Billing Code: 4160-90-P
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection; Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice
SUMMARY: This notice announces the intention of the Agency for Healthcare Research and
Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve a
revision of the currently approved information collection project: ‘‘Medical Expenditures Panel
Survey – Household and Medical Provider Components.’’ This proposed information collection
was previously published in the Federal Register on April 19, 2024 and allowed 60 days for
public comment. No comments were received. The purpose of this notice is to allow an
additional 30 days for public comment.
DATES: Comments on this notice must be received by [INSERT DATE 30 DAYS AFTER
DATE OF PUBLICATION IN THE FEDERAL REGISTER].
ADDRESSES: Written comments and recommendations for the proposed information
collection should be sent within 30 days of publication of this notice to
www.reginfo.gov/public/do/ PRAMain. Find this particular information collection by selecting
‘‘Currently under 30-day Review—Open for Public Comments’’ or by using the search function.
Copies of the proposed collection plans, data collection instruments, and specific details on the
estimated burden can be obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports Clearance
Officer, (301) 427-1477, or by email at REPORTSCLEARANCEOFFICER@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Medical Expenditures Panel Survey – Household and Medical Provider Components

AHRQ requests that OMB approve a revision to AHRQ’s collection of information for the
Medical Expenditures Panel Survey – Household and Medical Provider Components: OMB
Control number 0935–0118, expiration November 30, 2025. Requested changes are for the
Household Component (MEPS-HC) only.
The MEPS was initiated in 1996. Each year a new panel of sample households is selected.
Recent annual MEPS-HC sample sizes average about 13,500 households. Data can be analyzed
at either the person, family, or event level. The panel design of the survey, which includes 5
rounds of interviews covering 2 full calendar years, provides data for examining person level
changes in selected variables such as expenditures, health insurance coverage, and health status.
This research has the following goals:
1) To produce nationally representative estimates of health care use, expenditures, sources of
payment, and health insurance coverage for the U.S. civilian noninstitutionalized population.
2) To produce nationally representative estimates of respondents’ health status, demographic
and socio-economic characteristics, employment, access to care, and satisfaction with health
care.
Proposed Changes for the 2025 MEPS-HC:
•

Core MEPS Interview and Adult SAQ – The Core interview and the Adult SelfAdministered Questionnaire (SAQ) include four questions from the Consumer
Assessment of Healthcare Providers and Systems 5.0 (CAHPS 5.0). These questions will
have wording changes to update them to CAHPS 5.1. These wording changes will help
identify telehealth utilization and access, as well as maintain consistency between
CAHPS and MEPS-HC questionnaire items. Below are the four questions, both the
current version and the proposed version:
Current: In the last 12 months, did {you/{PERSON}} have an illness, injury or
condition that needed care right away in a clinic, emergency room, or doctor's office?

Proposed: In the last 12 months, did {you/{PERSON}} have an illness, injury, or
condition that needed care right away?
Current: In the last 12 months, did you make any appointments for a check-up or routine
care for {yourself/{PERSON}} at a doctor's office or clinic?
Proposed: In the last 12 months, did you make any in-person, phone, or video
appointments for a check-up or routine care for {yourself/{PERSON}}?
Current: Looking at card CS-2, in the last 12 months, how often did you get an
appointment for a check-up or routine care for {yourself/{PERSON}} at a doctor's office
or clinic as soon as {you/he/she} needed?
Proposed: Looking at card CS-2, in the last 12 months, how often did you get an
appointment for a check-up or routine care for {yourself/{PERSON}} as soon as
{you/he/she} needed?
Current: Looking at card CS-3, in the last 12 months, not counting times
{you/{PERSON}} went to an emergency room, how many times did {you/he/she} go to
a doctor's office or clinic to get health care?
Proposed: Looking at card CS-3, in the last 12 months, not counting the times
{you/{PERSON}} went to an emergency room, how many times did {you/he/she} get
health care in person, by phone, or by video?
•

Burdens and Economic Impacts of Medical Care Self-Administered Questionnaire
(ESAQ) - The Office of the Secretary – Patient Centered Outcomes Research Trust Fund
is funding this SAQ to expand the collection of economic outcomes data for patientcentered outcomes research (PCOR) via the Medical Expenditure Panel Survey (MEPS).
The ESAQ will be completed during Round 3, Panel 30 and Round 5, Panel 29 (Spring

2025) by adult household members (aged 18 and over). The ESAQ will be administered
in a mixed-mode of paper and online. Respondents will be offered a $20.00 monetary
incentive to complete the ESAQ. This is a one-time data collection and the ESAQ will
be removed from the MEPS after the 2025 fielding. The goal of the ESAQ is to enhance
the MEPS data by adding new domains related to the economic burdens of seeking and
receiving health care, to study economic outcomes in patient-centered outcomes research.
There is no other survey that is now or has been recently conducted that will meet the
objectives of the ESAQ. The ESAQ will supplement MEPS data on direct care
expenditures with data on major indirect costs, including time costs of getting care and
administrative hassles; lost work productivity due to presenteeism, lost productivity in
non-market activities, and time costs of informal care. With this new data, researchers
will be able to better examine health care economic burdens and equity in health care
access, utilization, and outcomes, for example to aggregate social costs of health care and
poor health, examine indirect costs associated with common conditions, and analyze
disparities and equity in indirect costs.
In developing the ESAQ, AHRQ consulted with several experts in the area and used their
expertise to identify priority topics and questions that have already been tested and
widely accepted. Nearly all items are either from Federal surveys, federally funded
surveys, or adapted from instruments that have been carefully validated. Two questions
related to affordability and access are from Kaiser Family Foundation surveys. One
question about informal care was cognitively tested in a prior question development
project. One question on the high-priority topic of administrative hassles of health
insurance was developed from phrases from the carefully tested and widely accepted
Consumer Assessment of Health Plans and Systems.

•

Cancer Self-Administered Questionnaire (CSAQ) – The CSAQ will be removed from
the 2025 MEPS-HC.

This study is being conducted by AHRQ through its contractor, Westat, pursuant to AHRQ’s
statutory authority to conduct and support research on healthcare and on systems for the delivery
of such care, including activities with respect to the cost and use of health care services and with
respect to health statistics and surveys. 42 U.S.C. 299a(a)(3) and (8); 42 U.S.C. 299b-2.
Method of Collection
The MEPS-HC uses a combination of computer assisted personal interviewing (CAPI), computer
assisted video interviewing (CAVI), and self-administered paper and web questionnaires, to
collect information about each household member, and the survey builds on this information
from interview to interview. CAVI is a new data collection technology and offers the best of
both telephone and in-person interviewing, while offering opportunities for cost savings and
more accurate reporting.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for the respondents' time to participate in
the MEPS-HC and the MEPS-MPC.

MEPS-HC:
1. MEPS-HC Core Interview - completed by 12,683 "family level" respondents. Since the
MEPS-HC typically consists of 5 rounds of interviewing covering a full two years of
data, the annual average number of responses per respondent is 2.5 responses per year.
The MEPS-HC core requires an average response time of 88 minutes to administer.

2. Adult SAQ - completed once during the 2-year panel, in rounds 2 and 4 during odd
numbered years, making the annualized average 0.5 times per year. The Adult SAQ will
be completed by 15,600 adults and requires an average of 7 minutes to complete.
3. PSAQ - completed once during the 2-year panel, in rounds 2 and 4 during even numbered
years, making the annualized average 0.5 times per year. The PSAQ will be completed
by 15,600 adults and requires an average of 7 minutes to complete.
4. DCS - completed by 1,398 persons with diagnosed diabetes each year and requires 3
minutes to complete.
5. Burdens and Economic Impacts of Medical Care SAQ - completed by 16,170 and is
estimated to take 10 minutes to complete. This SAQ will be completed only once in
2025 and will be removed in 2026; to annualize the burden hours the number of
responses per respondent is 0.5 times per year.
6. Authorization forms for the MEPS-MPC and Pharmacy Survey - completed by 7,386
respondents. Each respondent will complete an average of 5.2 forms each year, with
each form requiring an average of 3 minutes to complete.
7. Validation interview - conducted with approximately 1,826 respondents each year and
requires 5 minutes to complete.

The total annual burden hours for the respondent’s time to participate in the MEPS-HC is
estimated to be 51,814 hours.
MEPS-MPC:
1. Contact Guide/Screening Call - conducted with 38,683 providers and pharmacies each
year and requires 5 minutes to complete.
2. Home Care Providers Event Form - completed by 540 providers, with each provider
completing an average of 5 forms and each form requiring 3 minutes to complete.

3. Office-based Providers Event Form - completed by 9,300 providers. Each provider will
complete an average of 2.8 forms and each form requires 3 minutes to complete.
4. Separately Billing Doctors Event Form - will be completed by 4,676 providers, with each
provider completing 1.2 forms on average, and each form requiring 3 minutes to
complete.
5. Hospital Event Form - completed by 3,935 hospitals or HMOs. Each hospital or HMO
will complete 5.9 forms on average, with each form requiring 3 minutes to complete.
6. Institutions (non-hospital) Event Form - completed by 86 institutions, with each
institution completing 1.3 forms on average, and each form requiring 3 minutes to
complete.
7. Pharmacy Event Form - completed by 6,112 pharmacies. Each pharmacy will complete
31.3 forms on average, with each form requiring 3 minutes to complete.
The total burden hours for the respondent’s time to participate in the MEPS-MPC is estimated to
be 15,674 hours. The total annual burden hours for the MEPS-HC and MPC is estimated to be
67,488 hours.
Exhibit 1. MEPS-HC and MPC estimated annualized respondents and burden hours, 2025
to 2027
Number of
Total
Number of
Hours per
Form Name
responses
per
Burden
Respondentsa
response
respondent
hours
MEPS-HC
1. MEPS-HC Core Interview
12,683
2.5
88/60
46,504
*
2. Adult SAQ
15,600
0.5
7/60
910
**
3. Preventive Care SAQ (PSAQ)
15,600
0.5
7/60
910
4. Diabetes Care Survey (DCS)
1,398
1
3/60
70
5. Burdens and Economic Impacts of
16,170
0.5
10/60
1,348
Medical Care SAQ
6. Authorization forms for the MEPS7,386
5.2
3/60
1,920
MPC Provider and Pharmacy Survey
7. MEPS Validation Interview
1,826
1
5/60
152
Subtotal for the MEPS-HC
70,663
--51,814
MEPS-MPC
1. Contact Guide/Screening Call
38,683
1
5/60
3,224
2. Home Care Providers Event Form
540
5.0
3/60
135
3. Office-based Providers Event Form
9,300
2.8
3/60
1,302
4. Separately Billing Doctors Event

Form
5. Hospitals & HMOs (Hospital
Event Form)
6. Institutions (non-hospital) Event
Form
7. Pharmacies Event Form
Subtotal for the MEPS-MPC
Grand Total

4,676

1.2

3/60

3,935

5.9

3/60

1,161

86
6,112
63,332
133,995

1.3
31.3


3/60
3/60


6
9,565
15,674
67,488

The Adult SAQ is completed once every two years, on the odd numbered years.
The PSAQ is completed once every two years, on the even numbered years.
a See the Supporting Statement Part B, Table 1 and Table 3, for information on the sample size
and number of respondents.
*

**

Exhibit 2 shows the estimated annual cost burden associated with the respondents' time to
participate in this information collection. The annual cost burden for the MEPS-HC is estimated
to be $1,631,105 and the annual cost burden for the MEPS-MPC is estimated to be $326,612.
The total annual cost burden for the MEPS-HC and MPC is estimated to be $1,957,716.
Exhibit 2. Estimated annualized cost burden
Form Name

MEPS-HC
1. MEPS-HC Core Interview
2. Adult SAQ*
3. Preventive Care SAQ (PSAQ)**
4. Diabetes Care Survey (DCS)
5. Burdens and Economic Impacts of
Medical Care SAQ
6. Authorization forms for the MEPSMPC Provider and Pharmacy Survey
7. MEPS Validation Interview
Subtotal for the MEPS-HC
MEPS-MPC
1. Contact Guide/Screening Call
2. Home Care Providers Event Form
3. Office-based Providers Event Form
4. Separately Billing Doctors Event
Form
5. Hospitals & HMOs (Hospital
Event Form)
6. Institutions (non-hospital) Event
Form
7. Pharmacies Event Form
Subtotal for the MEPS-MPC
Grand Total

Total
burden
hours

Average hourly
wage rate

Total cost
burden

46,504
910
910
$31.48*
$31.48*
$31.48*
$31.48*

$1,463,946
$28,647
$27,082
$2,204

1,348

$31.48*

$42,435

1,920

$31.48*

$60,442

152
51,814

$31.48*
--

$4,785
$1,631,105

3,224
135
1,302

$20.85**
$20.85**
$20.85**

$67,220
$2,815
$27,147

281
1,161
6
9,565
15,674
67,488

$20.85**
$20.85**
$20.85**
$20.83***


$5,859
$24,207
$125
$199,239
$326,612
$1,957,716

*

Mean hourly wage for All Occupations (00-0000)
Mean hourly wage for Medical Secretaries (43-6013)
*** Mean hourly wage for Pharmacy Technicians (29-2052)
Occupational Employment Statistics, May 2023 National Occupational Employment and Wage
Estimates United States, U.S. Department of Labor, Bureau of Labor Statistics.
**

Request for Comments
In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-3520, comments on AHRQ’s
information collection are requested with regard to any of the following: (a) whether the
proposed collection of information is necessary for the proper performance of AHRQ’s health
care research and health care information dissemination functions, including whether the
information will have practical utility; (b) the accuracy of AHRQ’s estimate of burden (including
hours and costs) of the proposed collection(s) of information; (c) ways to enhance the quality,
utility and clarity of the information to be collected; and (d) ways to minimize the burden of the
collection of information upon the respondents, including the use of automated collection
techniques or other forms of information technology.
Comments submitted in response to this notice will be summarized and included in the Agency’s
subsequent request for OMB approval of the proposed information collection. All comments
will become a matter of public record.
Dated: June 26, 2024.
Marquita Cullom,
Associate Director.
[FR Doc. 2024-14474 Filed: 6/28/2024 8:45 am; Publication Date: 7/1/2024]