Validity of Reported Medicare Part D Enrollment in the Medical Expenditure Panel Survey

Abstract The Medicare Part D donut hole has been gradually closed since 2010. But it is still unclear how it has impacted the beneficiaries’ relative financial burdens, especially in the later stage of the closing plan. The measurement of catastrophic health expenditure induced by prescription drugs (CHE-Rx) reflects the relative financial burdens to beneficiaries’ household income, which bears more information than the measure of dollar-value expenses or the absolute poverty line used in prior studies. Using the Medical Expenditure Panel Survey 2008-2017 longitudinal national representative data and the method of difference-in-differences, this study found that the donut hole closing policy was associated with more usage of prescription drugs (b=2.84, p=0.023) and a higher likelihood of experiencing CHE-Rx (b=2.4%, p=0.011) among those who fell in the donut holes. Besides, the results show that the donut hole closing policy did not generate any immediate effects on prescription drug usage, CHE, and CHE-Rx. For the first time, this paper examined both the aggregated and marginal impact of the policy implementation, which had closed by an additional 35% between 2013 and 2017, on the relative financial burden among the beneficiaries.

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Introduction to the Use of MEPS (Medical Expenditure Panel Survey)

Advances in Medical Technologies and Clinical Practice - Clinical Data Mining for Physician Decision Making and Investigating Health Outcomes ◽

10.4018/978-1-61520-905-7.ch003 ◽

2010 ◽

pp. 19-56

Author(s):

Patricia Cerrito ◽

John Cerrito

Keyword(s):

Medical Expenditure Panel Survey ◽

Complete Information ◽

Medical Expenditure ◽

Patient Treatment ◽

Panel Survey ◽

Patient Privacy ◽

Part D ◽

Physician Visits ◽

Medication Information ◽

Healthcare Profession

We will begin with data from the Medical Expenditure Panel Survey and use it throughout the text. This dataset has been provided since 1996 and contains yearly information concerning every interaction with the healthcare profession for a cohort of approximately 30,000 patients and 11,000 households. Each household is included in the survey for a two-year period. It contains every inpatient and outpatient event, all physician visits, medications, and lab orders for every member of this cohort. It is usually two years behind, so that in 2008, medication information concerning Medicare, Part D from 2006 first became available for analysis. Because of patient privacy, patient treatment and diagnosis information is incomplete. However, this database contains very complete information about reimbursements from private insurers, government agencies, and individual patients. Therefore, it can be used to determine healthcare expenditures by individuals and households.

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Medicare Part D and the Financial Protection of the Elderly

American Economic Journal Economic Policy ◽

10.1257/pol.3.4.77 ◽

2011 ◽

Vol 3 (4) ◽

pp. 77-102 ◽

Cited By ~ 35

Author(s):

Gary V Engelhardt ◽

Jonathan Gruber

Keyword(s):

Prescription Drug ◽

Insurance Coverage ◽

Medicare Part D ◽

The Elderly ◽

Medical Expenditure ◽

Medicare Part ◽

Part D ◽

Drug Insurance ◽

Crowd Out ◽

Prescription Drug Insurance

We examine the impact of the expansion of public prescription-drug insurance coverage from Medicare Part D and find evidence of substantial crowd-out. Using the 2002–2007 waves of the Medical Expenditure Panel Survey, we estimate the extension of Part D benefits resulted in 75 percent crowd-out of both prescription-drug insurance coverage and expenditures of those 65 and older. Part D is associated with sizeable reductions in out-of-pocket spending, much of which has accrued to a small proportion of the elderly. On average, we estimate a welfare gain from Part D comparable to the deadweight cost of program financing. (JEL H51, I18, J14)

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