Common use of Medical Provider Component Clause in Contracts

Medical Provider Component. The MEPS MPC supplements and validates information on medical care events reported in the MEPS HC by contacting medical providers and pharmacies identified by household respondents. The MPC sample includes all hospitals, hospital physicians, home health agencies, and pharmacies reported in the HC. Also included in the MPC are all office-based physicians who: were identified by the household respondent as providing care for HC respondents receiving Medicaid. were selected through a 75-percent sample of HC households receiving care through an HMO (health maintenance organization) or managed care plan. were selected through a 25-percent sample of the remaining HC households. Data are collected on medical and financial characteristics of medical and pharmacy events reported by HC respondents, including: Diagnoses coded according to ICD-9-CM (9th Revision, International Classification of Diseases) and DSM-IV (Fourth Edition, Diagnostic and Statistical Manual of Mental Disorders). Physician procedure codes classified by CPT-4 (Common Procedure Terminology, Version 4). Inpatient stay codes classified by DRGs (diagnosis-related groups). Prescriptions coded by national drug code (NDC), medication name, strength, and quantity dispensed. Charges, payments, and the reasons for any difference between charges and payments. The MPC is conducted through telephone interviews and mailed survey materials. In some instances, providers sent medical and billing records which were abstracted into the survey instruments.

Medical Provider Component. The MEPS MPC supplements and validates information on medical care events reported in the MEPS HC by contacting medical providers and pharmacies identified by household respondents. The MPC sample includes all hospitals, hospital physicians, home health agencies, and pharmacies reported in the HC. Also included in the MPC are all office-based physicians whophysicians: were identified by the household respondent as providing • Providing care for HC respondents receiving Medicaid. were selected through • Associated with a 75-percent sample of HC households receiving care through an HMO (health maintenance organization) or managed care plan. were selected through • Associated with a 25-percent sample of the remaining HC households. Data are collected on medical and financial characteristics of medical and pharmacy events reported by HC respondents, including: • Diagnoses coded according to ICD-9-CM (9th Revision, International Classification of Diseases) and DSM-IV (Fourth Edition, Diagnostic and Statistical Manual of Mental Disorders). • Physician procedure codes classified by CPT-4 (Common Procedure Terminology, Version 4). • Inpatient stay codes classified by DRGs (diagnosis-related groups). • Prescriptions coded by national drug code (NDC), medication namenames, strength, and quantity dispensed. • Charges, payments, and the reasons for any difference between charges and payments. The MPC is conducted through telephone interviews and mailed survey materials. In some instances, providers sent medical and billing records which were abstracted into the survey instruments.