Medical Expenditure Panel Survey
The Medical Expenditure Panel Survey (MEPS) is a nationally representative survey that provides detailed information on healthcare. MEPS collects data on healthcare use, expenditures, sources of payment, and health insurance coverage as well as information on respondents' health status, employment status, access to healthcare, satisfaction with healthcare, and demographic characteristics. These data are sourced from large-scale surveys of individuals, families, their medical providers (doctors, hospitals, pharmacies, etc.), and employers across the United States. The MEPS data and methodologies are summarized in the table below.
The Consumer Expenditure Surveys (CE) consist of two separate nationwide surveys: The Interview Survey and the Diary Survey.1 MEPS is also a nationwide survey, and has three components: HC, IC, and MPC. (For more information, see "Data Source" in the table above). Since the HC is the only household-based survey in MEPS, it is the only source compared with the CE.
Chart 1 compares CE and MEPS estimated expenditures for Total healthcare; Prescription drugs; and Dental services. These components of healthcare are chosen for comparison because they are the most direct matches between the two estimates.
Charts 1 and 2 show a consistent gap between CE and MEPS, with the CE-to-MEPS ratio being roughly 0.43 over the time series.2 This can be explained by the differences between the CE and MEPS approaches. For example, while CE total healthcare expenditures include nonprescription drugs, MEPS excludes these. MEPS also excludes indirect payments such as the Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, and any charges associated with uncollected liability, bad debt, and charitable care (unless provided by a public clinic or hospital).
There are also differences in the way prescription drug data are collected between CE and MEPS. For example, MEPS data include diabetic supplies and equipment, such as syringes and test strips; however, CE counts those as medical supplies. In addition, while CE and MEPS both ask survey participants about their prescription drugs, MEPS asks their permission to collect more detailed information from their pharmacies, including type, dosage, and payment for each filled prescription, while the CE only asks for out of pocket expenditures. MEPS is designed to collect the full cost of drugs, while CE is designed to collect only the portion of that cost for which the consumer pays directly. Even though the dental services categories are similar across CE and MEPS, the ratios range from 0.36 to 0.40 as the samples and survey questions differ.
Although both CE and MEPS make estimates for the same Census regions, it mirrors the observations above that CE has consistently lower estimates, which is shown in Chart 2, with ratios between 0.59 and 0.88.
Methodology and Concordance:
The CE and MEPS data comparison was developed utilizing comparable annual average and total healthcare expenditure categories with a supporting analysis conducted on a regional scale.
1 In BLS publications of CE data, most healthcare expenditures are taken from the Interview Survey. The exceptions are Nonprescription drugs, Nonprescription vitamins, and Topicals and dressings, which are taken from the Diary Survey.
2 That is, the average of CE-to-MEPS ratios from 2010-2018 for the three categories considered is 0.43. (See the CE data comparison Excel file in Supporting Documentation)
Last Modified Date: April 28, 2022