Recommendations for Monitoring Access to Care among Medicaid Beneficiaries at the State-level. Endnotes


[1] An overview of the state specific surveys, including the thirteen states that regularly conduct these surveys, is available through the State Health Access Data Assistance Center (SHADAC):; accessed October 1, 2012.

[2] Smith et al. "The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession, Results of a 50-State Medicaid Budget Survey for State Fiscal Years 2009 and 2010." Report of the Kaiser Commission on Medicaid and the Uninsured, 2009.

[3] "Measuring and Reporting Sources of Error in Surveys." Working Paper 31, Prepared by the Subcommittee on Measuring and Reporting the Quality of Survey Data at the Federal Committee on Statistical Methodology (FCSM) for the Statistical Policy Office, Office of Information and Regulatory Affairs at OMB (June 2001).

[4] Information abstracted from CDC's About BRFSS website available at:; accessed October 1, 2012.

[5] Pierannunzi C, et al. "Methodologic Changes in the Behavioral Risk Factor Surveillance System in 2011 and Potential Effects on Prevalence Estimates," MMWR, 61 (2012): 22.

[6] Information abstracted from CDC's "About NHIS" website available at:; accessed October 1, 2012.


[8] Gentleman, J. "Using the National Health Interview Survey to Monitor the Early Effects of the Affordable Care Act." Paper presented at the Joint Statistical Meetings in San Diego, CA, July 28 - August 2 2012. Abstract available at:; accessed October 10, 2012. Full paper forthcoming.

[9] The precision issue and whether there are enough sample cases to use the estimate for policy purposes becomes more complicated with the sub-sampling that occurs during the household interview in the NHIS. For example the interviewer asks all members of the family about their health insurance coverage (e.g., whether they are uninsured, have Medicaid or have some other type of coverage), but some other items regarding access to care are asked of only one sample adult or sample child within the household. Questions asked of only one person in the household (e.g., trouble finding a doctor) have fewer responses than questions asked of everyone in the household (e.g., health insurance coverage). The design effect will typically be smaller for estimates generated off the sample adult or child estimates than those generated off the entire family.

[10] Additional information on the NCHS and Census RDC procedures is available on the website available at:; accessed December 9, 2012.

[11] The 2011 NSDUH sample included 14,303 respondents who reported having Medicaid or CHIP coverage. Sample size data for 2010 and 2011 are available at:; accessed December 9, 2012.

[12] Information abstract from CDC's "About NAMCS" website, available at:; accessed October 1, 2012.

[13] Information abstracted from CDC's NAMCS participant website, available at:, accessed October 1, 2012.

[14] Information abstracted from SK&A's data website, available at:, accessed October 1, 2012.

[15] Jessica Nysenbaum, Ellen Bouchery, and Rosalie Malsberger. "The Availability and Usability of Behavioral Health Organization Encounter Data in MAX 2009." MAX Medicaid Policy Brief #14. Mathematica Policy Research, December 2012, Document No. PP12-107..

[16] James Gorman. "T-MSIS Pilot Overview." Presented at Medicaid Enterprise Systems Conference (MESC), August 2012. Available at:; accessed December 9, 2012.

[17] These measures can also be assessed for the largest thirty-four states using the 2012 NAMCS once the data are available.

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