A. Population-based Surveys
The population-based surveys we abstracted are:
COBRA
retiree group
individual
public
The employer surveys we abstracted are:
The insurer surveys we abstracted are:
The policy databases we abstracted are:
| Organization | Census Bureau |
| Contact | General: (301) 457-3806 Health: Robert Bennefield (301) 763-8578 |
| Type | public-use |
| Availability/Cost | $150/CD,
available about 6 months after data collection can extract data or generate tables from /ferret.bls.census.gov/cgi-bin/ferret or extract data from /www.census.gov/DES/www/welcome.html |
| Time Period | annual; conducted in March |
| Reference Period | health insurance
questions pertain to any time during previous calendar year.
Starting in 1995, also asks about current coverage. |
| Scope of coverage | noninstitutionalized civilians and members of Armed Forces in civilian housing units |
| Analysis unit | person, family, household |
| Sample size | 48,000 households,
136,000 persons |
| Response rate | 92-93% provide
basic labor force information
80-82% of households complete supplement |
| Geography | 50 states and
DC
Allows for state-level analyses, though might want to pool consecutive years to improve the estimates for smaller states. (The states with at least 1,400 people sampled are CA, NY, FL, TX, PA, IL, OH, MI, NJ, NC, MA) States can be identified. |
| Design | sample selected
using the 1990 Decennial Census
probability sample stratified by state to select households. oversample hispanics |
| Data collection mode | primarily telephone, some in-person |
| Content | insurance coverage:
recent work history industry code of worker occupation code of worker health status (April 1993 include offers of employer health insurance) |
| Organization | Census Bureau |
| Contact | Michael McMahon (301) 457-3819 or Robert Bennefield (301) 763-8578 |
| Type | public-use |
| Availability/Cost | $200/CD(wave),
$1050 for longitudinal file.
can extract data or generate tables from /ferret.bls.census.gov/cgi-bin/ferret or extract data from /www.census.gov/DES/www/welcome.html |
| Time Period | continuous series of panels from 2.5 to 4 years; most recent 2/93-2/96 |
| Reference Period | health insurance questions pertain to any time in the four months since the previous interview |
| Scope of coverage | noninstitutionalized civilians and members of Armed Forces in civilian housing units |
| Analysis unit | person (household and family composition is not constant throughout reference period) |
| Sample size | 1993 panel: 20,000 households |
| Response rate | 91% of occupants in eligible living quarters were interviewed |
| Geography | 50 states and
DC
States can be identified, but state-level estimates are subject to high variance and are not recommended. Allows for regional analyses. |
| Design | multi-staged stratified sample |
| Data collection mode | decentralized telephone and in-person |
| Content | insurance coverage:
recent work history industry code of worker occupation code of worker health status |
| Organization | National Center for Health Statistics (conducted by Westat) |
| Contact | Owen Thornberry, Jr, (301) 436-8500 |
| Type | public-use |
| Availability/Cost | $21 for CD
purchase through NTIS (through 1994)
$60 for CD purchase through GPO (through 1994) $645 for tape purchase through NTIS (through 1995) 1995 data is expected to be available on CD in July, 1998 order from www.cdc.gov/nchswww/products/catalogs/subject/nhis/tapeform.htm |
| Time Period | annual; continuous sampling covers past 12 months; most recent available: 1995 |
| Reference Period | health insurance questions pertain to current status and changes in past 12 months |
| Scope of coverage | noninstitutionalized civilians |
| Analysis unit | person |
| Sample size | 36,000-49,000
households per year
92,000-125,000 persons |
| Response rate | 90% of households completed interviews |
| Geography | 50 states and
DC
starting in 1995, design of sample modified to allow state-level estimates for the larger states, or can pool across years to obtain estimates for each state. States can NOT be identified on main file, but region and large MSAs are identified. |
| Design | multistage probability sample (with oversampling of black and Hispanic households) |
| Data collection mode | in-person |
| Content | insurance coverage:
denied or restricted coverage because of health condition premiums (individual/employee contribution) current work status recent work history industry code of worker occupation code of worker health status |
| Organization | AHCPR (conducted by Westat) |
| Contact | MEPS project manager at AHCPR (301) 594-1406 |
| Type | public-use |
| Availability/Cost | $60/CD purchase
from NTIS (800) 533-6847 or www.ntis.gov/fcpc
Free from AHCPR Publications Clearinghouse (800) 358-9295 or www.ahcpr.gov |
| Time Period | continuous rotating panels starting in 1996; most recent round completed in 12/97. |
| Reference Period | health insurance questions pertain to coverage in effect at any time during the round |
| Scope of coverage | noninstitutionalized civilians |
| Analysis unit | person, family |
| Sample size | 24,676 persons in round 1 eligible households (23,612 with positive weights) |
| Response rate | 78% |
| Geography | 50 states and
DC
allows for regional, but NOT state-level analyses. census region identified on public-use file (state NOT identified) |
| Design | drawn from NHIS sampling frame |
| Data collection mode | five times in-person, sixth time by phone |
| Content | insurance coverage:
employer offers health insurance premiums (individual/employee contribution can be obtained by linking to MEPS-IC) current work status recent work history (can be ascertained after multiple rounds) health status |
Also can be linked to data collected from the respondents’ medical providers and insurance providers.
Panel rounds allow for examination of changes in insurance status.
Citation: Cohen, J. W., Monheit, A. C., et al. "The Medical Expenditure Panel Survey: A National Health Information Resource," Inquiry 33: 373-389, 1996/1997.
| Organization | Center for Studying Health System Change (conducted by Mathematica) |
| Contact | center@hschange.com, Peter Cunningham (202) 554-7549 |
| Type | public-use |
| Availability/Cost | free; will be available through ICPSR later in 1998 |
| Time Period | in field 7/96-7/97 |
| Reference Period | health insurance questions pertain to current status and any change in past 12 months |
| Scope of coverage | non-institutionalized civilians |
| Analysis unit | person, family (insurance unit), healthcare "community" |
| Sample size | 36,200 families:
1,225 per high-intensity metropolitan site 375 per low-intensity metropolitan site 4,500 total from non-metropolitan areas 3,500 total from unclustered national sample |
| Response rate | 65% |
| Geography | 12 high-intensity
metropolitan areas, 36 low-intensity metropolitan areas, 12 non-metro areas.
Supplemental sample allows for national estimates. Also allows for analysis of 12 high-intensity sites. |
| Design | 60 communities:
separate probabilistic samples of high-intensity communities, low-intensity
metropolitan areas, and non-metro areas stratified geographically.
supplement: unclustered national sample |
| Data collection mode | telephone (in-person for those without phone in high-intensity communities) |
| Content | insurance coverage:
employer offers insurance premiums current work status industry code of worker (open-ended) health status |
Citation: Kemper, B., Blumenthal, D., Corrigan, J., et al, "The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effects on People," Inquiry 33: 195-206. Summer 1996.
| Organization | Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC |
| Contact | Craig Lutzinger at (770) 488-5304 or ccdinfo@cdc.gov |
| Type | public-use |
| Availability/Cost | free through GPO |
| Time Period | annually; most recently available: 1996 |
| Reference Period | health insurance questions pertain to current status |
| Scope of coverage | noninstitutionalized civilian adults (18 and above) |
| Analysis unit | person |
| Sample size | 1,100 to 4,000 interviews per state |
| Response rate | 78% cooperation rate (median of rates by state) |
| Geography | 50 states,
DC, and 3 territories
allows for state-level analyses. States can be identified. |
| Design | random phone within state (design varies by state) |
| Data collection mode | telephone |
| Content | insurance coverage:
current work status recent work history (if not currently working, have you been out of work less than 1 year?) health status |
| Organization | Urban Institute (conducted by Westat) |
| Contact | (202) 828-1815 or email anfinfo@ui.urban.org |
| Type | public-use |
| Availability/Cost | (will be available in 1998) |
| Time Period | data collection: February through November 1997 (follow-up survey in 1999 or 2000). |
| Reference Period | health insurance questions pertain to current status. |
| Scope of coverage | Families with children under age 18 and non-aged adults without children under age 18 |
| Analysis unit | person, family |
| Sample size | sampled approximately 44,000 persons |
| Response rate | still preliminary |
| Geography | 13 states:
AL, CA, CO, FL, MA, MI, MN, MS, NJ, NY, TX, WA, WI plus 5,000 respondents
from rest of nation to allow for national estimates.
Allows for state-level estimates of the 13 states. States can be identified. |
| Design | random digit dial survey with oversampling of low-income households (<200% poverty) |
| Data collection mode | telephone survey (3.5% of sample are non-telephone households that were supplied with cellular phones) |
| Content | insurance coverage:
current work status industry code of worker (open-ended) occupation code of worker (open-ended) health status (asked of most knowledgeable adult and up to 2 children) |
| Organization | Robert Wood Johnson Foundation (conducted by Mathematica) |
| Contact | ICPSR (313)-763-5010 |
| Type | public-use |
| Availability/Cost | available through ICPSR at /www.icpsr.umich.edu/archive1.html (study #=6894) |
| Time Period | data collection: last half of 1993 and early 1994 |
| Reference Period | health insurance questions pertain to current status and ever in past 12 months |
| Scope of coverage | noninstitutionalized civilians |
| Analysis unit | person, family (insurance unit) |
| Sample size | 62,549 persons |
| Response rate | range from 77-91% by state |
| Geography | 10 states -
CO, FL, MN, NM, NY, ND, OK, OR, VT, WA.
allows for state-level analyses. States can be identified. |
| Design | random digit
dialing by state to screen eligible families.
oversampled families containing one or more Medicaid or uninsured persons. Also selected families without telephones in a few geographic areas per state. |
| Data collection mode | telephone supplemented with in-person interviews for those without phones |
| Content | insurance coverage:
employer offers insurance premium (individual policies only) current work status recent work history (if not currently working, were you looking for work during past 4 weeks?) industry code of worker (open-ended) health status |
Citation: Cantor, J. C., Long, S. H., Marquis, M. S., "Challenges of State Health Reform: Variations in Ten States," Health Affairs (January/February 1998): 191-200.
| Organization | KPMG (conducted by National Research, Inc.) |
| Contact | Jon Gabel (703) 469-3369 |
| Type | proprietary |
| Availability/Cost | $150 for the
written report.
Data have been sold to some organizations, but KPMG prefers to be used as a subcontractor. |
| Time Period | conducted annually in late winter and early spring; most recent: 1997 |
| Reference Period | health insurance questions pertain to current status |
| Scope of coverage | private and
public firms
1992, 1994, 1997: firms with >=200 employees and who offer health benefits 1993, 1995, 1996, (1998): includes smaller firms and those who do not offer health benefits. |
| Analysis unit | firm, employee |
| Sample size | 1,500 |
| Response rate | 60% |
| Geography | 50 states and
DC
allows for national and regional analyses, but NOT state-level. |
| Design | random draw from D&B, stratified by industry, employee size and region (uses location of headquarters) |
| Data collection mode | telephone |
| Content | premium (asked
of the largest conventional, HMO, PPO, and POS health plans)
pre-existing limits (not asked of those in HMO) covered employees |
| Organization | BLS |
| Contact | (202) 606-6222 or c2ideas@bls.gov |
| Type | tabulation are public-use (actual database not available) |
| Availability/Cost | selective access of tabulations available online at stats.bls.gov/ebshome.htm |
| Time Period | annual; updates are generally available in the summer following the reference year. |
| Reference Period | health insurance questions pertain to current status. |
| Scope of coverage | even years:
state and local government plus private non-farm establishments with fewer
than 100 employees.
odd years: private establishments with at least 100 employees limited to firms offering health benefits |
| Analysis unit | employee |
| Sample size | 1993: 2,325
1994: 2,135 |
| Response rate | 1993: 67%
1994: 69% |
| Geography | 50 states and
DC.
allows for regional, but NOT state-level, analyses. |
| Design | two-stage probability sample -- establishments and then occupations within establishments. Occupation categories are grouped by professional, technical, and related; clerical and sales; and blue collar and service |
| Data collection mode | in-person, telephone |
| Content | average employee contribution |
The EBS is being integrated with the Employment Cost Index (ECI) and Occupational Compensation Survey (OCS) into the National Compensation Survey (Comp2000). It will broaden the occupational coverage of the data, allow for state level analyses, and will eventually include information on costs for compensation and benefit plan provisions.
| Organization | Mercer/Foster-Higgins |
| Contact | Mitchell Stein (212) 345-7925 |
| Type | proprietary |
| Availability/Cost | entire database
is not available for sale, but extracts can be purchased.
$500 for 1997 report |
| Time Period | annual; most recent: 1997 |
| Reference Period | health insurance questions pertain to status as of July 1st of that year. |
| Scope of coverage | private and public firms with at least 10 employees AND who offer health benefits |
| Analysis unit | firm |
| Sample size | 1997: 3,915 respondents (from random sample) |
| Response rate | 50% |
| Geography | all states
and DC
does NOT allow for state-level analyses, but can analyze census regions as well as five CMSA/MSAs (New York City, Chicago, Los Angeles, Dallas, Atlanta). States can be identified. |
| Design | private firms:
random D&B draw stratified by employee size
gov: random draw from COG convenience: sample of F-H clients oversample of metro areas to allow for metro-level analyses |
| Data collection mode | mail with telephone follow-up |
| Content | recent changes
to benefit plans
premium (asked of the largest conventional, HMO, PPO, and POS health plans) pre-existing condition limitations covered employees average age of active employees industry code |
| Organization | NCHS/CDC (conducted by Westat) |
| Contact | (301) 436-8500 |
| Type | confidential |
| Availability/Cost | not yet available
to the public (due to confidentiality issues that are yet to be resolved)
check /www.cdc.gov/nchswww/nchshome.htm |
| Time Period | data collected from April to December 1994 |
| Reference Period | provision of
health insurance and employee characteristics pertain to status as of December
31, 1993.
characteristics of health insurance plan pertain to 1993 plan year (the plan year ending prior to April 1, 1994). |
| Scope of coverage | private/public/self-employed companies (including those with no additional employees) |
| Analysis unit | establishment |
| Sample size | 35,000 private
3,000 public 919 self-employed |
| Response rate | private: 71%
public: 87% self-employed: 80% |
| Geography | 50 states and
DC,
allows for state-level analyses. States can be identified. |
| Design | private: random
draw from D&B
public: random draw from 1992 COG self-employed: 1993 NHIS |
| Data collection mode | telephone |
| Content | offer health
insurance coverage
recently dropped (for those not offering, when did you last offer?) premium (probability sample of up to 5 plans) pre-existing condition limitations (probability sample of up to 5 plans) covered employees (total and by plan for up to 5 plans) covered dependents (total and by plan for up to 5 plans) - data of poor quality industry code |
includes information about employers who are self-insured
Citation: National Center for Health Statistics. "Employer-sponsored health insurance: State and National Estimates." Hyattsville, MD. 1997.
| Organization | Robert Wood Johnson Foundation (conducted by Westat) |
| Contact | ICPSR (313)-763-5010 |
| Type | public-use |
| Availability/Cost | available through ICPSR at /www.icpsr.umich.edu/archive1.html (study #=6908) |
| Time Period | data collection: 1993 and early 1994 |
| Reference Period | health insurance questions pertain to status at time of survey |
| Scope of coverage | private/public/self-employed establishments |
| Analysis unit | establishment, insurance plan |
| Sample size | 22,890 establishments
22,465 plans |
| Response rate | 71% |
| Geography | 10 states (CO,
FL, MN, NM, NY, ND, OK, OR, VT, WA)
allows for state-specific analyses of these 10 states. States can be identified. |
| Design | D&B probability sample of public and private employers stratified by employee size |
| Data collection mode | telephone |
| Content | employer offers
premiums (all plans) pre-existing condition limitations covered employees (total and by plan) # of employees with family plans industry code (open-ended) age distribution of workers (by sex: % less than <25, 25-54, 55 or older) |
| Organization | Robert Wood Johnson Foundation (conducted by Research Triangle Institute) |
| Contact | Steve Long and Susan Marquis at RAND (202) 296-5000 |
| Type | public-use |
| Availability/Cost | not yet available (plan to make available through ICPSR) |
| Time Period | data collection: fall 1996 through 1997 |
| Reference Period | health insurance questions pertain to status at time of survey |
| Scope of coverage | private/public/self-employed establishments |
| Analysis unit | establishment, insurance plan |
| Sample size | 23,000 establishments |
| Response rate | (preliminary estimate) 60% |
| Geography | 48 states and
DC (excludes Alaska and Hawaii)
allows for state-level analyses of CA, CT, FL, MA, MN, MD, NJ, NY, OR, WA also allow for analyses of 12 CTS intensive sites. States can be identified. |
| Design | stratify by
geography (60 CTS sites, other selected states with significant rating
reforms, and rest of nation) and by establishment size using D&B for
private and COG for local government.
also used a list sample of firms participating in a health insurance purchasing alliance in CA, CT, FL. |
| Data collection mode | telephone, mail |
| Content | employer offers
premiums (all plans) pre-existing condition limitations covered employees (total and by plan) industry code age of workers (% less than 30, 30-39, 40-49, 50 or older) |
| Organization | AHCPR (conducted by Census Bureau) |
| Contact | MEPS project manager at AHCPR (301) 594-1406 |
| Type | public-use |
| Availability/Cost | to be available
in fall 1998.
$265/tape purchase from NTIS (800) 533-6847 or www.ntis.gov/fcpc |
| Time Period | Data collection from March 1997 through November 1997. |
| Reference Period | Health insurance questions such as premiums and enrollment pertain to the pay period that included 7/1/96. Health insurance questions such as annual totals pertain to calendar year 1996. |
| Scope of coverage | insurance providers identified by respondents in MEPS household component as well as private and government establishments |
| Analysis unit | establishment |
| Sample size | 7,000 insurance
providers linked to MEPS household component
27,000 other private 1,900 government 1,000 self-employed |
| Response rate | 70% |
| Geography | 50 states and
DC
allows for state-level analyses of 40 states (only 100 cases were sampled in AK, CT, DE, ID, MT, ND, NH, RI, SD, VT and DC) |
| Design |
|
| Data collection mode | phone call to determine whether they offer ins, then mail followed by telephone follow-up or in-person visit if necessary. |
| Content | offers health
insurance
recently dropped or added premiums (up to 4 plans with highest enrollment) pre-existing condition limitations (up to 4 plans) number of enrolled employees (up to 4 plans) industry code number of workers 50 years or older |
Citation: Cohen, J. W., Monheit, A. C., et al. "The Medical Expenditure Panel Survey: A National Health Information Resource," Inquiry 33: 373-389, 1996/1997.
| Organization | A.M. Best |
| Contact | (908) 439-2200 |
| Type | proprietary |
| Availability/Cost | $375 for 1st year, see dfa.risknet.com/insurance/ambest/ambest.htm |
| Time Period | annual |
| Scope of coverage | health insurers included in NAIC annual financial report |
| Analysis unit | accident and health insurers |
| Sample size | over 1,200
companies reviewed
provides detail for up to 80 leading companies by line (the remainder are grouped together as "other") |
| Response rate | not applicable |
| Geography | presented by
state.
States can be identified. |
| Design | NAIC annual statement |
| Data collection mode | information extracted from statements |
| Content | aggregate premiums
(accident AND health) attributable to each principal line of coverage
market share number of carriers by line of insurance and state |
Note: The Accident and Health lines are broken down by
| Organization | Alpha Center |
| Contact | Deborah Chollet (202) 296-1818 |
| Type | public-use |
| Availability/Cost | an overview of the findings are reported in the monograph "Mapping Insurance Markets: The Group and Individual Health Insurance Markets in 26 States" which can be dowloaded from docs.ac.org/shopping_cart/FMPro |
| Time Period | calendar year 1995 |
| Scope of coverage | group and nongroup
major medical health insurance markets where insurers wrote at least $500,000
of comprehensive major medical business in 1995.
Does not include self-insured employers. |
| Analysis unit | insurance plan |
| Sample size | 1,022 group
health insurers
518 individual |
| Response rate | not applicable |
| Geography | 25 states (AL,CA,CT,FL,IA,ID,IL,KY,LA,MA,MD,MN,MS,MT
ND,NH,NY,OR,PA,RI,SC,TX,UT,VT,WA) for group and individual plus MI for individual only. States can be identified. |
| Design | include states in which at least 85% of total group health-related market and individual market are understood. |
| Data collection mode | compiled from
financial reports filed from HMOs, commercial insurers and BC/BS.
Also searched websites and telephoned company headquarters and states’ department of insurance. |
| Content | premiums (aggregate)
market share number of carriers by market (group and individual broken down by BC/BS, HMOs, and Commercial) |
Note: They occasionally had to impute major medical coverage to multi-state insurers and impute the proportion of major medical coverage to multiple-line insurers.
Citation: Chollet, D. J., Kirk, A. M., Ermann, R. D. "Mapping Insurance Markets: The Group and Individual Health Insurance Markets in 26 States," State Initiatives in Health Care Reform monograph. Alpha Center, October, 1997.
| Organization | Health Insurance Association of America |
| Contact | (202) 824-1600 |
| Type | proprietary database |
| Availability/Cost | no set fee |
| Time Period | annual |
| Scope of coverage | HIAA member companies (commercial insurers) |
| Analysis unit | commercial insurer |
| Sample size | 200+ insurers |
| Response rate | not applicable |
| Geography | state level |
| Design | survey |
| Data collection mode | survey |
| Content | number of commercial carriers active in small group market |
| Organization | Communicating for Agriculture |
| Contact | Bruce Abbe (612) 854-9005 or www.cainc.org/insurance/riskpool.html |
| Type | publication |
| Availability/Cost | $29.95 per copy |
| Time Period | annual; 1998 will be available in October. |
| Reference Period | operating statistics are for year end of previous year |
| Scope of coverage | state comprehensive health insurance programs (risk-sharing pools) |
| Analysis unit | state |
| Sample size | 28 programs (see note) |
| Response rate | 100% |
| Geography | state level for 28 states with risk pools (AL,AK,AR,CA,CO,CT,FL,IL,IN,IO,KS, LA,MN,MS,MO,MT,NE,NM,ND,OK,OR, SC,TN,TX,UT,WA,WI,WY) |
| Design | survey |
| Data collection mode | information supplied by state health plan administrators and obtained through research conducted by Communicating for Agriculture. |
| Content | summary of
plan composition
eligibility requirements benefits design waiting period and pre-existing conditions number of participants (overall and by plan type) premiums collected premiums paid |
| Organization | Interstudy |
| Contact | (800) 844-3351 or www.hmodata.com/index.html |
| Type | publications and proprietary databases |
| Availability/Cost | varies ($200-$12,000) |
| Time Period | annual and semi-annual; most recent - reporting date of July 1, 1997 (reporting date as of January 1, 1998 expected to be available in Fall 1998). |
| Reference Period | Competitive Edge Database includes information for current year as well as for two previous years |
| Scope of coverage | target all HMOs nationwide |
| Analysis unit | HMOs |
| Sample size | varies |
| Geography | nationally, by region, state and metro area |
| Design | contact all HMOs |
| Data collection mode | information extracted from surveys and regulatory data |
| Content | premium
market share enrollment financial indicators competitive indicators |
Note: "The Competitive Edge" database contains HMO industry data and enrollment and utilization information.
"The Regional Market Analysis" publication maps marketplaces for all MSAs and identifies HMO penetration, cost and premium information.
Glossary
AHCPR Agency for Health Care Policy and Research
BC/BS Blue Cross and Blue Shield
BLS Bureau of Labor Statistics
CA Communicating for Agriculture
CDC Center for Disease Control
COG Census of Governments - a list of government firms maintained by the Census Bureau.
D&B Dun and Bradstreet. Their Marker Identifier file is a national census of employment establishments.
GPO Government Printing Office
HIAA Health Insurance Association of America
HMO Health Maintenance Organization
ICPSR Inter-university Consortium for Political and Social Research
NAIC National Association of Insurance Commissioners
NCHS National Center for Health Statistics
NTIS National Technical Information Service
POS Point-of-service health plan
PPO Preferred Provider Organization
SSEL Standard Statistical Establishment List - a list of private sector business establishments maintained by the Census Bureau.
Go to next section of this document. (Part IV.
HIPPA Evaluation Design)