MEPS-MPC Sample Design and Data Collection
Process
The Medical Provider Component (MPC) of MEPS is a survey of hospitals,
physicians, and other medical facilities that provided care to
sampled household members in the course of the survey year. Patients
in sampled households were asked to sign permission forms authorizing
contact with their health care providers. The purpose of the MPC
is to supplement and verify information provided by household respondents
about the charges, payments, and sources of payment associated
with specific health care encounters. This is important because
people cannot always answer questions about the health services
they received and about the cost of those services. The data collected
from the MPC is not designed to be a nationally representative
sample. The information is used solely for editing and imputation
purposes on the Household Component. Therefore, this data will
not be released as a stand-alone file. This data is collected once
for each calendar year of data in the year following the referent
year.
The following types of care and providers were included in the
MPC sample:
- Office-based medical doctors (MDs), doctors of osteopathy (DOs),
and other medical providers under the supervision of MDs and DOs
- Hospital facilities providing inpatient, outpatient and emergency
room care; for hospital care, the provider was defined so as to
include both the hospital facility and all individually identified
physicians who treated the patient at the hospital, but who bill
separately
- Home health care agencies
- Long-term care institutions
Dentists, optometrists, psychologists, podiatrists, chiropractors
and others not providing care under the supervision of an MD or
DO were considered out of scope for the MPC.
The MPC sample was designed to target specific types of individuals
and providers for whom household reported expenditure data was
expected to be insufficient. All inpatient hospital stays and home
health agencies that provided services to household respondents
were included in the MPC. Other providers were subsampled at varying
rates. In addition, households with one or more Medicaid enrollee
and households with one or more persons enrolled in an HMO or managed
care plan were also targeted for inclusion in the MPC because those
groups were expected to have limited information about payments
for their medical care. These households were included in the sample
for the MPC at a higher rate than other households. Once a household
was selected for the sample, all in-scope medical care providers
associated with care to persons in those households became part
of the MPC sample.
The MPC questionnaires are designed to obtain information on both
the medical and financial characteristics of medical events. For
office and hospital events, this includes diagnoses, procedure
and inpatient stay codes (CPT-4s and DRGs), charges or charge equivalents
(where available) before any contractual adjustments or discounts,
sources and amounts of all payments made, and the reasons for any
difference between charges and payments. The home health questionnaire
asks for the type of practitioner who provided the service and
the number of hours of service or visits provided during the applicable
month. Home health charges and payments also are collected on a
monthly basis.
The MPC will serve as an imputation source to reduce the level
of bias in survey estimates of medical expenditures due to item
non-response and household data of questionable quality. Its' purpose
is to supplement household reported data and it is not intended
to be an independent sample of providers for estimation purposes.
If the respondent with the prescription gave written permission
to release his or her pharmacy records, pharmacy providers identified
by the household were contacted by
telephone for the pharmacy follow-back component. Following an
initial telephone contact, the signed permission forms and materials
explaining the study were faxed (or mailed)
to cooperating pharmacy providers. The materials informed the
providers of all persons participating in the survey who had
prescriptions filled at their place of business and
requested a computerized printout of all prescriptions filled
for each person. For each medication listed, the following information
was requested: date filled, national drug code
(NDC), medication name, strength of medicine (amount and unit),
quantity (package size/amount dispensed), total charge, and
payments by
source.
Home Care Provider Booklet. This questionnaire is used to collect
data from home health care agencies which provide medical care
services to household respondents. Information collected includes
type of personnel providing care, hours or visits provided per
month, and the charges and payments for services received.
Home Care Provider Booklet for Non-health Care Providers. This
is used to collect information about services provided in the home
by non-health care workers to household respondents because of
a medical condition; for example, cleaning or yard work, transportation,
shopping, or child care.
Institutional Event Form for Non-hospital Facilities. This form
is used to collect information on services and expenditures for
persons from the household sample who were admitted to a nursing
home, rehabilitation center, or other non-hospital institution
during the survey year.
Medical Event Booklet for Office-based Providers. This questionnaire
is for the office-based physician sample, including doctors of
medicine (MDs) and osteopathy (DOs), as well as providers practicing
under the direction or supervision of an MO or DO (e.g.,physician
assistants and nurse practitioners working in clinics). Providers
of care in private offices as well as staff model HMOs were included.
Medical Event Booklet for Separately Billing Doctors. Information
from physicians identified by hospitals as providing care to sampled
persons during the course of inpatient, outpatient department or
emergency room care, but who bill separately from the hospital,
is collected in these questionnaires.
Hospital Event Form. This questionnaire is used to collect information
about hospitals events, including inpatient stays, outpatient department
and emergency room visits. Hospital data were collected not only
from the billing department, but the medical records and administrative
records departments as well. Medical records was contacted to determine
the names of all the doctors who treated the patient during a stay
or visit. In many cases, the hospital administrative office also
had to be contacted to determine whether the doctors identified
by medical records billed separately from the hospital itself.
Suggested
Citation:
MEPS-MPC Sample Design and Data Collection Process.
October 2004. Agency for Healthcare Research and Quality,
Rockville,
MD. http://www.meps.ahrq.gov/survey_comp/mpc_
data_collection.jsp
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