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Using the MEPS-HC For State-Level Estimates of High Financial Burden Presented at National Conference on Health Statistics, Washington, August 17, 2010.

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Presentation on theme: "Using the MEPS-HC For State-Level Estimates of High Financial Burden Presented at National Conference on Health Statistics, Washington, August 17, 2010."— Presentation transcript:

1 Using the MEPS-HC For State-Level Estimates of High Financial Burden Presented at National Conference on Health Statistics, Washington, August 17, 2010 Peter Cunningham

2 Introduction  Affordability central to national health reform  Financial burden of medical care increasing nationally  State variation in financial burden likely to be substantial  Suggests that states will be affected differently by affordability provisions in health reform

3 MEPS – Household Component  Conducted annually since 1996  Detailed information on health care expenditures, insurance coverage, and family income  Provider followbacks to verify use and expenditures  Representative of civilian, noninstitutionalized population in U.S.

4 State-level capability of MEPS-HC  NHIS sample frame – selection of PSUs stratified by state  29 states have sufficient number of PSU’s and sample to support state estimates (most have at least 4 PSUs)  Pooling of multiple years increases precision of state estimates  Weights post-stratified to state totals based on CPS

5 Sample sizes for 10 largest states (less than age 65) 20062004-2006 CA4,60013,400 TX3,30010,400 NY1,6004,900 FL1,4004,300 IL1,1003,500 AZ 9002,600 OH1,0002,600 NC1,0002,700 MI1,0002,600 PA 8002,600 Source: MEPS-HC 2004-2006

6 Sample sizes for 10 smallest states (less than age 65) 20062004-2006 OR5001,400 MD5001,700 LA4001,200 CT4001,200 SC4001,000 OK4001,000 CO4001,000 AL3001,100 IN300900 MA300900 Source: MEPS-HC, 2004-2006

7 Measure of financial burden  Out-of-pocket spending relative to family income  Includes spending for premiums and services  Before-tax family income  High burden defined as OOP spending greater than 10% of family income

8 National trends in financial burden Family Income Average spending on premiums Average spending on services % spending GT 10% of income 2001$62,0001,300*1,150*14.4* 2004$61,4001,570*1,28016.4* 2006$61,1001,7201,37019.1 * Difference with 2006 is statistically significant at.05 level Income and expenditures are in 2006 dollars Source: MEPS-HC 2001, 2004, 2006

9 High financial burden by insurance coverage

10 Insured with high financial burden in 10 largest states, 2004-2006 % insured with high burden Standard errorChange from 2001-2003 TOTAL U.S15.70.31.9 CA12.4*0.761.2 TX14.6*0.810.9 NY16.01.693.0 FL16.30.9-0.1* IL13.8*1.0-1.4* AZ13.2*1.19-0.5* OH16.62.01.8 NC18.9*1.033.9* MI14.50.951.8 PA17.2*1.370.3 *Difference with total U.S. is statistically significant at.05 level Source: MEPS-HC, 2001-2006

11 Insured with high financial burden in 10 smallest states, 2004-2006 % insured with high burden Standard errorChange from 2001-2003 TOTAL U.S15.70.31.9 OR17.4*1.263.4 MD15.61.546.5* LA19.34.240.9 CT17.21.786.7* SC20.04.343.3 OK24.8*3.657.7* CO15.52.790.9 AL26.4*3.645.6 IN14.62.610.6 MA14.91.492.2 *Difference with total U.S. is statistically significant at.05 level Source: MEPS-HC, 2001-2006

12 States with highest and lowest financial burden, 2004-2006 % hi burden (insured) % uninsuredFamily income (thousands) OOP premium Total health care $ Hi burden AL26.4*14.154*2,4007,520 OK24.8*25.0*56*2,970*7,670 TN21.8*10.2*702,7008,200 KY21.2*16.2*61*2,000*7,640 SC20.013.2682,5008,060 Lo burden WA14.3*11.2*85*2,040*7,410 GA14.116.1*742,1106,700 IL13.8*13.6742,0708,660 AZ13.2*16.1*742,2406,280* CA12.4*18.0*782,090*6,550 *Difference with Total U.S. is statistically significant at.05 level Source: MEPS-HC, 2004-2006

13 Limitations of MEPS-HC for state estimates  Can’t do for 21 states (mostly small and rural)  Limited ability to analyze subgroups  State identifiers and weights not on public use files  Lag in availability of state estimates at data centers

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