Using Census Business Data to Augment the MEPS-IC

Abstract This paper has two aims: first to describe methods, issues, and outcomes involved in matching data from the Insurance Component of the Medical Expenditure Panel Survey (MEPS-IC) to other business microdata collected by the U.S. Census Bureau, and second to present some simple results that illustrate the usefulness of such combined data. We present the results of linking the MEPS-I

Essays on health care services and insurance coverage for older persons

Three essays examine the history of nursing homes and home health care, the demand for health services by older persons, and firms\u27 decisions regarding retiree health insurance. The first essay is a qualitative discussion of how public policy, which has developed in reaction to social, medical, and economic environments, influences the ownership and integration patterns in the home care and nursing home industries during the twentieth century. The analysis focuses on how the organizational structure of these long-term care providers evolved as a consequence of policymakers\u27 attempts to ensure quality care and contain costs. In the second essay, data from the Medical Expenditure Panel Survey—(Household Component and Nursing Home Component on individuals ages 65 and older)—are used to analyze living arrangements, the demand for paid health services in private settings, and the choice of nursing home type using a common set of explanatory variables. The behavioral models include measures of individuals\u27 predisposing, need, and enabling characteristics to explain the utilization of health services. The results show that Medicaid coverage increases the likelihood of nursing home use, while Medicare coverage reduces it. Deductibles and other costs paid by individuals appear to reduce demand for physician visits but not paid home health or hospital visits. Horizontal integration of nursing homes allows a greater differentiation of service provision across the related facilities. Finally, the third essay examines manufacturing firms\u27 decisions regarding whether or not to offer health insurance to retirees and the amount to contribute towards the premium cost for retiree health insurance. Using data from four different sources, including the Medical Expenditure Panel Survey—Insurance Component and the Census of Manufactures, this analysis uniquely controls for economic factors and market conditions as well as firm and workforce characteristics. The findings indicate that firms with better financial performance offer more generous benefits to their retirees. In addition, the results show that firms\u27 decisions are also significantly influenced by the premium cost and availability of Medigap insurers and Medicare managed care plans.

Health Insurance and Productivity: Evidence from the Manufacturing Sector

This paper examines the relationship between employer-sponsored offers of health insurance and establishments’ labor productivity. Our empirical work is based on unique plant level data that links the 1997 and 2002 Medical Expenditure Panel Survey-Insurance Component with the 1992, 1997, and 2002 Census of Manufactures. These linked data provide information on employer-provided insurance and productivity. We find that health insurance offers are positively associated with levels of establishments’ labor productivity. These findings hold for all manufacturers as well as those with fewer than 100 employees. Our preliminary results also show a drop in health care costs from the 75th to the 25th percentile would increase the probability of a plant offering insurance by 1.5-2.0 percent in both 1997 and 2002. The results from this paper provide encouraging and new empirical evidence on the benefits employers may reap by offering health insurance to workers.Employer-provided health insurance, labor productivity, manufacturing industries

Using Census Business Data to Augment the MEPS-IC

This paper has two aims: first to describe methods, issues, and outcomes involved in matching data from the Insurance Component of the Medical Expenditure Panel Survey (MEPSIC) to other business microdata collected by the U.S. Census Bureau, and second to present some simple results that illustrate the usefulness of such combined data. We present the results of linking the MEPS-IC with data from the 1997 Economic Censuses (EC), but also discuss other possible sources of business data. An issue in any linkage is whether the linked sample remains representative and large enough to be useful. The EC data are attractive because, given the survey’s broad coverage and large sample, most of the MEPS-IC sample can be matched to it. We use the combined EC/MEPS-IC data to construct productivity measures that are useful auxiliary data in examining employers’ health insurance offering decisions.

Health-Related Research Using Confidential U.S. Census Bureau Data

Economic studies on health-related issues have the potential to benefit all Americans. The approaches for dealing with the growth of health care costs and health insurance coverage are ever changing and information is needed on their efficacy. Research on health-related topics has been conducted for about a decade at the Census Bureau\u2019s Center for Economic Studies and the Research Data Centers. This paper begins by describing the confidential business and demographic Census Bureau data products used in this research. The discussion continues with summaries of nearly 30 papers, including how this work has benefited the Census Bureau and its research findings. Some focus on data linkages and assessing data quality, while others address important questions in the employer, public, and individual insurance markets. This research could not have been accomplished with public-use data. The newly available data from the Agency for Healthcare Research and Quality and National Center for Health Statistics, as well as additional Census Bureau data now available in the Research Data Centers are also discussed.

Contributions to Health Insurance Premiums: When Does the Employer Pay 100 Percent?

We identify the characteristics of establishments that paid 100 percent of health insurance premiums and the policies they offered from 1997-2001, despite increased premium costs. Analyzing data from the MEPS-IC, we see little change in the percent of establishments that paid the full cost of premiums for employees. Most of these establishments were young, small, singleunits, with a relatively high paid workforce. Plans that were fully paid generally required referrals to see specialists, did not cover pre-existing conditions or outpatient prescriptions, and had the highest out-of-pocket expense limits. These plans also were more likely than plans not fully paid by employers to have had a fee-for-service or exclusive provider arrangement, had the highest premiums, and were less likely to be self-insured.employer-sponsored health insurance, contributions, premiums

The Utilization of Different Modes of Residence and Health Services by the Elderly

Demand for health services are examined among Americans ages 65 and older using the Medical Expenditure Panel Survey. Analyses are provided of mode of residence, demand for paid health services in private settings, and the choice of type of nursing home using a common set of explanatory variables. The research shows that age, Medicare coverage, and the use of assistive technology are the strongest predictors of mode of residence. The second analysis shows that total expenditures for paid home health care (HHC) and hospital care do not decrease as expected when the percentage paid by individuals and/or their families increases. Finally, the third analysis suggests that the distribution of nursing home (NH) services is related to ability to pay.CES,economic,research,micro,data,microdata,chief,economist

Older Workers' Access to Employer-Sponsored Retiree Health Insurance, 2000-2004

Using a multivariate framework, we analyze recent trends in employer provision of retiree health insurance (RHI), eligibility for new retirees, and retiree contribution requirements. We also explore whether local labor market characteristics such as the unemployment rate influence RHI provision. Finally, we examine whether the Medicare Modernization Act (MMA) was associated with diverging trends in RHI access for Medicare-eligible and early retirees. Data come for the Medical Expenditure Panel Survey—Insurance Component (MEPS-IC). We find that, while RHI provision to existing retirees remained stable, eligibility for new retirees declined, and contribution requirements increased between 2000 and 2004. The local labor market had no effect on RHI provision. While early retiree coverage was more common than coverage for Medicare-eligible retirees, we did not find a divergence subsequent to MMA. These results suggest growing financial instability for retirees, both because RHI contribution requirements increased, and because businesses dropped coverage for new retirees.retiree health insurance, employers, Medicare, aging