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ERPREXOPU
Annual total of direct health care payments from other public source for separately billed doctor expenses from emergency room medical providers

Description

For all persons, ERPREXOPU captures the sum of direct payments made by other public insurance source for "separately billing doctor," or SBD, expenses associated with all visits to emergency room medical providers. SBD expenses include those for services provided to patients in hospital settings by providers like radiologists, anesthesiologists, and pathologists, whose charges are often not included in hospital bills. Payments for over-the-counter drugs and indirect payments not related to specific medical events, such as Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, are not included in this amount.

AHRQ staff advise users to exercise caution when interpreting the expenditures recorded in ERPREXOPU. While these payments stem from apparent inconsistent responses to the health insurance and source of payment questions in the survey, some of these inconsistencies may have logical explanations. For example, some of the "other public" payments may stem from confusion between Medicaid and other state and local programs or may be for persons who were not enrolled in Medicaid, but were presumed eligible by a provider who ultimately received payments from the program. For more information on how MEPS collects expenditure data, please refer to our user note on medical expenditures.

 

Note that hospitals usually include expenses associated with emergency room visits that immediately result in an inpatient stay with the charges and payments for the inpatient stay. Therefore, to avoid the potential for double counting when imputing missing expenses, separately reported facility expenditures for emergency room visits that were identified in the Medical Provider Component (MPC) as directly linked to an inpatient stay were included as part of the inpatient stay only (see HPCHGTOT and HPFCHT). This strategy to avoid double counting resulted in $0 facility expenditures for these emergency room visits (but there still may be associated separately-billing doctor expenses). However, these $0 emergency room visits are still counted as separate visits in the utilization variable ERTOTVIS.

Related variables
Variables related to total annual health care expenditures by source of payment, total annual health care expenditures by type of medical service, and total annual health care charges are also available. Please refer to our user note on expenditures for a list of these variables.

Codes

ERPREXOPU is a 6-digit numeric variable.

Comparability

This variable is completely comparable over time.

Universe

  • 1996-2018: All persons.

Availability

  • 1996-2018

Weights

Flags

This variable has no flags.