The Use of Respondent Records in Collecting Cost and Utilization 

Data on the Medicare Current Beneficiary Survey (MCBS)

July 2018

Debbie Reed-Gillette, Director 

Division of Survey Management & Analytics

Office of Enterprise Data & Analytics

Centers for Medicare & Medicaid Services
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■ The Medicare Current Beneficiary Survey (MCBS) is a continuous, in-person, multi-purpose longitudinal 

survey covering a representative national sample of the Medicare population, including the population of 

beneficiaries aged 65 and over and beneficiaries aged 64 and below with disabilities, residing in the 

United States and Puerto Rico. 

■ The MCBS is sponsored by the Office of Enterprise Data and Analytics (OEDA) of the Centers for 

Medicare & Medicaid Services (CMS) and is conducted through a contract with NORC at the University of 

Chicago (NORC).

■ The MCBS has been in the field continuously since 1991, collecting over 1 million interviews with over 

200,000 beneficiaries. 

■ The MCBS provides important information on beneficiaries that is not available in CMS administrative 

data and plays an essential role in monitoring and evaluating beneficiary health status and their 

experiences with the Medicare program.

What is the Medicare Current Beneficiary Survey (MCBS)?
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■ The MCBS uses a rotating panel sample design. The total annual sample is approximately 14,000. One 

panel is retired during each summer round, and a new panel of about 6000 is selected each fall round 

to replace it and to account for any attrition due to death, and loss of benefits.

■ Each sampled beneficiary is interviewed up to three times per year for four consecutive years to form a 

continuous profile of their health care experiences during their participation in the survey.

■ The three data collection rounds per year are referred to seasonally (Fall, Winter, Summer). 

■ Sampled beneficiaries may be living in the community (e.g., their homes) or a facility (e.g., nursing 

homes).

■ We collect information not only on the beneficiaries’ health and experiences with the health care 

system, but also on their health care expenditures and reimbursements.

What is the Medicare Current Beneficiary Survey (MCBS)? 
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■ CMS provides users with multiple ways to access MCBS data and a wide array of documentation that is 

publically available on the CMS MCBS website. 

■ Data users have several options to access MCBS data https://www.cms.gov/mcbs:

■ MCBS data are made available via two annual Limited Data Set (LDS) releases and an annual Public Use File 

(PUF). These releases are accompanied by detailed Data User’s Guides as well as other technical documentation.

■ The initial LDS file release includes the Survey File which contains questionnaire collected and administrative data 

on the beneficiary. It includes information on chronic conditions, health status, mobility, health insurance 

coverage, residence type, and other health related data. The subsequent LDS release, the Cost Supplement, 

provides information on the beneficiary’s utilization of medical services, supplies, and prescription drugs, and their 

associated costs and out-of-pocket and insurance payments. 

■ MCBS documentation is publically available on the CMS website, such as an annual Chartbook, Data 

User’s Guides, Methodology Reports, codebooks, and questionnaire specifications. 

Available Data 
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■ Respondent records on their health care utilization, costs, and reimbursements are used to provide a 

total picture of the out-of-pocket costs for their health care expenditures.

■ During a beneficiaries baseline (first) interview, they are provided with instructions on the types of 

records to save for their next interview.

■ We begin at this interview to “train” our respondents to keep all documents relating to their health care 

utilization including: receipts, bills, insurance explanation of benefits (EOBs), Medicare Summary Notices 

(MSNs), prescription drug bottles, health insurance premium notices, canceled checks for medical 

payments, and any other information about their medical appointments and the cost and payment of 

their medical expenses.

■ We provide them with a planner and a folder to use in tracking and collecting this information.

Collecting and Using Respondent Records
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MCBS Planner
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MCBS Folder
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■ Our 220 field interviewers go through detailed training to learn how to identify, sort, and bundle 

respondent records.

■ The information on utilization such as appointments and purchases are matched with the bills, and 

insurance statements to provide a picture of the utilization, costs, and payments for each event.

■ Interviewers have initial in-person intensive training, and then attend annual on-line refresher trainings. 

■ The Field Managers periodically observe each interviewer for correct handling of the records. Field 

Managers observe approximately 17 interviewers.

Interviewer Training
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■ Determining what is relevant is important 

for our interviewers

■ We train interviewers using “real world” 

examples of relevant and not relevant 

documents.

■ Organizing the various documents saved by 

the respondent into related bundles of 

information is important for entering the 

information efficiently about utilization and 

costs.

Using the Respondent Records in the Survey
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Understanding the Relationship between Events, Bills, and 

Reimbursement
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■ Statements vs non-Statements

Understanding Key Elements from Records
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Understanding the Key Elements of a Bill
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Understanding the Elements of a Prescription Medication Label
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Understanding Key Elements for Other Medical Costs 
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Understanding Insurance Statements
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Reading Insurance Statements
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Medicare Summary Notices (MSNs)
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Other Types of Insurance Statements
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Prescription Medication Statements
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Understanding the Bundling of Charges on MSNs
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■ Statements and relevant non-statement 

information is organized into “bundles” to 

identify dates of service, types of service, 

payments by Medicare and other insurances, 

and ultimately the out-of-pocket expenses paid 

by the respondent and/or their family.

■ Prescription Medications are bundled with the 

Prescription Drug Statements (if covered by a 

Prescription Drug benefit).

■ Items covered by Medicare and items NOT 

covered by Medicare like vision, hearing, and 

dental services are all recorded.

Organizing Medical Service Records
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■ Once all of the relevant information has been organized for each medical event, information is entered 

into the questionnaire.

■ Medical Events, Services, and Supplies:

■ Provider, date of service, event type, total cost of the service, reimbursements by Medicare and other insurance 

policies, and any out of pocket costs

■ All filled medications are recorded

■ Medication name: Brand name and/or generic

■ Dates and number of times filled, strength, dose, form 

■ Interviewers use the information from the RX label/receipt when possible

■ OTC, free samples, vitamins are not recorded

■ Total costs for drugs and reimbursements by Medicare and other insurance policies, and any out of pocket costs

Recording of Medical Events and Other Medical Expenses
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■ The information collected from these respondent records are used to estimate the total cost burden and 

utilization of health care for the calendar year for the beneficiary.

■ The collected cost and utilization data is matched back to any administrative data when available, such 

as the Medicare Fee-for-Service (FFS) claims for those beneficiaries who have traditional FFS Medicare.

■ Using the respondent records allows us to have more information than is provided by the administrative 

data alone, and provides a look at the total cost burden for the services and the resulting out-of-pocket 

expenses, as well as the premiums being paid for other supplemental insurance policies.

Using the Collected Information
Visit our website at: https://www.cms.gov/mcbs

Thank you!