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MEPS-HC Summary Data Tables Technical Notes

This document provides a listing of the variables and their definitions found in the following four table series: (1) Expenditures per person by health care service; (2) Expenditures per event by health care service type; (3) Expenditures by medical condition; and, (4) Health insurance. Each variable is categorized by whether it appears in a column or a row of the table in the series. The parenthetical statement after each variable identifies which table series the variable is used (a variable could appear in more than one series).

Column Variables

Expenditures/Expenses (1, 2, 3)

Refer to payments for medical events (office and hospital-based care, home health care, prescribed medicines, dental services, and other medical equipment and services reported during the calendar year). More specifically, expenditures in MEPS are defined as the sum of direct payments for care provided during the year, including out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources. Payments for over-the-counter drugs and phone contacts with medical providers are not included in MEPS total expenditure estimates. Indirect payments not related to specific medical events, such as Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, also are not included. Any charges associated with uncollected liability, bad debt, and charitable care (unless provided by a public clinic or hospital) are not counted as expenditures.

Health insurance status (4)

Private: Nonpublic insurance that provided coverage for hospital and physician care (including Medigap coverage). Individuals covered by single-service plans only (e.g., dental, vision, or drug plans) were not considered to be privately insured.
Public only: People were considered to have public only health insurance coverage if they were not covered by private insurance and they were covered by Medicare, Medicaid, TRICARE, or other public hospital and physician coverage.
Uninsured (First half of year, Tables 1-5): The uninsured were defined as people not covered by Medicare, Medicaid, TRICARE, other public hospital and physician programs, or private hospital and physician insurance (including Medigap coverage) from January 1st through the date of the round 1 (year 1 panel) or round 3 (year 2 panel) interview date. People covered only by single-service plans (e.g., dental, vision, or drug plans) were considered to be uninsured.
Uninsured (Full year, Tables 1a-5a): The uninsured were defined as people not covered by Medicare, Medicaid, TRICARE, other public hospital and physician programs, or private hospital and physician insurance (including Medigap coverage) at any time during the year. People covered only by single-service plans (e.g., dental, vision, or drug plans) were considered to be uninsured.

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Service type (3)

In addition to expenditures for total health services, expenses are classified into various service types. The categories for service type are described below and, where relevant, in the footnotes to the tables.

Hospital outpatient services and office based provider visits: Outpatient diagnostic and laboratory expenses associated with the basic facility charge and payments for separately billed inpatient services. This category also covers expenses for visits to a medical provider seen in an office-based setting.
Hospital inpatient stays: Room and board and all hospital diagnostic and laboratory expenses associated with the basic facility charge and payments for separately billed physician inpatient services.
Emergency room (ER) services: Hospital diagnostic and laboratory expenses associated with the ER facility charge and payments for separately billed inpatient services.
Prescribed medicines: Expenses for all prescribed medications that were initially purchased or otherwise obtained during the calendar year, as well as any refills.
Home health services: Expenses for care provided by home health agencies and independent home health providers. Agency providers accounted for most of the expenses in this category.
Dental services: Expenses for any type of dental care provider, including general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists.
Other medical equipment and services: Expenses for eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, and other miscellaneous items or services that were obtained, purchased, or rented during the year.

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Source of payment (1, 2)

Estimates of sources of payment represent the percentage of the total sum of expenditures paid for by each source. Sources of payment are classified as follows.

Out-of-pocket by user or family.
Private insurance: Includes payments made by insurance plans covering hospital and medical care (excluding payments from Medicare, Medicaid, and other public sources). Payments from Medigap plans or TRICARE (Armed-Forces-related coverage) are included. Payments from plans that provide coverage for a single service only, such as dental or vision coverage are not included.
Medicare: A federally financed health insurance plan for the elderly, persons receiving Social Security disability payments, and most persons with end-stage renal disease. Medicare Part A, which provides hospital insurance, is automatically given to those who are eligible for Social Security. Medicare Part B provides supplementary medical insurance that pays for medical expenses and can be purchased for a monthly premium.
Medicaid/SCHIP: A means-tested government program jointly financed by federal and state funds that provides health care to those who are eligible. Program eligibility criteria vary significantly by state, but the program is designed to provide health coverage to families and individuals who are unable to afford necessary medical care.
Other: Includes payments from the Department of Veterans Affairs (excluding TRICARE); other federal sources (Indian Health Service, military treatment facilities, and other care provided by the Federal Government); various state and local sources (community and neighborhood clinics, State and local health departments, and State programs other than Medicaid); Medicaid payments reported for people who were not enrolled in the Medicaid program at any time during the year; payments from Workers’ Compensation; and, other unclassified sources (e.g., automobile, homeowner’s, or liability insurance, and other miscellaneous or unknown sources).

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Row Variables

Age (1, 4)

Respondents were asked to report the age of each family member as of the date of each interview for each round of data collection. The age is based on the sample person’s age as of the end of the year. If data were not collected during a round because the sample person was out of scope (e.g., deceased or institutionalized), then age at the time of the previous round was used.

Census region (1, 4)

Each sample person was classified as living in one of the following four regions as defined by the Bureau of the Census:

Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania.
Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.
South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.
West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii.

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Conditions (3)

For definitions of the medical conditions used in the summary tables, see background information on the Clinical Classification System (CCS) http://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccsfactsheet.jsp.

Health insurance status (1)

Individuals under 65 were classified into the following three insurance categories:

Any private: Nonpublic insurance that provided coverage for hospital and physician care (including Medigap coverage). Individuals covered by single-service plans only (e.g., dental, vision, or drug plans) were not considered to be privately insured.
Public only: People were considered to have public only health insurance coverage if they were not covered by private insurance and they were covered by Medicare, Medicaid, TRICARE, or other public hospital and physician coverage.
Uninsured: The uninsured were defined as people not covered by Medicare, Medicaid, TRICARE, other public hospital and physician programs, or private hospital and physician insurance (including Medigap coverage) at any time during the year. People covered only by single-service plans (e.g., dental, vision, or drug plans) were considered to be uninsured.

Individuals over 65 were classified into the following four insurance categories:

Medicare only: Individuals who, at any time during the year, were covered by Medicare only.
Medicare and private: Individuals who, at any time during the year, were covered by a combination of Medicare and TRICARE or private insurance.
Medicare and other public coverage: Individuals who, at any time during the year, were covered by Medicare and some other type of public insurance, but had no private coverage.
No Medicare: Estimates are not shown for persons 65+ with no Medicare due to extremely small sample sizes.

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Metropolitan Statistical Area (MSA) (1, 4)

Individuals were identified as residing either inside or outside an as designated by the U.S. Office of Management and Budget (OMB). An MSA is a large population nucleus combined with adjacent communities that have a high degree of economic and social integration within the nucleus. Each MSA has one or more central counties containing the area’s main population concentration. In New England, metropolitan areas consist of cities and towns rather than whole counties. Regions of residence are in accordance with the U.S. Bureau of the Census definition.

Perceived health status (1, 4)

The MEPS respondent was asked to rate the health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing health status in a round, the response for health status at the previous round was used, if available. In the tables the five health status categories are the following: (1) excellent; (2) very good; (3) good health; (4) fair; and, (5) poor health.

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Poverty status (1)

Each sample person was classified according to the total annual income of his or her family. Within a household, all individuals related by blood, marriage, or adoption were considered to be a family. Personal income from all family members was summed to create family income. Possible sources of income included annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Worker’s Compensation; interest and dividends; alimony, child support, and other private cash transfers; private pensions, individual retirement account (IRA) withdrawals, Social Security, and Department of Veterans Affairs payments; Supplemental Security Income and cash welfare payments from public assistance, Aid to Families with Dependent Children and Aid to Dependent Children; gains or losses from estates, trusts, partnerships, S corporations, rent, and royalties; and a small amount of "other" income. Poverty status is the ratio of family income to the corresponding federal poverty thresholds, which control for family size and age of the head of family. Categories are defined as follows:

Negative or Poor: Persons in families with income less than or equal to the poverty line and includes those who reported negative income.
Near-poor: Persons in families with income over the poverty line through 125 percent of the poverty line.
Low income: Persons in families with income over 125 percent through 200 percent of the poverty line.
Middle income: Persons in families with income over 200 percent through 400 percent of the poverty line.
High income: Persons in families with income over 400 percent of the poverty line.

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Race/ethnicity (1, 4)

Classification by race and ethnicity is based on information reported for each family member. Respondents were asked if the race of the sample person was best described as American Indian, Alaska Native, Asian or Pacific Islander, black, white, or other. They also were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported in one of these Hispanic groups, regardless of racial background, are classified as Hispanic. Since the Hispanic grouping can include black Hispanic, white Hispanic, and other Hispanic, the race categories of black, white, and other do not include Hispanic people.

Type of Service (2)

Hospital outpatient services and office based provider visits: Outpatient diagnostic and laboratory expenses associated with the basic facility charge and payments for separately billed inpatient services. This category also covers expenses for visits to a medical provider seen in an office-based setting.
Hospital inpatient stays: Room and board and all hospital diagnostic and laboratory expenses associated with the basic facility charge and payments for separately billed physician inpatient services.
Emergency room (ER) services: Hospital diagnostic and laboratory expenses associated with the ER facility charge and payments for separately billed inpatient services.
Prescribed medicines: Expenses for all prescribed medications that were initially purchased or otherwise obtained during the calendar year, as well as any refills.
Home health services: Expenses for care provided by home health agencies and independent home health providers. Agency providers accounted for most of the expenses in this category.
Dental services: Expenses for any type of dental care provider, including general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists.
Other medical equipment and services: Expenses for eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, and other miscellaneous items or services that were obtained, purchased, or rented during the year.

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Suggested Citation:
MEPS-HC Summary Data Tables Technical Notes. October 2013. Agency for Healthcare Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/survey_comp/hc_technical_notes.shtml

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