AHRQ Views: Blog posts from AHRQ leaders
AHRQ Measures Americans’ Healthcare Spending by Going Door to Door
When the Nation’s top health services researchers want information about what patients are spending on healthcare, they turn to a reliable source: AHRQ’s Medical Expenditure Panel Survey (MEPS), an integral part of the Agency’s unique inventory of data tools and resources.
MEPS is central to AHRQ’s plans for establishing an integrated data, analytics, and information platform, one that will help Federal, State, and local policymakers have timely and accurate data and useful analytic resources to make informed policy decisions about the healthcare system.
Since 1996, more than 20,000 peer-reviewed journal publications and news articles have cited MEPS data. AHRQ scientists and collaborators have drawn on MEPS information to develop more than 500 statistical briefs on topics ranging from out-of-pocket costs to dental visits to prescription drugs.
MEPS’ ongoing portrait of what people are spending on healthcare serves many purposes. It provides a critical foundation for discussions of public policy issues, such as access to healthcare and health insurance, and how healthcare spending is distributed according to individual and family characteristics. MEPS data also address the cost of health insurance for individuals and employers, and how specific kinds of private and public health insurance are associated with types of healthcare spending.
AHRQ is able to collect and disseminate these data on Americans’ out-of-pocket healthcare spending thanks to thousands of families across the United States participating in a survey that asks a comprehensive set of questions about their health, health insurance, visits to the doctor, medications they are taking, socioeconomic status, and more.
But how do we get more than 35,000 individuals and 12,000 families to fill out five surveys over a 30-month period every spring/summer and fall? We’re glad you asked.
The effort is undertaken by people like Sharon, one of hundreds of field interviewers who, under contract with AHRQ, go door to door to visit with individuals and families, discussing all aspects of their healthcare. She and others meet survey respondents at kitchen tables, in living rooms or coffee shops, in small towns and urban centers, in the early morning or late at night.
The surveys conducted by field interviewers build on work by the Centers for Disease Control and Prevention (CDC). Each year, the CDC evaluates the health of people in more than 35,000 households via its National Health Interview Survey. After that survey is conducted, families are informed that AHRQ’s MEPS field interviewers may request additional interviews about their healthcare spending.
On a recent interview, as part of her field work in the southern United States,, Sharon met with a young woman to talk about her recent medical appointments and prescriptions. As part of her inquiry, she reviewed the woman’s insurance status and medical receipts while collecting demographic information and updates on her employment history.
The MEPS survey is designed to elicit a comprehensive portrait of households’ healthcare spending as well as critical issues that people may be facing, such as multiple chronic conditions or other health concerns. Consequently, interviews also include questions about visits to physician offices or hospitals, vaccinations for children and adults, dental appointments, eye exams, chiropractic care or massages, home healthcare, and physical or speech therapy.
Once each survey is completed, information on families’ healthcare spending is added to the data gleaned from thousands of others across the country. The aggregate data allow AHRQ research staff to make estimates of healthcare spending at the national level.
Participating families understand that their responses are absolutely confidential. Even so, field interviewers understand that convincing respondents to participate in MEPS interviews can be challenging. Low health literacy rates and language barriers may present complications.
Interviewers overcome these barriers with patience and by explaining the vital value of MEPS. They point out that policymakers, researchers, public health advocates, and the media use MEPS data to better understand the healthcare system and the impact of healthcare policy, which affects everyone’s lives.
The hard work of the interviewers and respondents have not gone unnoticed. In 2016, a blog post in Health Affairs characterized MEPS as “the number one single source of data” for papers published in the influential journal. That’s a very powerful statement, and AHRQ is gratified that so many researchers and policymakers rely on MEPS.
AHRQ truly appreciates the hundreds of field interviewers who hit the streets day in and day out to administer the survey, as well as the thousands of respondents who participate in the survey. It’s a tribute to their shared appreciation for MEPS—the “gold standard” for data on healthcare spending in America.
Joel Cohen is Director of AHRQ’s Center for Financing, Access and Cost Trends.