Medical Expenditure Panel Survey (MEPS)
Authorizing Legislation: Federal funds pursuant to Title IX and Section 927(c) of the Public Health Service
Act.
|
FY 2004 Actual |
FY 2005 Appropriation |
FY 2006 Estimate |
Increase or Decrease |
Percent Change |
Safety/Quality |
BA |
0 |
0 |
0 |
|
|
PHS Eval |
0 |
0 |
0 |
|
|
Efficiency |
BA |
0 |
0 |
0 |
|
|
PHS Eval |
$55,300,000 |
$55,300,000 |
$55,300,000 |
$- |
0.00% |
Effectiveness |
BA |
0 |
0 |
0 |
|
|
PHS Eval |
0 |
0 |
0 |
|
|
Organizational Excellence |
BA |
0 |
0 |
0 |
|
|
PHS Eval |
0 |
0 |
0 |
|
|
Total |
BA |
0 |
|
|
|
|
PHS Eval |
$55,300,000 |
$55,300,000 |
$55,300,000 |
$ - |
0.00% |
FTEs |
NA |
NA |
NA |
|
|
A. Statement of Budget
A total of $55,300,000 is provided for Medical Expenditure Panel Survey (MEPS). These funds
will be used to support the contracts and IAAs used for the conduct of the MEPS.
B. Program Description
The MEPS is the only national source for annual data on how Americans use and pay for
medical care. It supports all of AHRQ's research related strategic goal areas. The survey
collects detailed information from families on access, use, expense, insurance coverage and
quality. Data are disseminated to the public through printed and web-based tabulations, micro
data files and research reports/journal articles.
The data from the MEPS have become a linchpin for the public and private economic models
projecting health care expenditures and utilization. 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, as well as estimates of who benefits
and who bears the cost of a change in policy. No other surveys provide 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. Government
and non-governmental entities rely upon these data to evaluate health reform policies, the effect
of tax code changes on health expenditures and tax revenue, and proposed changes in
government health programs such as Medicare. In the private sector (e.g., RAND, Heritage
Foundation, Lewin-VHI, and the Urban Institute), these data are used by many private
businesses, foundations and academic institutions to develop economic projections. These
data represent a major resource for the health services research community at large. Since
2000, data on premium costs from the MEPS Insurance Component have been used by the
Bureau of Economic Analysis to produce estimates of the GDP for the nation. In addition, the
MEPS establishment surveys have been coordinated with the National Compensation Survey
conducted by the Bureau of Labor Statistics through participation in the Inter-Departmental
Work Group on Establishment Health Insurance Surveys.
C. Performance Analysis
The MEPS is part of AHRQ's Efficiency strategic plan area and the Data Development Portfolio.
The first MEPS data (from 1996) became available in April 1997. This rich data source has
become not only more comprehensive and timely, but MEPS' new design has enhanced
analytic capacities, allowed for longitudinal analyses, and developed greater statistical power
and efficiency. During the last few years, AHRQ has developed a series of Statistical Briefs
using MEPS data. These briefs, released on the MEPS Web site, provide timely statistical
estimates on topics of current interest to policymakers, medical practitioners and the public at
large. During 2004, topics included diabetes, obesity, expenditures and insurance coverage.
MEPS has also met all of its performance goals in terms of data products and data release.
National Survey Details Changes in Expenses for Prescribed Medications
In 1987, approximately 57 percent of the 239.4 million persons in the U.S. civilian
noninstitutionalized population purchased 1.2 billion prescribed medicines at a total expenditure
of $35.1 billion (in 2002 dollars), while in 2002 approximately 64 percent of 288.2 million
persons purchased close to 2.7 billion prescribed medicines for $151 billion. For those with a
prescribed medicine expense, average total expenditures for prescribed medicines rose
significantly from 1987 to 2002, from $256 in 1987 (in 2002 dollars) to $812 in 2002.
A similar pattern was observed when comparing average total out-of-pocket expenditures for prescribed
medicines for those with a prescribed medicine expense, going from $146 in 1987 (in 2002
dollars) to $344 in 2002 (Figure 1, 11 KB).
State Differences in the Cost of Job-Related Health Insurance, 2002
Nationwide, the average premiums were $3,189 for single coverage, $6,043 for employee-plusone
coverage, and $8,469 for family coverage. Among the 10 largest states, single premiums
ranged from $2,936 in California to $3,458 in Illinois, employee-plus-one premiums ranged from
$5,306 in Georgia to $6,778 in New Jersey, and family premiums ranged from $7,944 in
Georgia to $9,424 in New Jersey. Contributions towards health insurance premiums made by
employees nationwide averaged $565 for single coverage, $1,220 for employee-plus-one
coverage, and $1,987 for family coverage. Among the 10 largest states, employee contributions
for single coverage ranged from $446 in California to $687 in Georgia, for employee-plus-one
coverage from $949 in Michigan to $1,437 in Texas, and for family coverage from $1,361 in
Michigan to $2,298 in Texas.
Table 2: Average Annual Health Insurance Premium per Enrolled Employee at Private-Sector Establishments Offering Health Insurance: United States and Ten Largest States, 2002
State |
Single Coverage |
Employee-Plus- One Coverage |
Family Coverage |
United States |
$3,189 |
$6,043 |
$8,469 |
California |
$2,936 |
$5,643 |
$8,380 |
Texas |
$3,268 |
$5,854 |
$8,837 |
New York |
$3,326 |
$6,225 |
$8,691 |
Florida |
$3,258 |
$5,941 |
$8,748 |
Illinois |
$3,458 |
$6,712 |
$9,067 |
Pennsylvania |
$3,311 |
$6,590 |
$8,217 |
Ohio |
$3,087 |
$5,860 |
$8,163 |
Michigan |
$3,250 |
$6,538 |
$8,452 |
New Jersey |
$3,453 |
$6,778 |
$9,424 |
Georgia |
$3,047 |
$5,306 |
$7,944 |
Source: Center for Financing Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey—Insurance Component, 2002, Tables II.C.1, II.D.1, II.E.1
MEPS Impact
Since its inception in 1996, MEPS has been used in several hundred scientific publications, and
many more unpublished reports.
- The MEPS has been used to estimate the impact of the recently passed Medicare Modernization Act (MMA) by the Employee Benefit Research Institute (the effect of the MMA on availability of retiree coverage), by the Iowa Rural Policy Institute (effect of the MMA on rural elderly) and by researchers to examine levels of spending and copayments (Curtis, et al, Medical Care, 2004).
- The MEPS has been used in Congressional testimony on the impact of health insurance coverage rate increases on small businesses.
- The MEPS-IC has been used by a number of States in evaluating their own private insurance issues including eligibility and enrollment by the State of Connecticut; and community rating by the State of New York. As part of the Robert Wood Johnson Foundation's State Coverage Initiative, MEPS data was cited in 69 reports, representing 27 states.
- MEPS data have been used in DHHS reports to Congress on expenditures by sources of payment for individuals afflicted by conditions that include acute respiratory distress syndrome, arthritis, cancer, chronic obstructive pulmonary disease, depression, diabetes, and heart disease.
- MEPS data are used to develop estimates provided in the Consumers Checkbook Guide to Health Plans, of expected out-of-pocket costs (premiums, deductibles and copays) for Federal employees and retirees for their health care. The Checkbook is an annual publication that provides comparative information on the health insurance choices offered to Federal workers and retirees.
- MEPS data has been extensively used to examine the pharmacological treatment of many conditions including depression (in both adults and children), back pain, ADHD, obesity, hypertension and cardiovascular diseases.
- MEPS data has been used by CDC and others to evaluate the cost of common conditions including arthritis, injuries, diabetes and cancer.
- MEPS data has been used to examine quality of care, including the receipt of preventive care and barriers to that receipt.
D. Rationale for the FY 2006 Request
The FY 2006 Request for the Medical Expenditure Panel Survey (MEPS) totals $55,300,000 in
PHS evaluation funds, maintaining the FY 2005 Appropriation.
Continuation of MEPS Activities
The FY 2006 funding for MEPS will be used to maintain enhancements to the sample size and
content of the MEPS Household and Medical Provider Surveys necessary to satisfy the
congressional mandate to submit an annual report on national trends in health care quality and
to prepare an annual report on health care disparities. The MEPS Household Component
sample size is maintained at 15,000 households in 2006 with full calendar year information.
These sample size specifications for the MEPS permit more focused analyses of the quality of
care received by special populations due to significant improvements in the precision of survey
estimates. This design, in concert with the survey enhancements initiated in prior years,
significantly enhances AHRQ's capacity to report on the quality of care Americans receive at the
national and regional level, in terms of clinical quality, patient satisfaction, access, and health
status both in managed care and fee-for-service settings.
These funds will also permit the continuation of an oversample in MEPS of Asian and Pacific
Islanders and individuals with incomes <200% of the poverty level in MEPS. These
enhancements, in concert with the existing MEPS capacity to examine differences in the cost,
quality and access to care for minorities, ethnic groups and low income individuals, will provide
critical data for the National Healthcare Quality Report and the National Healthcare Disparities
Report. Developmental work will also continue in FY 2006 as permitted within existing budget
to facilitate the transition of the MEPS Computer Assisted Personal Interview System (CAPI) to
a Windows®-based system.
Funds will also be allocated to the MEPS Insurance Component to maintain improvements in
the availability of data to the States. In FY 2006, data on employer sponsored health insurance
will be collected to support separate estimates for all 50 States and these funds would be used
to enhance the tabulations we provide to the States to support their analysis of private,
employer sponsored health insurance. The IC consists of two sub-components, the household
sample and the list sample. In FY 2006, the MEPS Insurance Component employer sample
linked to the household sample will not be conducted. In prior years, the data obtained, when
linked back to the household respondent, allowed for analysis of individual behavior and choice
made with respect to health care use and spending.
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Internet Citation:
Medical Expenditure Panel Survey (MEPS). From: Justification for Budget Estimates for Appropriations Committees, Fiscal Year 2006, February 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/cj2006/meps06.htm