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

The Agency for Healthcare Research and Quality (AHRQ) was created in 1989 "to enhance the quality, appropriateness and effectiveness of health care services and access to such services, through the establishment of a broad base of scientific research and through the promotion of improvements in clinical practice (including the prevention of diseases and other health conditions and in the organization, financing and delivery of health care services)." In 1999, Congress, in its reauthorization language, stated that the Director of the AHRQ “shall conduct and support research and build private-public partnerships to (1) identify the causes of preventable health care errors and patient injury in health care delivery; (2) develop, demonstrate, and evaluate strategies for reducing errors and improving patient safety; and (3) disseminate such effective strategies throughout the health care industry.”

The Medical Expenditure Panel Survey (MEPS) Household Component (HC), Medical Provider Component (MPC), and Insurance Component (IC), which began in 1996, is a set of large-scale surveys of families and individuals (MEPS-HC), their medical providers (doctors, hospitals, pharmacies, etc.) (MEPS-MPC), and employers across the United States (MEPS-IC). MEPS collects 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. For further discussion of the MEPS family of surveys as well as historical context please see: http://www.meps.ahrq.gov/mepsweb/about_meps/survey_back.jsp

During the household interviews, MEPS-HC collects the following detailed information for each person in the household: demographic characteristics, health conditions, health status, use of medical services, charges and source of payments, access to care, satisfaction with care, health insurance coverage, income, and employment. Data collection consists of contacting upwards of 14,500 households (representing 35,000 individuals) five times over a two and a half year period for face-to-face interviews.  The interviewer workforce would consist of approximately 350 interviewers employed throughout the United States (approximately 200 primary sampling units to be provided to the contractor once appropriate security measures are in place). The survey itself is conducted through the use of a computer assisted personal interview (CAPI).  Contact of households is a multi-step process (combined phone, mail effort) designed to maximize cooperation rates (assume an expected Round 1 response rate of 80%) with regards to scheduling in person interviews. Programming the CAPI instrument consists of converting approximately 50 different questionnaire sections representing over 1,000 pages of hardcopy material into a Windows based medium.  Annually, interviewers are to be recruited, hired and trained over a one week period to address attrition of current hires.  Training takes place at a central location. After the initial in person training in home training materials are developed and distributed to interviewers reflecting continuing data collection efforts over a two and half year period.  Additionally, all experienced interviewers will receive in person refresher training every third year of employment.  Appropriate security measures must be demonstrated with regards to maintaining the confidential protection of data collected.  This consists of, but 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 data for public release.  Approximately 20 public use files are released annually representing thousands of analytical variables pertaining health care utilization and expenditures as well as demographic characteristics of the sample population. 

The contractor shall perform the following types of services under this contract:

Survey/project management

• Continue operation of MEPS-HC
• Preparation of MEPS-HC documentation
• Liaison with MEPS-HC principals
• Cooperation and liaison with MEPS-MPC contractor assuring timely file transfers for editing/imputation work
• Cooperation with AHRQ to obtain clearances
• Meeting arrangements
• Project closeout/transfer of operations
• Reporting, work planning, management meetings

 Household Component

• Implementation and documentation of sample
• Development of weights for producing national estimates and variables for variance estimations
• Imputation to correct for item nonresponse
• Geocoding the database
• Producing questionnaires and supporting materials
• Revise CAPI instruments as requested by AHRQ
• Recruiting, training, and managing interviews
• Collecting data
• Interviewing in Spanish and other languages
• Updating the provider directory on an ongoing basis
• Collecting permission forms and establishing the sample for the MPC and providing such to the MPC contractor

         Data Processing 

• Providing data security
• Between round processing
• Forms control and receipt
• Data entry
• Conducting training program for coders and verifiers
• Benchmarking to outside data sources and previous years MEPS estimates
• Developing analytic files
• Production of public use data files with accompanying benchmarking and documentation

The contractor shall store all necessary materials for a period of time determined by the Government and shall investigate available technology and use the most efficient means to store all the necessary materials and documents and sensitive data.

The contractor shall also set up and maintain a File Transfer Protocol (FTP) network so that confidential data and documents can be transmitted from the contractor to AHRQ. 

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 Award date