of the U.S. civilian noninstitutionalized
population and reflects an oversampling of blacks, Asians, and
Hispanics. In certain years, MEPS oversamples additional policyrelevant subgroups, such as children with disabilities or people
likely to have high medical expenses. This design allows linkage
back to the previous year's NHIS for purposes of analysis.

Medical Provider Component (MPC):

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After obtaining permission from the HC respondents, medical
providers are contacted by telephone. They provide information
that household respondents cannot accurately provide: dates of
visits, diagnosis and procedure codes, charges, and payments.
The Pharmacy Component (PC), a subcomponent of the MPC,
does not collect charges or diagnosis and procedure codes but
does collect drug detail information, including National Drug
Code (NOC) and medicine name, as well as the date the
prescription was filled and sources and amounts of payment. The
MPC is not designed to yield national estimates on its own.
These data are primarily used to supplement or replace
expenditure information reported by the household.

Insurance Component (IC):
The MEPS IC is conducted each year. It is an independent
survey of private and public-sector employers to collect data on
employer-sponsored health insurance. This survey provides
annual national and State-level estimates of the supply and cost

of private health insurance available to American workers and is
used to evaluate policy issues pertaining to health insurance.
Data obtained in the IC include the number and type of private
health insurance plans offered , benefits associated with these
plans, premiums, contributions by employers and employees,
eligibility requirements, and employer characteristics.

Who Uses MEPS?
MEPS provides policymakers, health care administrators,
businesses, and the press with timely information on the
determinants of health care use, spending, quality, and insurance
coverage. In fact, the Institute of Medicine has indicated that
MEPS prod uces the most comprehensive data on America's use
of health services and how health care is paid for. The Bureau of
Economic Analysis uses national estimates of employer
contributions to group insurance derived from the MEPS IC when
computing the Gross Domestic Product (GDP).

Data Availability
The primary method of MEPS data dissemination is through the
MEPS Web site. All public-use data files can be downloaded free
of charge from the MEPS Web site: www.meps.ahrq.gov.
Besides being the primary source of MEPS public-use data files,
the Web site contains:
•
Useful background information on MEPS.
•

Electronic versions of MEPS publications (Statistical Briefs,
Methods Reports, Chartbooks, and Findings Reports) .

•

Information on the onsite data center.

•

Copies of survey instruments.

•

Tabular data.

•

MEPSnet-an interactive query tool that facilitates the
analysis of MEPS HC and IC data in a nonprogramming
easy-to-use environment.

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The Web site also allows users to subscribe to mailing lists and
receive email notifications when new data products and
publications are available.
Researchers are invited to sign up to participate in the MEPS list
server. It is a moderated forum designed to facilitate free
exchange of ideas and information about MEPS. Currently more
than 400 data users have subscribed.
Periodically, MEPS user workshops are conducted. The Web site
contains information on planned workshops and enrollment
information.

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For reasons of confidentiality, some of the MEPS data cannot be
publicly released. To allow outside researchers selected access
to these data, AHRQ has established an onsite data center. The
AHRQ Data Center is located in Rockville, Maryland. Outside
researchers whose research meets certain AHRQ criteria are
allowed to use confidential data for research purposes only,
under AHRQ supervision. They are not allowed to take
confidential data off the AHRQ premises. Data Center
researchers conduct their own analyses on stand-alone PCs with
minimal assistance from AHRQ staff. Arrangements can also be
made to utilize nonpublic MEPS data at Census Bureau
Research Data Centers.
For more information and application procedures, see the Data
Center section of the MEPS Web site.

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•

Sample MEPS Findings
MEPS produces a variety of publications that summarize
important health information. Selected findings from MEPS have
garnered significant national media attention. Some examples are
shown here.
In 2011, an estimated total of $1.33 trillion was spent for
health care. This total includes hospital inpatient and
outpatient care, emergency room services, office-based
medical provider services, dental services, and others.

Percentage distribution of health care spending, by
type of service, U.S. civilian noninstitutionalized
population, 20 I I

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•

Hospital inpatient

D
D

Office-based visits

•

Hospital outpatient

Prescribed medicines

•

Dental

D

Emergency room

•

Home health care
Other medical services
and equipment

Total expenses = $1.33 trillion
Note: Percentages do not add to exactly 100% due to rounding .
Source: Statistical Brief #425 : National Health Care Expenses in the
U.S. Civilian Noninstitutionalized Population , 2011 .

The national average expenditure for prescription drugs in
2010 for all persons who had an expenditure was $1,432.
The average expenditures for those in New York ($1,517),
Florida ($1,537), Michigan ($1,642), and North Carolina
($1,602) were all higher than the national average.

Mean prescription drug expenditures for persons who
had an expenditure in 20 I0, United States and I0 largest
States
2000
1,642

1500

1,432

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Source: Statistical Brief #413: Prescription Drug Expenditures in the 10
Largest States, 2010.

From 1996 to 2012, the proportion of those under age 65
who were uninsured for the entire year ranged from 12.4
percent to 15.5 percent.

Percentage of uninsured under age 65, 1996-2012

--+- Any time in year

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year

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18.8 18.5 18.8 19.0

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15.2 15.4 15.5 15.0

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13.3 13.3 13.4 13.7 14.1 14.1 14.3

14.5

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1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Source: Statistical Brief #420: The Uninsured in America, 1996-2012:
Estimates for the U.S. Civilian Noninstitutionalized Population Under
Age 65.

Employee contributions for family premiums in Florida
($5,490, or 35.5 percent of the premium) were higher than
the national average of $4,236, or 27.4 percent of the
premium; while those for Michigan ($3,507, or 24.4 percent
of the premium), Pennsylvania ($3,601, or 23.4 percent of
the premium), and Illinois ($3, 796 or 24. 1 percent of the
premium) were lower than the national average.

Average annual employee premium contributions for
family health insurance coverage at private-sector
establishments in 2012, United States and I0 largest
States
Family coverage

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State

Dollars

Percentage
of premium

United States
California
Texas
New York
Florida
Illinois
Pennsylvania
Ohio
Michigan
Georgia
North Carolina

$4,236
$4,193
$4,535
$4,289
$5,490
$3,796
$3,601
$3,878
$3,507
$4,473
$4,529

27.4%
26.4%
31 .0%
25.3%
35.5%
24.1%
23.4%
25.1%
24.4%
30.5%
29.0%

Source: Statistical Brief #418: State Differences in the Cost of
Job-Related Health Insurance, 2012.

Contact Information:
mepsprojectd [email protected]
301-427-1406

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