2.2 Budget Line 2—Medical Expenditure Panel Survey (MEPS)

Funding Levels

Fiscal Year 1999: $29,300,000 (Enacted).
Fiscal Year 2000: $36,000,000 (Enacted).
Fiscal Year 2001: $40,850,000 (Fiscal Year 2001 Request).

AHRQ's Medical Expenditure Panel Survey (MEPS) collects detailed information regarding the use and payment for health care services from a nationally representative sample of Americans. No other surveys supported by the Federal Government or the private sector provide this level of detail regarding:

• The health care services used by Americans at the household level and their associated expenditures (for families and individuals).
• The cost, scope, and breadth of private health insurance coverage held by and available to the U.S. population.
• The specific services that are purchased through out-of-pocket and/or third-party payments.

This level of detail enables public and private-sector economic models to develop national and regional estimates of the impact of changes in financing, coverage, and reimbursement policy and estimates of who benefits and who bears the cost of a change in policy. No other survey provides the foundation for estimating the impact of changes on different economic groups or special populations of interest, such as the poor, elderly, veterans, the uninsured, or racial/ethnic groups.

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GPRA Goal 6: Collect current data and create data tapes and associated products on health care use and expenditures for use by public and private-sector decisionmakers and researchers. (Medical Expenditure Panel Survey—MEPS)

Strategy

AHRQ will continue to assess the essential components of the MEPS program—development of new, updated, or otherwise enhanced databases; creation of products for use by researchers and policymakers outside AHRQ; and facilitation of the use of MEPS-related products.

Previous Successes

By mid-Fiscal Year 1999, the MEPS program:

• Released seven major data files.
• Released eight Findings, three chartbooks, and nine highlights.
• Released three methods reports

Additionally, the MEPS program:

• Provides technical assistance to more than 80 persons each month, usually within 2 working days of the request.
• Has a fully operational Web site, averaging nearly 3,000 hits and 160 user sessions each day.
• Has developed an active LISTSERV® that allows MEPS users to consult with each other.
• Conducted six user 3-hour workshops in Fiscal Year 1999. Based on customer feedback, there will not be as many, but they will be two days each.

Select for Figure 4: Percent of Women Reporting Fair/Poor Health, by Race/Ethnicity.

Types of indicators

Process and output indicators are used for Goal 6 to present information on the core activities of MEPS. Process indicators reflect major enhancements to the MEPS to support expanding Agency activities in data development and quality measurement. Output indicators present the data on the release of data products for public use that are scheduled annually.

Use of results by AHRQ

The Fiscal Year 1999 results present a thorough review of AHRQ's success in the data collection and development and release of data products and publications associated with MEPS database.

Data Issues

Many of these indicators are yes/no indicators where the data collection or product release happened as scheduled, or didn't. The evidence of successful completion of the indicators will be available on the AHRQ Web site, where products can be accessed. Other data will come from contract monitoring files. Where deadlines have been missed, the Agency determined the cause for the delays and is making the necessary corrections. Beginning with the Fiscal Year 2000 performance report, AHRQ will include the results of evaluations in Section 4.2 of the use of the MEPS products.

GPRA Goal 6—Fiscal Year 1999 Results

Objective 6.1: Release and disseminate MEPS data and information products in timely manner for use by researchers, policymakers, purchasers, and plans. (MEPS).

Indicator

Core MEPS public use files (PUFs) available through Web site and CD-ROM within 9-12 months after data collection completed.

Results

Significant progress towards releasing public use files within a year after data collection has been made.

Indicator

Specific products due in Fiscal Year 1999:

2a. 1997 point-in-time file.
2b. 1996 full-year expenditure file.
2c. 1996 full-year event, job, and condition files.
2d. 1998 point-in-time file.

Results

Specific products:

2a. Delivered March 1999.
2b. December 1999.
2c. Job and Condition Files delivered November 1999 and August 1999 respectively; event files will be available by March 2000.
2d. December 1999.

Indicator

Research findings and survey reports developed and disseminated for use by policymakers and researchers including MEPS Research Findings, MEPS Highlights, Chartbooks, peer-reviewed journal articles, book published on contributions of expenditure surveys to policy making, publications oriented toward non-researchers.) Baseline in Fiscal Year 1998: Total of 27 findings or reports produced.

Results

In Fiscal Year 1999, the following MEPS related products were published:

• Five Findings.
• Five Methods reports.
• Two Highlights.
• Two Chartbooks.
• A book on expenditure surveys and policy making.
• Twelve peer-reviewed papers.
• Three book chapters (excluding book).
• Numerous presentations and proceedings.

Indicator

Customer satisfaction data from use of MEPS tapes and products was rated at 85 percent. (Baseline: Fiscal Year 99 results.)

Results

From our baseline Web site survey, the percentages of respondents rating products as good, very good or excellent follows:

• Data files on Web: 92 percent.
• Data files on CD: 86 percent.
• Publications: 93-96 percent.

This survey was conducted under the clearance of the Agency's generic customer satisfaction survey approval.

Indicator

Requests received from policy makers, purchasers and plans for MEPS data tapes, analyses, and/or reports responded to within promised time frames 85 percent of the time. Baseline data: 5 working days is the current standard.

Results

All requests received by the Center responsible for MEPS were responded to within 5 working days of request. Efforts continue to decrease the response time.

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Objective 6.2: Facilitate use of MEPS data and associated products as tools by extramural researchers, policymakers, purchasers, and plans.

Indicator

Inclusion of MEPS data in extramural research grants with AHRQ and other funders. Baseline: 1999 is the first year where the MEPS data have been available in time to be included in research applications.

Results

Of the 20 grant applications using MEPS data that were received, 5 were funded.

Indicator

Plan for extramural researcher access to MEPS data fully implemented.

Results

The implementation of the plan for providing access to extramural researchers was delayed due to unanticipated complications related to insuring that the Department privacy standards were fully implemented and delays in equipment delivery. The plan is expected to be fully implemented in February 2000.

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Objective 6.3: Modify and enhance MEPS to enable reporting on the quality of health care in America.

Indicator

MEPS Household Survey: Interviews with 9,000 previously surveyed families to obtain calendar year 1998 health care data, and with 5,600 new families. The MEPS Household Component is a nationally representative survey of the U.S. civilian noninstitutionalized population which collects medical expenditure data at both the person and household levels. The Household Component 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.

Results

All data collection is successfully ongoing.

Indicator

MEPS Medical Provider Survey: Interviews with approximately 3,000 facilities, 12,000 office-based providers, 7,000 hospital-identified physicians, and more than 500 home health providers.

Results

All data collection is successfully ongoing.

Indicator

MEPS Insurance Component (MEPS-IC): Interviews with more than 40,000 employers and 1,000 insurance carriers.

Results

All data collection is successfully ongoing.

Indicator

MEPS data collection successfully moved to ongoing survey mode from data collection every ten years.

Results

All data collection is successfully ongoing.

GPRA Goal 6—Fiscal Year 2000 and 2001 Indicators

Objective	Fiscal Year 2000 Indicator	Fiscal Year 2001 Indicator
Objective 6.1: Release and disseminate MEPS data and information products in timely manner for use by researchers, policymakers, purchasers, and plans (MEPS).	Core MEPS public use files (PUFs) available through Web site and CD-ROM within 9-18 months after data collection completed. Specific products due in Fiscal Year 2000: 1999 point-in-time file. 1997 expenditure data available. 1996 full panel file available. Customer satisfaction data from use of MEPS tapes and products rated at least 90 percent. (Baseline: 86 percent-96 percent. See Fiscal Year 1999 results for details.) Response time for requests received from policymakers, purchasers and plans for MEPS data tapes, analyses, and/or reports responded to within promised time frames 95 percent of time. (Baseline: 100 percent responded to within 5 days.)	Core public use data files available within a year of the end of data collection (except the full-year expenditure file, which will be available 18 months after the end of data collection.) Budget: Commitment Base. Response time for requests received for information, assistance or specific products is as promised 90 percent of time. Budget: Commitment Base.
Objective 6.2: Facilitate use of MEPS data and associated products as tools by extramural researchers, policymakers, purchasers, and plans.	Data centers operational: xx requests for use of the centers. xx user-days at the data centers. xx projects completed. These are the categories AHRQ will track in the beginning of the data centers program to illustrate that the program has been established successfully and is fully operational. Baseline to be established in Fiscal Year 2000 when the data centers program begins.	Increase number of Data Center user days by 20 percent over Fiscal Year 2000 baseline. Budget: Commitment Base. Distribution of MEPS data sets to 1,000 users. Budget: Commitment Base.
Objective 6.3: Modify and enhance MEPS to enable ongoing reporting on the quality of health care in America.	The design decisions necessary for the expansion of MEPS databases in order to collect data that will support the National Healthcare Quality Report are completed by August 2000. The design decisions will be operationalized in the coming fiscal years.	Data collection begins on the treatment of common clinical conditions over time for a nationally representative portion of the population in support of the National Healthcare Quality Report. Select for Budget: The National Healthcare Quality Report.

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2.3 Budget Line 3—Program Support

Funding Levels

Fiscal Year 1999: $2,341,000 (Enacted).
Fiscal Year 2000: $2,484,000 (Enacted).
Fiscal Year 2001: $2,500,000 (Fiscal Year 2001 Request).

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Goal 7: Support the overall direction and management of AHRQ (PS)

This goal involves supporting the overall direction and management of AHRQ through prudent acquisition performance management, capital asset planning, personnel support and information technology planning.

Types of indicators

Outcome indicators that document customer satisfaction with two major functions within the Agency are used.

Use of results by AHRQ

The scores for each of the measures, in combination with the written comments received in the survey, continue to be used to improve the acquisition systems and the Intranet.

Data Issues

The data collection is accomplished through customer surveys administered to Agency staff annually.

GPRA Goal 7—Fiscal Year 1999 Results

Objective 7.1: Provide prudent planning for all capital assets.

AHRQ included this objective in the plan because we understood we needed to acknowledge this requirement. However, the Agency has no capital assets and didn't include any indicators.

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Objective 7.2: Maintain acquisition performance management system to ensure: (1) timely completion of transactions, (2) vendor and customer satisfaction, and (3) efficient and effective use of resources.

Indicator

Internal customer satisfaction was rated at minimum of 4.5/5. Baseline in Fiscal Year 1998 - 4.2/5.

Results

4.4/5.

Indicator

External customer satisfaction was rated at 4/5. Baseline in Fiscal Year 1998 - 3.6/5.

Results

4.0/5.

Indicator

Customer satisfaction survey results assessed and used to implement changes to improve and enhance services.

Results

The results of the 1998 Procurement Customer Survey were distributed to the Agency on June 3, 1999. Improvements were noted over the 1997 survey. As a result of the improvements, no new areas for process improvements have been specifically targeted. We are, however, continuing to focus on increasing communication with our customers and improving the service that we provide.

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Objective 7.3: Continued enhancement and expansion of Agency Intranet site to ensure staff have immediate access to all current information. The site covers Agency administrative and operational processes, procedures, and policies. It also covers information on ongoing health care research as well as results and findings from all the research supported by the Agency.

Indicator

Customer satisfaction rated at minimum of 3.5/4. Baseline in Fiscal Year 1998 - 2.9/4.

Results

3.1/4. The survey was completed before the release of the revised Intranet, so problems identified by staff had not been fixed. The scores are expected to improve in the next survey.

Indicator

Customer satisfaction surveys assessed and used to implement changes to improve and enhance services as necessary. Baseline: Based on responses to Fiscal Year 1998 survey, a totally revised Intranet will be introduced in January 1999.

Results

The revised Intranet was made available in November 1999 for beta testing and content population by office and center staff. The Beta test period will last about 60-90 days. The Intranet is essentially a living document/Web site that will become more useful as O/C staff contribute to the content.

GPRA Goal 7— Fiscal Year 2000 and 2001 Indicators

Objective	Fiscal Year 2000 Indicators	Fiscal Year 2001 Indicators
Objective 7.1: Provide prudent planning for all capital assets.	AHRQ has no major fixed (capital) assets or information systems. However, AHRQ will continue to follow the principles and guidance outlined in OMB Circular A-11 Part 3 with regard to planning, and developing fixed assets.	Deleted in Fiscal Year 2001.
Objective 7.2: Maintain acquisition performance management system to ensure: Timely completion of transactions. vendor and customer satisfaction. efficient and effective use of resources.	1. Internal customer satisfaction rated at minimum of 4.5/5. Baseline in Fiscal Year 1999 - 4.4/5. External customer satisfaction rated at 4.5/5. Baseline in Fiscal Year 1999 - 4.0/5. 2. Customer satisfaction survey results assessed and used to implement changes to improve and enhance services.	Deleted in Fiscal Year 2001.
Objective 7.3: Continued enhancement and expansion of Agency Intranet site to ensure staff have immediate access to all current information. The site covers Agency administrative and operational processes, procedures, and policies. It also covers information on ongoing health care research as well as results and findings from all the research supported by the Agency.	Customer satisfaction rated at minimum of 3.5/4. Baseline in Fiscal Year 1999 - 3.1/4. Demonstration through customer satisfaction surveys that the daily work of staff has been facilitated by the Intranet. Assessment of customer satisfaction surveys and use of such surveys to implement changes to improve and enhance services as necessary.	Deleted in Fiscal Year 2001.

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