Medical Expenditure Survey Panel (MEPS) Household Component (HC)

AMENDMENT 1 - Soliciation Amendment and Responses to soliciation questions - see amended solication cover page for a summary of changes

The Medical Expenditure Panel Survey (MEPS) is a set of large-scale surveys of families and individuals, their medical providers (doctors, hospitals, pharmacies, etc.), and employers across the United States.  Collectively these MEPS surveys collect data on the specific health services that Americans use, how frequently they use them, the cost of these services, and how they are paid for, as well as data on the cost, scope, and breadth of health insurance held by and available to U.S. workers.  It has been conducted since 1996 and is administered by the Agency for Healthcare Research and Quality (AHRQ). 

The MEPS-HC collects data from a sample of families and individuals in selected communities across the United States, drawn as a subsample from a nationally representative sample of households that participated in the prior year’s National Health Interview Survey (NHIS).  During the MEPS-HC household interviews, field interviewers (FIs) collect the following detailed information for each person in the household from a single household respondent: demographic characteristics, health conditions, health status, use of medical services, charges and sources of payments for medical services, access to healthcare, satisfaction with healthcare, health insurance coverage, income, and employment.  The MEPS-HC also includes supplemental self-administered questionnaires (SAQs) that are administered in web-based and/or paper-based form to certain sample members. As well, for respondents reporting medical events the MEPS-HC administers authorization forms that seek signed permission from the respondent to contact their medical providers  (as part of the MEPS Medical Provider Component or MEPS-MPC).

The MEPS-HC employs a panel design, with a new panel fielded every calendar year.  For each panel, data collection consists of contacting upwards of 14,500 households (representing 35,000 individuals) five times over a two-and-a-half-year period (approximately every 6 months).  The FI  workforce consists of approximately 350 interviewers recruited and employed throughout the United States and spread across approximately 200 primary sampling units.  The MEPS-HC interviews are conducted primarily face-to-face in the respondents’ households using Computer Assisted Personal Interviewing (CAPI). However, following the COVID-19 pandemic other data collection modes have been introduced, including both Computer Assisted Virtual Interviewing (CAVI) and phone interview modes, with data collection mode varying for purposes to gaining data collection efficiencies.   Households sampled for voluntary MEPS-HC participation are initially contacted by phone and/or mail for the purpose of legitimizing the survey and maximize cooperation rates before scheduling in-person interviews. The most recent Panel 28 Round 1 finished with a 65 percent response rate.  

The existing CAPI instrument for the core MEPS-HC interview is programmed in Blaise software and consists of approximately 50 different questionnaire sections representing over 1,000 pages of hardcopy material with an average interview time of approximately 90 minutes.  The main MEPS-HC interview  is routinely updated to accommodate new questionnaire content or to apply edits to existing content.  Additionally, the CAPI instrument contains a medical provider directory to enable to a more efficient search and entry of reported medical providers and searchable lookup tools for commonly reported medical conditions and prescribed medicines.  Annually, new FIs are recruited, hired, and trained over a one-week period to address staffing needs as a result of field interviewer attrition from previous hiring cohorts.  New-to-Project (NTP) FI training  is a combination of in-person training conducted at a central location and web-based training.  Following the NTP training, FIs receive in-home training materials that are designed to continue training in support of data collection spanning a two- and half-year time period.  Additionally, all veteran (returning) FIs receive in-person refresher training every third year of employment on the project.  Data security  measures consistent with a FIPS-Moderate classification must be deployed  to maintain confidentiality protections of the MEPS-HC data collected.  This consists of, but is not limited to, the encryption of interviewer laptops, the electronic transfer of data through encrypted means to a central location for data processing, and the preparation of public use data files.   

Several analytic weights are developed to enable nationally representative point estimates and accurate standard errors.  Data are cleaned and processed through data editing, coding, statistical imputation of some variables with missing data, and implementation of statistical disclosure limitation techniques.  Editing and imputation work requires coordination with the MEPS Medical Provider Component (MEPS-MPC) contractor, which collects information from healthcare providers on charges and sources of payments for medical events.  Approximately 20 public use data files are released annually representing thousands of analytical variables pertaining to health care utilization and expenditures as well as demographic characteristics of the sample population.  More information on the public use data files that MEPS-HC releases is available at https://meps.ahrq.gov/mepsweb/data_stats/download_data_files.jsp.  

This project consists of the following tasks:

Project Management, Reporting, and Meetings

• Project meetings
• Project planning, including quality control plan and continued operation of the MEPS-HC
• Project Reporting, including monthly progress, finance, and EVM reports
• Data Security plan, ATO documentation, and continuous monitoring
• MEPS-HC and MEPS-MPC project coordination activities
• Project closeout/transfer of operations

Instrumentation

• Instrument Development, including updating main interview and self-administered questionnaires (SAQ) in both English and Spanish
• Programming (and testing) the CAPI, CAVI, and SAQ instruments in both English and Spanish
• Develop supporting household data collection field materials in both English and Spanish
• OMB Paperwork Reduction Act (PRA) clearance

Sample Design and Selection

• Designing and implementing the MEPS-HC sample design
• NHIS-HC sample file linkages
• MEPS-HC panel sample maintenance
• Prepare and transfer MEPS-MPC sample files to MPC contractor

Field Staff Preparation

• Field Interviewer and Supervisor recruitment/hiring for nationwide panel survey
• Field Interviewer and Supervisor training and management for nationwide panel survey

                MEPS-HC Data Collection

• Collect main interview household data
• Collect SAQ data
• Collect Authorization Forms from MEPS-HC respondents for MEPS-MPC sample
• Collect Pharmacy Patient Profiles

Data management and Data Processing

• Data management and data processing plan
• Forms control and receipt
• Between round data processing
• Data coding/recoding
• Data editing and imputation
• Data weighting and variance estimation, and benchmarking to outside data sources and previous MEPS estimates
• MEPS-HC/MPC statistical matching

Data Files and Documentation

• Public-Use File (PUF) disclosure review
• Preparing Developing PUF analytic files and supporting documentation

Survey Documentation

• Annual MEPS-HC Methodology Report
• Ad-Hoc Methods Reports

Further discussion and detail pertaining to the MEPS-HC may be found at: http://www.meps.ahrq.gov/mepsweb/survey_comp/household.jsp

The anticipated period of performance: 5 Year Ordering Period from date of Award