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Design, Methods, and Field Results of the

1996 Medical Expenditure Panel Survey

Medical Provider Component

Methodology Methodology 

U.S. Department of Health and Human Services

Public Health Service

Agency for Healthcare Research and Quality

Agency for Healthcare Research and Quality
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Abstract

The Medical Expenditure Panel Survey (MEPS) is

the third in a series of nationally representative surveys

of medical care use and expenditures sponsored by the

Agency for Healthcare Research and Quality (AHRQ).

MEPS comprises four component surveys. The Medical

Provider Component (MPC) is a survey of medical

professionals and institutions that provided care to

sample persons in the MEPS Household Component.

The MPC’s primary focus is to collect data on

expenditures for medical services provided to MEPS

respondents. MPC data are critical in the development of

MEPS national medical expenditure estimates because

household respondents are not always a reliable source of

information on medical expenditures. This report

describes the design of and methods used in the 1996

MEPS MPC. In addition, information is included on the

MPC objectives, instruments and procedures for data

collection, sample sizes, and response rates.

Suggested citation

Machlin SR,Taylor AK. Design, methods, and field results of the

1996 Medical Expenditure Panel Survey Medical Provider

Component. Rockville (MD):Agency for Healthcare Research and

Quality; 2000. MEPS Methodology Report No. 9.AHRQ 

Pub. No. 00-0028.

http://www.ahrq.gov/ http://www.ahrq.gov/
Design, Methods, and Field Results of the

1996 Medical Expenditure Panel Survey

Medical Provider Component

U.S. Department of Health and Human Services

Public Health Service

Agency for Healthcare Research and Quality

   yyyyy zzzz {{{{{ |||| Report 9

Methodology Methodology 

AHRQ Pub. No. 00-0028

May 2000
The Medical Expenditure Panel

Survey (MEPS)

Background

The Medical Expenditure Panel Survey (MEPS) is

conducted to provide nationally representative estimates

of health care use, expenditures, sources of payment,

and insurance coverage for the U.S. civilian

noninstitutionalized population. MEPS also includes a

nationally representative survey of nursing homes and

their residents. MEPS is cosponsored by the Agency for

Healthcare Research and Quality (AHRQ), formerly the

Agency for Health Care Policy and Research, and the

National Center for Health Statistics (NCHS).

MEPS comprises four component surveys: the

Household Component (HC), the Medical Provider

Component (MPC), the Insurance Component (IC), and

the Nursing Home Component (NHC). The HC is the

core survey, and it forms the basis for the MPC sample

and part of the IC sample. The separate NHC sample

supplements the other MEPS components. Together

these surveys yield comprehensive data that provide

national estimates of the level and distribution of health

care use and expenditures, support health services

research, and can be used to assess health care policy

implications.

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 (NMCES) was

conducted in 1977, the National Medical Expenditure

Survey (NMES) in 1987. Beginning in 1996, MEPS

continues this series with design enhancements and

efficiencies that provide a more current data resource to

capture the changing dynamics of the health care

delivery and insurance system.

The design efficiencies incorporated into MEPS are

in accordance with the Department of Health and

Human Services (DHHS) Survey Integration Plan of

June 1995, which focused on consolidating DHHS

surveys, achieving cost efficiencies, reducing respondent

burden, and enhancing analytical capacities. To

accommodate these goals, new MEPS design features

include linkage with the National Health Interview

Survey (NHIS), from which the sample for the MEPS

HC is drawn, and enhanced longitudinal data collection

for core survey components. 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 collected from the respondents’ medical

providers, employers, and insurance providers.

Household Component

The MEPS HC, a nationally representative survey

of the U.S. civilian noninstitutionalized population,

collects medical expenditure data at both the person and

household levels. The 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 HC uses an overlapping panel design in which

data are collected through a preliminary contact

followed by a series of five rounds of interviews over a

21⁄

2-year period. Using computer-assisted personal

interviewing (CAPI) technology, data on medical

expenditures and use for 2 calendar years are collected

from each household. This series of data collection

rounds is launched each subsequent year on a new

sample of households to provide overlapping panels of

survey data and, when combined with other ongoing

panels, will provide continuous and current estimates of

health care expenditures.

The sampling frame for the MEPS HC is drawn

from respondents to NHIS, conducted by NCHS. NHIS

provides a nationally representative sample of the U.S.

civilian noninstitutionalized population, with

oversampling of Hispanics and blacks.

Medical Provider Component

The MEPS MPC supplements and validates

information on medical care events reported in the

MEPS HC by contacting medical providers and

pharmacies identified by household respondents. The

MPC sample includes all hospitals, hospital physicians,

home health agencies, and pharmacies reported in the

ii
iii

HC. Also included in the MPC are all office-based

physicians: 

• Providing care for HC respondents receiving

Medicaid.

• Associated with a 75-percent sample of households

receiving care through an HMO (health maintenance

organization) or managed care plan.

• Associated with a 25-percent sample of the

remaining households.

Data are collected on medical and financial

characteristics of medical and pharmacy events reported

by HC respondents, including:

• Diagnoses coded according to ICD-9 (9th Revision,

International Classification of Diseases) and DSMIV (Fourth Edition, Diagnostic and Statistical

Manual of Mental Disorders).

• Physician procedure codes classified by CPT-4

(Current Procedural Terminology, Version 4).

• Inpatient stay codes classified by DRG (diagnosisrelated group).

• Prescriptions coded by national drug code (NDC),

medication names, strength, and quantity dispensed.

• Charges, payments, and the reasons for any

difference between charges and payments.

The MPC is conducted through telephone

interviews and mailed survey materials.

Insurance Component

The MEPS IC collects data on health insurance

plans obtained through employers, unions, and other

sources of private health insurance. Data obtained in the

IC include the number and types of private insurance

plans offered, benefits associated with these plans,

premiums, contributions by employers and employees,

and employer characteristics.

Establishments participating in the MEPS IC are

selected through four sampling frames:

• A list of employers or other insurance providers

identified by MEPS HC respondents who report

having private health insurance at the Round 1

interview.

• A Bureau of the Census list frame of private-sector

business establishments.

• The Census of Governments from the Bureau of the

Census.

• An Internal Revenue Service list of the selfemployed.

To provide an integrated picture of health insurance,

data collected from the first sampling frame (employers

and other insurance providers) are linked back to data

provided by the MEPS HC respondents. Data from the

other three sampling frames are collected to provide

annual national and State estimates of the supply of

private health insurance available to American workers

and to evaluate policy issues pertaining to health

insurance.

The MEPS IC is an annual panel survey. Data are

collected from the selected organizations through a

prescreening telephone interview, a mailed

questionnaire, and a telephone followup for

nonrespondents.

Nursing Home Component

The 1996 MEPS NHC was a survey of nursing

homes and persons residing in or admitted to nursing

homes at any time during calendar year 1996. The NHC

gathered information on the demographic

characteristics, residence history, health and functional

status, use of services, use of prescription medications,

and health care expenditures of nursing home residents.

Nursing home administrators and designated staff also

provided information on facility size, ownership,

certification status, services provided, revenues and

expenses, and other facility characteristics. Data on the

income, assets, family relationships, and caregiving

services for sampled nursing home residents were

obtained from next-of-kin or other knowledgeable

persons in the community.

The 1996 MEPS NHC sample was selected using a

two-stage stratified probability design. In the first stage,

facilities were selected; in the second stage, facility

residents were sampled, selecting both persons in

residence on January 1, 1996, and those admitted during

the period January 1 through December 31.

The sampling frame for facilities was derived from

the National Health Provider Inventory, which is

updated periodically by NCHS. The MEPS NHC data

were collected in person in three rounds of data

collection over a 11⁄

2-year period using the CAPI system.

Community data were collected by telephone using

computer-assisted telephone interviewing (CATI)

technology. At the end of three rounds of data collection,
iv













































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|||| the sample consisted of 815 responding facilities, 3,209

residents in the facility on January 1, and 2,690 eligible

residents admitted during 1996.

Survey Management

MEPS data are collected under the authority of the

Public Health Service Act. They are edited and

published in accordance with the confidentiality

provisions of this act and the Privacy Act. NCHS

provides consultation and technical assistance.

As soon as data collection and editing are

completed, the MEPS survey data are released to the

public in staged releases of summary reports and

microdata files. Summary reports are released as printed

documents and electronic files. Microdata files are

released on CD-ROM and/or as electronic files.

Printed documents and CD-ROMs are available

through the AHRQ Publications Clearinghouse. Write or

call:

AHRQ Publications Clearinghouse

Attn: (publication number)

P.O. Box 8547

Silver Spring, MD 20907

800-358-9295

410-381-3150 (callers outside the United States only)

888-586-6340 (toll-free TDD service; hearing 

impaired only)

Be sure to specify the AHRQ number of the

document or CD-ROM you are requesting. Selected

electronic files are available through the Internet on the

AHRQ Web site: 

http://www.ahrq.gov/

On the AHRQ Web site, under Data and Surveys,

click the MEPS icon.

Additional information on MEPS is available from

the MEPS project manager or the MEPS public use data

manager at the Center for Cost and Financing Studies,

Agency for Healthcare Research and Quality, 2101 East

Jefferson Street, Suite 500, Rockville, MD 20852 

(301-594-1406).
v

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Relationship Between Household and Medical Provider Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Objectives of the MPC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Sample Selection: Design and Implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Instruments and Data Collection Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Sample Sizes and Participation Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Use of Data in Estimation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Tables showing information on the 1996 Medical Provider Component:

1. Office-based physician sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

2. Sample sizes and participation rates by provider type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

1

Introduction

The 1996 Medical Provider Component (MPC) of

the Medical Expenditure Panel Survey (MEPS) is a

survey of medical professionals and institutions that

provided care to sample persons in MEPS. The 1996

MEPS is the third in a series of nationally representative

surveys sponsored by the Agency for Healthcare

Research and Quality (AHRQ) to collect information on

the health care utilization and expenditures of the

American public. The first of these surveys, the

National Medical Care Expenditure Survey (NMCES),

was conducted in 1977, and the second, the National

Medical Expenditure Survey (NMES), in 1987. The

1996 MEPS is cosponsored by AHRQ and the National

Center for Health Statistics, both agencies of the U.S.

Public Health Service. 

The MPC’s primary focus was to collect data on

expenditures for medical services provided to MEPS

sample persons. Data from the MPC are critical in the

development of MEPS national medical expenditure

estimates because household respondents are not always

a reliable source of information on medical expenditures.

In a significant number of instances, they are simply not

aware of the total amount billed, services received, or

how much the provider is paid for these services. This is

especially true of individuals enrolled in the Medicaid

program, where financial transactions occur only

between the provider and the State Medicaid agency, and

enrollees of managed care plans, who may be aware only

of paying a predetermined copayment that is not

necessarily related to the total amount the provider

receives. In addition, inpatient hospital stays often

produce bills that survey respondents are likely to

overlook in the interview, such as bills from an

anesthesiologist or pathologist that are paid separately

from the main hospital bill. 

This report describes the design of and methods

used in the 1996 MEPS MPC. In addition, information

is included on the MPC objectives, instruments and

procedures for data collection, sample sizes, and

response rates. Westat, Inc., the prime contractor for

MEPS data collection, was assisted by the National

Opinion Research Center in the collection of data for the

1996 MPC.

Relationship Between Household

and Medical Provider

Components

The 1996 MEPS Household Component (HC) is a

nationally representative survey of the U.S. civilian

noninstitutionalized population (J. Cohen, 1997; S.

Cohen, 1997). Its purpose is to collect detailed

information on the demographic characteristics, health

status, health insurance, employment, and medical care

use and expenditures of individuals and families in this

country. In 1996, the HC collected full-year data from a

nationally representative sample of 8,655 families,

totaling approximately 23,000 individuals in 195

different communities across the United States. HC

information on all medical care events (e.g., doctor

visits, hospitalizations) and associated expenditures for

sample persons during 1996 was collected using

computer-assisted personal interviewing (CAPI) in three

interviews that were conducted during 1996-97. The

1996 MPC collected information about these medical

events from a subset of the medical care providers of HC

sample persons. These interviews were conducted

primarily by telephone during 1997.

Data collected in the MPC are used in conjunction

with HC data to produce MEPS national medical

expenditure estimates. In general, the methodology used

to develop these estimates was based on medical events

reported in the HC, with expenditure data from the MPC

used whenever possible.

Objectives of the MPC

The primary objective of the MPC is to supplement

and validate expenditure data collected in the HC for

Design, Methods, and Field Results of the 1996 Medical Expenditure

Panel Survey Medical Provider Component

by Steven R. Machlin, M.S., and Amy K.Taylor, Ph.D.,Agency for Healthcare Research and Quality
selected types of persons and medical events. More

specifically, MPC data are used to:

• Replace expenditure information reported in the HC

with information reported by providers, which is

generally more complete and may be less prone to

reporting errors.

• Serve as an imputation source for item nonresponse

to reduce the level of bias in survey estimates of

medical expenditures.

• Serve as the source of expenditure information on

physician charges that are associated with hospital

care but not included in the hospital bill.

• Serve as the primary source of expenditure

information for Medicaid recipients. 

Sample Selection: Design and

Implementation

The sample for the MPC was chosen from medical

care providers identified in the HC as having provided

care to MEPS sample persons in 1996. The major

categories of providers included were: 

• Office-based medical doctors (MDs), doctors of

osteopathy (DOs), and other medical providers under

the supervision of MDs and DOs.

• Hospitals providing inpatient care, outpatient care

(including visits to all provider types), or emergency

room care.

• Home health agencies.

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. A separate pharmacy component in

MEPS that collected data from pharmacies on

expenditures for prescription medicines is not covered

in this report.

A sampling scheme was developed for provider

types covered by the MPC. In general, this scheme

targeted providers associated with persons whose

household-reported data were expected to be least

sufficient for making estimates of medical expenses.

The sample included all identified hospitals, home

health agencies, and physicians providing care to

Medicaid recipients. In addition, office-based physicians

providing care to privately insured persons in managed

care plans were sampled at higher rates than other

physicians because households with members in those

plans were not expected to report third-party payments

accurately. The sampling scheme was implemented by

the CAPI. Only providers for whom the respondent

completed a signed permission form authorizing contact

were candidates for data collection in the MPC. The

overall rate at which respondents granted signed

permission to contact their providers was about 85

percent.

It is important to note that the MPC was not

designed as an independent survey for purposes of

producing national estimates of total medical

expenditures. In particular, the MPC does not cover all

types of health care providers. Also, the MPC sample is

generated from responses to the HC and only providers

for whom the respondent completed a signed

permission form were contacted. In summary, the MPC

was designed mainly to collect information to help

compensate for important areas of potentially unreliable

and missing expenditure data in the HC. 

Office-Based and HMO Physician Samples

The MPC office-based physician sample included

MDs and DOs, as well as providers practicing under the

direction or supervision of an MD or DO (e.g.,

physician assistants and nurse practitioners working in

clinics). Providers of care in private offices and health

maintenance organizations (HMOs) were in scope for

the MPC.

This sample was selected from each of the

following three different groups of households, as

classified from responses to the first household

interview:

• Medicaid: Households with one or more persons

enrolled in the Medicaid program.

• Managed Care: Households not classified as

Medicaid that had one or more persons reported as

covered by a private HMO insurance plan (with

hospital and physician benefits) or a private plan that

requires a person to sign up with a primary

physician.

2
Total 8,991

Not in sample 3,853

Total in sample 5,138

Medicaid 1,745

Managed care 2,379

Other 1,014

• Other: All households not classified as Medicaid or

managed care.

Different sampling rates were applied to these

groups in order to select higher proportions of persons

enrolled in Medicaid and in managed care because

those groups were expected to have less information on

third-party payments for their medical care.

Specifically, 100 percent of households with Medicaid

recipients and 75 percent of households with managed

care insurance arrangements were sampled, compared

with only 25 percent of other households. Once a

household was selected for the sample, all office-based

physicians and HMOs associated with physician care

provided to persons in that household in 1996 became

part of the MPC sample. Overall, all physicians

providing care for persons from more than half the

MEPS sample reporting units with any visits (5,138 out

of 8,991) were selected for the office-based physician

MPC sample (Table 1).1

Prior to sample selection, households were sorted

by selected geographic and demographic characteristics

within each sampling group. This sorting, in 

conjunction with the systematic procedure used to

select each sample, was designed to ensure greater

control over the sample allocation. 

Hospital and Separately Billing Doctor

Samples

All hospitals that were reported as the site of care

for inpatient stays, outpatient department visits, and

emergency room encounters for sample persons during

1996 were included in the MPC survey. Hospitals were

sampled with certainty because household responses

concerning hospital expenditures are often inaccurate or

3

Number of reporting

Household units with physician 

group visit(s)

Table 1. Medical Provider

Component office-based physician

sample, 1996

1 MEPS reporting units primarily represent distinct families

living in the same household (both single and multiple

persons), but college students under 24 years of age living

away from home are treated as living in separate reporting

units.

incomplete and a large percentage of national medical

expenditures are associated with hospital care. 

All physicians identified by sample hospitals as

providing care to sample persons during the course of

any hospital event in 1996 but whose charges were not

contained in the hospital bill (often anesthesiologists,

pathologists, and radiologists) were also included in the

MPC. Data were collected for these “separately billing

doctors” as a separate operation after the hospital data

collection process was completed. To avoid duplication,

separately billing doctors identified by hospitals were

not included in the separately billing doctor sample if

they had already been selected for the office-based

physician sample, since the required expenditure data

were already being collected.

Home Health Agency Sample

All home health agencies, hospitals, social service

agencies, and other places identified as providing paid

home health care services to sample persons during

1996 were included in the MPC. However, selfSource: Center for Cost and Financing Studies, Agency for

Healthcare Research and Quality: Medical Expenditure Panel

Survey Medical Provider Component, 1996.
4

employed and unpaid persons identified as providing

home health care were not considered in scope for the

MPC. 

Instruments and Data Collection

Procedures

Providers for the MPC sample were identified based

on three rounds of HC interviews in which data were

collected about all health care received by sample

persons in 1996. During these interviews, a provider

directory database was used to conduct a computerized

search for the sampled providers and to prepare a list for

fielding the MPC. As stated previously, only providers

for which sample persons had signed permission forms

were fielded for the MPC. 

The MPC data were collected primarily by telephone

during 1997.2 In these interviews, providers were asked

about all the care they provided to the sample persons

during 1996. The interview for office-based physicians,

home health agencies, clinics, and separately billing

doctors was directed to the person who handles the

billing for the provider (either someone in the provider’s

office or an outside billing agency). Hospital interviews

were conducted with both the billing department and the

medical records department (to determine the names of

all the doctors who treated the patient during a stay or

visit and who may have billed separately). In some

hospitals, it was also necessary to contact the

administrative office to determine whether the doctors

identified by medical records billed separately from the

hospital and, if so, their addresses and phone numbers. 

Different versions of the MPC questionnaires were

used to collect data from different types of providers and

are available on the MEPS Web site at the following

addresses:

• Office-based providers (http://www.meps.ahrq.gov/)

Medical Event Booklet (MPC) Questionnaire.

• Hospitals (http://www.meps.ahrq.gov/

misc/questmpc/m-hosp4.PDF).

• Separately billing doctors (http://www.meps.ahrq.gov/

misc/questmpc/sbd4.PDF).

• Home health agencies (http://www.meps.ahrq.gov/

misc/questmpc/hh0213.PDF).

These questionnaires were designed to obtain

information on both the medical and financial

characteristics of care provided to sample persons. The

following types of data were collected in the

questionnaires:

• Diagnoses.

• Procedure and inpatient stay codes—CPT-4 (Current

Procedural Terminology, Version 4) codes and DRGs

(diagnosis-related groups).

• Charges or charge equivalents (where available)

before any contractual adjustments or discounts.

• Sources and amounts of all payments made.

• The reasons for any difference between charges and

payments.

In contrast to the other questionnaires, the home

health questionnaire was structured to collect summary

data on a monthly basis rather than on an event basis. In

addition to the medical and financial items cited above

(except procedure codes), this questionnaire asked for the

types of practitioners who provided services and the

number of hours of service or visits provided during the

applicable month.

Interviewers who worked on the MPC data

collection were required to have experience conducting

interviews for an establishment survey or to have worked

in a medical or medical billing setting. All interviewers

had general training in basic interviewing techniques and

administrative procedures and completed a 4-day training

session covering the specifications and procedures for

the MPC questionnaire. 

Sample Sizes and Participation

Rates

For data collection purposes, a sampled medical

provider, along with its associated patients in 1996, was

considered an MPC case. A provider was classified as a

participant if data were obtained about medical care

2 About 10 percent of responding physician offices and

roughly one-third of responding hospitals chose to

provide medical records to the data collection contractors

for abstraction rather than respond to a telephone

interview.
5

provided during the year for any sample patients on most

key data items. Key data items are:

• Date of visit (month of visit reported).

• Associated diagnosis—ICD-9 (9th Revision,

International Classification of Diseases) or DSM-IV

(Fourth Edition, Diagnostic and Statistical Manual of

Mental Disorders) code.

• Service(s) provided (CPT-4 code or description).

• Reimbursement basis (fee-for-service or capitated).

• Sources of payments (for fee-for-service events only). 

Table 2 contains a summary of 1996 sample sizes

and participation rates for the various types of medical

providers included in the MPC. Responses were

obtained from 7,116 office-based physicians and HMOs,

3,067 hospitals, 6,857 separately billing doctors who

provided care to sample persons at responding hospitals,

and 309 home health agencies. Overall participation

rates ranged from 87.5 percent for office-based

physicians and home health agencies to 95.1 percent for

hospitals. Refusal to participate (including

unwillingness to accept signed permission forms)

accounted for about 40 percent of the nonresponding

hospitals and separately billing doctors, 50 percent of the

nonresponding home health agencies, and 56 percent of

the nonresponding office-based physicians and HMOs.

The primary other reasons for nonparticipation were that

the provider could not be located or had no record of the

patient.

The number of respondents at the person-provider

pair level can be calculated from Table 2 by multiplying

the number of respondents by the sample persons per

provider average. This average ranged from 1.1 for

home health agencies to 2.0 for hospitals. Participation

rates at the person-provider pair level were the same or

slightly lower than at the provider level—86.0 percent

for office-based physicians, 93.2 percent for hospital

facilities, 88.6 percent for separately billing doctors, and

87.5 percent for home health agencies.

Office-based physiciana 8,131 7,116 87.5 1.35

Hospitalb 3,224 3,067 95.1 2.00

Separately billing doctor 7,601 6,857 90.2 1.19

Home health agency 353 309 87.5 1.09

Sample persons 

Sample Participation per provider 

Provider type size Respondents rate (average)

Table 2. Sample sizes and participation rates in the Medical Provider

Component sample by provider type, 1996

aThis category includes health maintenance organization (HMO) providers. Based on provider’s name, about 7 percent of the

cases in this category were identified as HMO and were handled separately for data collection purposes.

bThe hospital sample size is greater than the number of unique facilities because inpatient departments and other affiliated units,

such as outpatient departments and satellite clinics, were treated as separate sample cases for some hospitals.

Source: Center for Cost and Financing Studies, Agency for Healthcare Research and Quality: Medical Expenditure Panel

Survey Medical Provider Component, 1996.
6

Use of Data in Estimation

Data obtained from providers in the MPC were

critical in the development of MEPS expenditure

estimates because household respondents did not always

know the total payments for their medical events.

Providers generally had complete information on

reimbursement arrangements (capitation vs. fee-forservice) and how much was paid by individuals and

other sources for the care delivered to sample persons. 

In general, the methodology used to develop MEPS

medical expenditure estimates was based on medical

events reported in the Household Component, with

expenditure data from the MPC used whenever possible.

The first stage of the MEPS expenditure estimation

methodology required matching the provider-reported

expenditure data in the MPC to the household-reported

medical events in the Household Component. When a

match was found for a particular medical event,

expenditure data from the MPC were substituted for

household-reported information. Data collected in the

MPC were also used to impute expenditures for medical

events that were missing both HC and MPC data. This

approach is similar to that used for the 1987 National

Medical Expenditure Survey (Cohen and Carlson, 1994).

In addition, more information on the 1996 estimation

strategy is available on the MEPS Web site at

<http://www.meps.ahrq.gov/> public use file HC-011.

References

Cohen J. Design and methods of the Medical

Expenditure Panel Survey Household Component.

Rockville (MD): Agency for Health Care Policy and

Research; 1997. MEPS Methodology Report No. 1.

AHCPR Pub. No. 97-0026. 

Cohen S. Sample design of the 1996 Medical

Expenditure Panel Survey Household Component.

Rockville (MD): Agency for Health Care Policy and

Research; 1997. MEPS Methodology Report No. 2.

AHCPR Pub. No. 97-0027. 

Cohen S, Carlson B. A comparison of household

and medical provider reported expenditures in the 1987

NMES. Journal of Official Statistics 1994;10(1):3-29.
U.S. Department of Health and Human Services

Public Health Service

Agency for Healthcare Research and Quality

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