Medical Expenditure Measures in the Health and Retirement Study

This paper reviews out-of-pocket (OOP) medical expenditure measures collected in the Health and Retirement Study (HRS). Medical expenditures are an important cost of poor health. Medical expenditure measures are important for understanding retirement decisions, financial preparation for retirement, and predicting the consequences of health care reform, particularly Medicare reform. Despite the comprehensiveness of the HRS, there are always limitations to what can be learned from population interviews. To assess the quality of current HRS measures of OOP spending, we compare various measures of OOP spending across survey waves to the Medical Expenditure Panel Survey (MEPS) and Medicare Current Beneficiary Survey (MCBS), two surveys that expend considerable resources on measuring both OOP spending and total medical expenditures. Such comparisons make it possible to identify potential bias in the HRS data and to improve HRS measures of OOP. We find that the HRS produces good quality and useful data on OOP spending.