A State-level telephone survey would be designed by HHS to be conducted periodically to obtain basic health status, access to care, insurance, and expenditure data of importance for national policy analysis, performance evaluation, and modeling. By using the available NHIS sample, already distributed widely in States, and using questionnaires from the consolidated national surveys, State level data can be obtained efficiently and be directly comparable to national data. Linkage to the NHIS sample, and use of common questionnaires will greatly enhance HHS' and State's ability to create analytic approaches in which more detailed data available on national surveys can be modeled to the State level. If funding can be identified, this survey would be conducted at intervals when the MEP is off-peak.
The design will allow States to "buy into" the consolidated HHS survey to obtain data on their States on a more frequent basis than would be available in the HHS survey of all States, or possibly to target content relevant to State needs. States may find this to be an efficient option for monitoring performance partnership grants, and for meeting State policy, planning, and public health purposes. HHS would develop questionnaire modules, sampling strategies, and contract mechanisms through which States could participate in the consolidated HHS survey. Options might include 1) augmenting the existing sample from national surveys that already exists in a given State, either with additional household or telephone interviews; 2) using consensus questionnaire modules to replicate national surveys within a State; or 3) using national surveys as benchmarks for improved modeling and estimation at the State level.
The NHIS sample redesign implemented in 1995 increased the number of sampling units, eliminated sampling units that overlapped State boundaries, and made other changes to make State estimates more attainable. NCHS has already used the NHIS to provide State-specific data to New York and California, and the sample allows for direct estimates for additional States. States would be able to pay for the additional sample sizes necessary to meet their analytic objectives. This plan will take advantage of the combined features of the NHIS sample and the range of content and methods that will be included in the NHIS and the MEP to provide States with options that do not currently exist.