Adapting Geographical Sampling Unit Size and Structure for a Changing Survey Landscape

Oregon Convention Center 

Recent changes in the survey landscape due to the Covid-19 pandemic include industry-wide declining response rates and mode changes. These shifts can impact the suitability of a survey's design. The Medicare Current Beneficiary Survey (MCBS), a longitudinal survey of a nationally representative sample of the Medicare population conducted by the Centers for Medicare and Medicaid Services (CMS), is a historically in-person survey with a three-stage geographically clustered design. The sizes of the secondary sampling units (SSUs) were set in 2014. Since then, declines in response rates and a switch to mostly phone interviewing in 2020 have required larger sample sizes than anticipated, straining the effectiveness of the existing SSU design. This paper describes these challenges, our methodology for evaluating alternative strategies for expanding the size and reach of SSUs, and the impacts of the size and structure of the SSUs on sample selection and estimation. We cover the role of SSUs in the MCBS design, options for increasing the size of the SSUs and the available sample within them, considerations for determining the size of SSUs, and tradeoffs between the SSU expansion methods.

sample design

data collection

survey sampling

healthcare surveys

Medicare

response rates 

Survey Research Methods Section