Medicaid Underreporting in the CPS: Results from a Record Check Study

Pascale, J.; Roemer, Marc; Resnick, Dean

doi:10.1093/poq/nfp028

Cited by 33 publications

(38 citation statements)

References 5 publications

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“…We also found effects of enrollment in other insurance programs on response error. We found evidence to support the shared coverage hypothesis for false‐positive responses but not for false‐negative response error; however, the latter may be related to our different operationalization of shared coverage from Pascale, Roemer, and Resnick . Future research should explore shared coverage related to overlapping coverage and whether the respondent is reporting for dependent children.…”

Section: Resultsmentioning

confidence: 60%

“…Cognitive testing revealed some respondents did not have accurate knowledge of other household members’ coverage, while others failed to include certain household members in their reports . Pascale, Roemer, and Resnick found support for a shared coverage hypothesis to explain response error in the 2001 CPS ASEC. In their analysis of matched CPS ASEC and MSIS data, respondents were most accurate reporting Medicaid coverage for other household members when the respondent and other household members shared coverage.…”

Section: Literature Reviewmentioning

confidence: 96%

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Response error and the Medicaid undercount in the current population survey

Noon

Fernández

Porter

2018

Health Services Research

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Objective To measure the Medicaid undercount and analyze response error in the 2007‐2011 Current Population Survey Annual Social and Economic Supplement (CPS ASEC). Data Sources/Study Setting Medicaid Statistical Information System (MSIS) 2006‐2010 enrollment data linked to the 2007‐2011 CPS ASEC person records. Study Design By linking individuals across datasets, we analyze false‐negative error and false‐positive error in reports of Medicaid enrollment. We use regression analysis to identify factors associated with response error in the 2011 CPS ASEC. Principal Findings We find that the Medicaid undercount in the CPS ASEC ranged between 22 and 31% from 2007 to 2011. In 2011, the false‐negative rate was 40%, and 27% of Medicaid reports in CPS ASEC were false positives. False‐negative error is associated with the duration of enrollment in Medicaid, enrollment in Medicare and private insurance, and Medicaid enrollment in the survey year. False‐positive error is associated with enrollment in Medicare and shared Medicaid coverage in the household. Conclusions Survey estimates of Medicaid enrollment and estimates of the uninsured population are affected by both false‐positive response error and false‐negative response error, and these response errors are non‐random.

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Section: Resultsmentioning

confidence: 60%

Section: Literature Reviewmentioning

confidence: 96%

Response error and the Medicaid undercount in the current population survey

Noon

Fernández

Porter

2018

Health Services Research

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“…Cognitive testing of the CPS ASEC health insurance questions suggested that some respondents focused on their current coverage status rather than the previous year reference period (Pascale et al 2009). SNACC researchers also found that those who are enrolled in Medicaid at the time of the survey are less likely to report false negatives (SNACC Phase V 2010).…”

Section: Literature Reviewmentioning

confidence: 99%

Response Error and the Medicaid Undercount in the Current Population Survey

Noon¹,

Fernández²,

Rastogi³

2017

Preprint

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The Current Population Survey Annual Social and Economic Supplement (CPS ASEC) is an important source for estimates of the uninsured population. Previous research has shown that survey estimates produce an undercount of beneficiaries compared to Medicaid enrollment records. We extend past work by examining the Medicaid undercount in the 2007-2011 CPS ASEC compared to enrollment data from the Medicaid Statistical Information System for calendar years 2006-2010. By linking individuals across datasets, we analyze two types of response error regarding Medicaid enrollment – false negative error and false positive error. We use regression analysis to identify factors associated with these two types of response error in the 2011 CPS ASEC. We find that the Medicaid undercount was between 22 and 31 percent from 2007 to 2011. In 2011, the false negative rate was 40 percent, and 27 percent of Medicaid reports in CPS ASEC were false positives. False negative error is associated with the duration of enrollment in Medicaid, enrollment in Medicare and private insurance, and Medicaid enrollment in the survey year. False positive error is associated with enrollment in Medicare and shared Medicaid coverage in the household. We discuss implications for survey reports of health insurance coverage and for estimating the uninsured population.

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“…Given these divergent estimates, a comprehensive research agenda has been underway at the Census Bureau since 1999 to examine and reduce measurement error associated with health insurance estimates from the CPS questionnaire. Research activities included an extensive and ongoing literature review, multiple rounds of cognitive testing and behavior coding, interviewer and respondent debriefings, split‐ballot field tests, and record‐check studies (Hess et al ; Pascale , , , , ; Pascale et al ). This research enterprise demonstrated that there were three key features of the CPS questionnaire that were associated with measurement error.…”

mentioning

confidence: 99%