AHRQ: Medical Expenditure Panel Survey (MEPS) Topics

The Medical Expenditure Panel Survey, which began in 1996, is a set of large-scale surveys of families and individuals, their medical providers (doctors, hospitals, pharmacies, etc.), and employers across the United States. MEPS collects data on the specific health services that Americans use, how frequently they use them, the cost of these services, and how they are paid for, as well as data on the cost, scope, and breadth of health insurance held by and available to U.S. workers.

Major MEPS Components MEPS currently has two major components: the Household Component and the Insurance Component. The Household Component provides data from individual households and their members, which is supplemented by data from their medical providers. The Insurance Component is a separate survey of employers that provides data on employer-based health insurance.

Household Component The Household Component (HC) collects data from a sample of families and individuals in selected communities across the United States, drawn from a nationally representative subsample of households that participated in the prior year's National Health Interview Survey (conducted by the National Center for Health Statistics). During the household interviews, MEPS collects detailed information for each person in the household on the following: demographic characteristics, health conditions, health status, use of medical services, charges and source of payments, access to care, satisfaction with care, health insurance coverage, income, and employment. The panel design of the survey, which features several rounds of interviewing covering two full calendar years, 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. The HC expenditures have been projected to future years by selected demographic characteristics by source of payment and type of service. HC data are available on the MEPS Web site in data tables, downloadable data files (person, job, event, or condition level), annually projected expenditures through 2016, and interactive data tools, as well as in publications using HC data.

Insurance Component The Insurance Component (IC) collects data from a sample of private and public sector employers on the health insurance plans they offer their employees. The survey is also known as the Health Insurance Cost Study. The collected data include the number and types of private insurance plans offered (if any), premiums, contributions by employers and employees, eligibility requirements, benefits associated with these plans, and employer characteristics. IC estimates are available on the MEPS Web site in tabular form for national, regional, state, and metropolitan areas, as well as in publications using IC data and interactive data tools. IC data files are not available for public release.

Other MEPS Components MEPS also includes a Medical Provider Component (MPC), which covers hospitals, physicians, home health care providers, and pharmacies identified by MEPS-HC respondents. Its purpose is to supplement and/or replace information received from the MEPS-HC respondents. Data files containing only this supplemental respondent information are not available, but the information is incorporated into the MEPS-HC data files. In 1996 only, MEPS included a Nursing Home Component (NHC) that gathered information from a sample of nursing homes and residents nationwide on the characteristics of the facilities and services offered; expenditures and sources of payment on an individual resident level; and resident characteristics, including functional limitation, cognitive impairment, age, income, and insurance coverage. The NHC also collected data on the availability and use of community-based care prior to admission to nursing homes. For reasons of confidentiality, NHC data are available only at the Data Center located at AHRQ or at one of the Federal Statistical Research Data Centers.

The National Center for Health Statistics (NCHS) provides information on the NCHS National Nursing Home Survey (NNHS), a continuing series of national sample surveys of nursing homes, their residents, and their staff that have been conducted in 1973-74, 1977, 1985, 1995, 1997, and 1999.

Earlier Surveys and MEPS Surveys collecting data on medical expenditures began in the 1970s at a time when the structure of health care services, private insurance, Federal health care programs and the characteristics of the U.S. population were undergoing enormous change. The first of these surveys, the National Medical Care Expenditure Surveys (NMCES), was conducted in 1977. Similar to the MEPS-HC survey, NMCES had three main components: a household survey, a survey of physicians utilized by the household members, and a health insurance employer component. Approximately 14,000 households participated in six rounds of interviews over a 14-month period. In 1987, the National Medical Expenditure Survey (NMES) was conducted. Approximately 16,000 households participated in NMES, including 2,000 American Indian and Alaskan Native households. Once again, the household information was supplemented by surveys of medical and health insurance providers utilized by respondents. In 1996, the current survey, MEPS-HC, was designed to provide more timely information about the nation's changing health care system. MEPS-HC introduces a new panel or sample of households into the survey every year and is conducted continually rather than once every 10 years. MEPS-HC households are a subsample of households that participate in the National Health Interview Survey (NHIS) conducted by the National Center for Health Statistics approximately six months to a year prior to MEPS. Like the earlier surveys, the information collected in MEPS-HC from households is supplemented by surveys of medical and health insurance providers. The predecessor to the MEPS-IC was the 1994 National Employer Health Insurance Survey (NEHIS) conducted by the National Center for Health Statistics. NEHIS measured the extent, cost, and coverage of employment-based health insurance and was the first federal survey designed to produce state and national estimates of employer-sponsored health insurance. NEHIS drew extensively from two previous employer surveys: the Survey of Health Insurance Plans, sponsored by the Health Care Financing Administration (now the Centers for Medicare & Medicaid Services) and conducted in the 1980s, and the 1993 Robert Wood Johnson Foundation 10 State Employer Health Insurance Survey. In 1996, the MEPS-IC began production of an expanded set of state and national estimates on an annual basis.