Affiliations: Bureau of Economic Analysis, Washington, DC, USA | Department of Economics, Harvard University and the
National Bureau of Economic Research, MA, USA | Department of Health Care Policy, Harvard Medical
School, and the National Bureau of Economic Research, MA, USA | Department of Quantitative Health Sciences, University
of Massachusetts Medical School and the National Bureau of Economic Research,
MA, USA
Abstract: As the core health expenditure survey in the United States, the
Medical Expenditure Panel Survey (MEPS) is increasingly being used by
statistical agencies to track expenditures by disease. However, while MEPS
provides a wealth of data, its sample size precludes examination of spending on
all but the most prevalent health conditions. To overcome this issue,
statistical agencies have turned to other public data sources, such as Medicare
and Medicaid claims data, when available. No comparable publicly available data
exist for those with employer-sponsored insurance. While large proprietary
claims databases may be an option, the data are convenience samples and the
extent to which the data are representative for employer-sponsored insurance
(ESI) enrollees is not known. This study compared MEPS and MarketScan estimates
of annual per person health care spending on individuals with
employer-sponsored insurance coverage. Both total spending and the distribution
of annual per person spending differed across the two data sources, with MEPS
estimates 10 percent lower on average than estimates from MarketScan. These
differences appeared to be a function of both underrepresentation of high
expenditure cases and underreporting across the remaining distribution of
spending.
