Description
For all persons, OPPHPREXOPU captures the sum of direct payments made by other public insurance source for "separately billing doctor," or SBD, expenses associated with all visits to outpatient physicians. 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 OPPHPREXOPU. 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.
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.
