The Impacts of the COVID-19 Pandemic on the Medical Expenditure Panel Survey

Abstract

The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). The MEPS is widely used to study how policy changes and major shocks, such as the COVID-19 pandemic, affect insurance coverage, access, and preventive and other health care utilization and how these relate to population health. We describe how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules. The impact of the pandemic on response rates varied considerably across the MEPS. Investigations to date show little effect on the quality of data collected. However, lower response rates may reduce the statistical precision of some estimates. We also describe several enhancements made to the MEPS that will allow researchers to better understand the impact of the pandemic on US residents, employers, and the US health care system. (Am J Public Health. 2021;111(12):2157-2166. https://doi.org/10.2105/AJPH.2021.306534).

FIGURE 1—

Overlapping Panel Design of the Medical Expenditure Panel Survey (MEPS)-Household Component: United States, 2019–2020 Note. NHIS = National Health Interview Survey. The figure depicts the standard 2-panel overlapping design of the MEPS used since 1996 and originally planned for the 2020 data collection year. Annually released full-year PUFs from 1997 through 2019 combine data from multiple rounds from each of 2 panels, as depicted. Subsequently, panel 23 was extended 4 additional rounds covering 2 additional calendar years, 2020 and 2021. As a result, the 2020 full-year PUFs will be composed of data from 3 panels (the Appendix and Figure A, available as supplements to the online version of this article at http://www.ajph.org, provide additional details). ^aPanel 24 was subsequently extended 4 additional rounds covering 2 calendar years, 2021 and 2022 (the Appendix and Figure A provide additional details).

FIGURE 2—

Household Reporting of Pre–COVID-19 Visits in Medical Expenditure Panel Survey (MEPS)-Household Component Round 5 Interviews Conducted After March 17 by Data Collection Year: United States, 2018–2020 Note. The figure represents the authors’ analyses of confidential MEPS-household component files. Usual reference period is from the date of round 4 interview to December 31 of the year before round 5 data collection. Adjusted Wald test of 2020 vs 2019 means: P = .50 office-based; P = .78 hospital outpatient department; P = .39 dental visits. Visits were annualized to account for slightly unequal average.