U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality (AHRQ); and Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).
The MEPS Household Component (HC), the core survey, is an interviewer-administered computer-assisted personal interview household survey. The Self-Administered Questionnaire (SAQ) and Diabetes Care Survey (DCS) are supplementary self-administered paper questionnaires.
The sampling frame for the MEPS-HC is drawn from respondents to the National Health Interview Survey (NHIS), conducted by NCHS. The MEPS-HC augments NHIS by selecting a sample of NHIS respondents, collecting additional data on their health care expenditures, and linking these data with additional information from the respondents' medical providers, employers, and insurance providers.
Each year a new panel of households is selected from among those households that participated in the previous year's NHIS. Data covering 2 calendar years of information are collected for each new annual sample (referred to as a panel), through a series of five rounds of data collection over a 2 1/2-year period. This series of data collection activities is repeated each year on a new sample of households, resulting in overlapping panels of survey data. MEPS annual data are based on information from two separate panels, the panel that began that year and the panel that began in the previous year.
NHIS provides a nationally representative sample of the U.S. civilian non-institutionalized population, with oversampling of Hispanics and Blacks. Starting in 2006, NHIS oversamples Asians as well. In addition to the oversampling by NHIS, MEPS oversamples policy-relevant groups such as low-income households.
MEPS consists of three component surveys: the HC, the Medical Provider Component, and the Insurance Component. The MEPS-HC collects detailed data on demographic characteristics, health conditions, health status, use of medical care services, charges and payments, access to care, satisfaction with care, health insurance coverage, income, and employment. The data for the NHQR and NHDR are primarily from the following sections of the 2002-2016 MEPS-HC:
SAQ: This paper questionnaire collects data on a variety of adult health and health care quality measures.
DCS: This paper questionnaire, given to persons identified as ever having had diabetes, asks about their diabetes care, such as services rendered.
Child Health and Preventive Care (CHPR) section: Starting in 2001, the CHPR section was added to the MEPS-HC interviews during the second half of the year. It included health care quality measures taken from the health plan version of CAHPS® (Consumer Assessment of Healthcare Providers and Systems); the Children With Special Health Care Needs screener questions; children's general health status as measured by several questions from the General Health Subscale of the Child Health Questionnaire; Columbia Impairment Scale questions about possible child behavioral problems; and child preventive care questions. Before 2001, the CAHPS questions and the Children with Special Health Care Needs screener questions had been in the Parent-Administered Questionnaire. Therefore, estimates from 2001 may not be comparable with estimates for 2000 or earlier years.
Access to Care: The Access to Care section of the MEPS-HC gathers information on five main topic areas: family members' origins and preferred languages; family members' usual source of health care; characteristics of usual source of health care providers; satisfaction with and access to the usual source of health care provider; and access to medical treatment, dental treatment, and prescription medicines.
Preventive Care: For each person, a series of questions was asked primarily about the receipt of preventive care or screening examinations.
Like the NHIS population from which its sample is drawn, the MEPS-HC is a nationally representative survey of the U.S. civilian non-institutionalized population.
The MEPS-HC collects data on demographic characteristics, including age, gender, race, ethnicity, education, industry and occupation, employment status, household composition, and family income. Race and ethnicity variables and categories changed in 2002 in compliance with Office of Management and Budget standards.
MEPS is the third in a series of national probability surveys conducted by AHRQ on the financing and use of medical care in the United States. The National Medical Care Expenditure Survey was conducted in 1977, the National Medical Expenditure Survey was conducted in 1987, and MEPS, an annual survey, began in 1996.
National; four U.S. Census Bureau regions; selected States; metropolitan and nonmetropolitan areas; and urban-rural areas, based on frameworks such as the 2006 and 2013 Urban-Rural Classification Scheme for Counties (https://www.cdc.gov/nchs/data_access/urban_rural.htm).
Estimates in the NHQR and NHDR Data Tables appendix that are based on MEPS data are weighted to reflect the experiences of the U.S. civilian non-institutionalized population. Standard errors of the estimates were derived using SUDAAN statistical software, which factors in MEPS complex survey design. MEPS estimates are suppressed when they are based on sample sizes of fewer than 100, or when their relative standard errors are 30% or more.
The combined response rate for MEPS, which includes the NHIS response rate, ranged from 46% to 65% during the 2002 to 22016 period.
Agency home page: http://www.ahrq.gov.
Data system home page: http://www.meps.ahrq.gov.
Cohen J. Design and methods of the Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 1. Rockville, MD: Agency for Health Care Policy and Research; 1997. AHCPR Publication No. 97-0026. Available at: http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr1/mr1.pdf.
Cohen JW, Monheit AC, Beauregard KM, et al. The Medical Expenditure Panel Survey: a national health information resource. Inquiry 1996/1997; 33:373-89. Rockville, MD: Agency for Health Care Policy and Research; 1997. AHCPR Publication No. 97-R043.Available at: http://www.meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Journal+Articles&opt=3&id=324.
Cohen S. Sample design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 2. Rockville, MD: Agency for Health Care Policy and Research; 1997. AHCPR Publication No. 97-0027. Available at: http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr2/mr2.pdf.
Cohen SB. Sample design of the 1997 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 11. Rockville, MD: Agency for Healthcare Research and Quality; 2000. AHRQ Publication No. 01-0001. Available at: http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr11/mr11.pdf.
Ezzati-Rice TM, Rohde F, Greenblatt J. Sample design of the Medical Expenditure Panel Survey Household Component, 1998-2007. MEPS Methodology Report No. 22. Rockville, MD: Agency for Healthcare Research and Quality; March 2008. Available at: http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr22/mr22.pdf.
Chowdhury, SR, SR Machlin, KL. Gwet. Sample Designs of the Medical Expenditure Panel Survey Household Component, 1996-2006 and 2007-2016. Methodology Report 33. Rockville, MD: Agency for Health Care Policy and Research, 2019. https://meps.ahrq.gov/data_files/publications/mr33/mr33.pdf