Papers written by Author(s): 'Thomas A. Hegland'
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Working PaperThe Underserved Have Less Access to Employer-Sponsored Telemedicine Coverage
September 2022
Working Paper Number:
CES-22-40
Telemedicine has been proposed as one means of improving health care access for underserved communities, and information about insurance coverage for telemedicine (TMC) is important in understanding its utilization and provision. We use 2018-2019 Medical Expenditure Panel Survey-Insurance Component data on employer-sponsored coverage to examine pre-pandemic TMC relative to employer, worker, and health plan characteristics. We find that the share of employees in private sector establishments offering TMC was lower in the most rural counties, in smaller firms, in establishments without unionized employees, and in establishments where most workers were low wage, part-time and older when compared to other establishments. These findings reflect differences across establishments in insurance offers, as well as differences in TMC conditional on an insurance offer, which suggests that TMC may function as a premium plan feature with limited availability and potential support for improving healthcare access for the underserved.View Full Paper PDF
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Working PaperIntroducing the Medical Expenditure Panel Survey-Insurance Component with Administrative Records (MEPS-ICAR): Description, Data Construction Methodology, and Quality Assessment
August 2022
Working Paper Number:
CES-22-29
This report introduces a new dataset, the Medical Expenditure Panel Survey-Insurance Component with Administrative Records (MEPS-ICAR), consisting of MEPS-IC survey data on establishments and their health insurance benefits packages linked to Decennial Census data and administrative tax records on MEPS-IC establishments' workforces. These data include new measures of the characteristics of MEPS-IC establishments' parent firms, employee turnover, the full distribution of MEPS-IC workers' personal and family incomes, the geographic locations where those workers live, and improved workforce demographic detail. Next, this report details the methods used for producing the MEPS-ICAR. Broadly, the linking process begins by matching establishments' parent firms to their workforces using identifiers appearing in tax records. The linking process concludes by matching establishments to their own workforces by identifying the subset of their parent firm's workforce that best matches the expected size, total payroll, and residential geographic distribution of the establishment's workforce. Finally, this report presents statistics characterizing the match rate and the MEPS-ICAR data itself. Key results include that match rates are consistently high (exceeding 90%) across nearly all data subgroups and that the matched data exhibit a reasonable distribution of employment, payroll, and worker commute distances relative to expectations and external benchmarks. Notably, employment measures derived from tax records, but not used in the match itself, correspond with high fidelity to the employment levels that establishments report in the MEPS-IC. Cumulatively, the construction of the MEPS-ICAR significantly expands the capabilities of the MEPS-IC and presents many opportunities for analysts.View Full Paper PDF