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What is the most complete source of data on the use and costs of health care for Americans?

Adding up health care cost and coverage with MEPS

Westat has conducted the Medical Expenditure Panel Survey – Household Component (MEPS-HC) since it began in 1996. MEPS, which is funded by the Agency for Healthcare Research and Quality, is the most complete source of data on the use and costs of health care for the general civilian population of the U.S.

The major challenges of the survey are to get full and accurate reporting of health care use and expenses for household respondents over a period of 2 calendar years and deliver files ready for public use on a demanding schedule.

Each year, Westat fields a new panel of approximately 10,000 households that participated in the National Health Interview Survey in the prior year. These households are invited to participate in a series of 5 interviews over a 2½-year period. The design calls for a series of overlapping panels, making it possible each year to combine data from 2 different panels to create annual estimates for the U.S. civilian population. Respondents report detailed information on health care use and expenditures and on a variety of topics related to the use of health care, such as health insurance coverage, employment, income, health conditions, and satisfaction with health care providers.

Data collected from household respondents are supplemented with data collected from their medical providers and pharmacies.

To support the processing of MEPS data, Westat developed and maintains an Oracle® database that includes more than 50 tables and 4,000 variables. Processing requires the extensive development of constructed variables, coding of information reported as text strings, merging matched health care events and prescribed medications collected from medical providers and pharmacies, imputation for missing data, and weighting to support use of the MEPS data for estimation of key measures for the national population and for major subpopulations relevant to public policy.

Each year, Westat produces 3 major data files and a series of topic-specific files. The major data files include a point-in-time file, which provides early annual estimates of health insurance coverage; a full-year use file, which provides annual, person-level estimates of health care use; and a full-year use and expenditure file, which combines data from the household and medical provider surveys to provide estimates of expenditures for health care by major payment sources.

Westat led the design and development of a full technology upgrade to the data collection instrument and home office processing system and implemented it in the field in 2018. The goal was to seamlessly introduce the new technology without jeopardizing data quality or the annual schedule for release of the major data files.

This study uses Blaise, a comprehensive commercial, off-the-shelf (COTS) survey processing system. It provides integrated multimode support for computer-assisted survey data collection.

The MEPS Survey provides annual national estimates of the use of health care services, charges, and payments for the services, health insurance coverage, health conditions, and other items related to health care usage.

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