The 2023 Ohio Medicaid Assessment Survey (OMAS) is a critical resource for assessing health statuses, health care access and service utilization, and select behavioral risks for Ohioans, with an emphasis on current Medicaid members and adults who are potentially eligible to receive Medicaid insurance. The 2023 OMAS is the 10th iteration of the series and builds upon prior surveys to identify trend changes for Ohio's Medicaid, Medicaid-eligible, and non-Medicaid populations. It is a cross-sectional random probability survey of non-institutionalized Ohio adults ages 19 years and older and proxy interviews of children ages 18 years and younger. The 2023 survey had a sample size of 39, 626 adult interviews and 5,505 child interviews (via proxy adults).
The 2023 OMAS is an Ohio Medicaid Technical Assistance and Policy Program (MedTAPP) project funded by the Ohio Department of Medicaid (ODM), the Ohio Department of Health (ODH), the Ohio Department of Mental Health and Addiction Services (OhioMHAS), and The Ohio State University (OSU). The OMAS survey vendor is RTI International, a non-profit organization that provides research and technical services.
Survey Data
The 2023 OMAS public use dataset and documentation are available for download below. This public use dataset contains data collected from the adult and child questionnaires, except for select variables relating to the administration of data collection.
2023 Public Use Datasets
2023 OMAS Analytical Codebook
2023 Questionnaire
To increase the precision of key 2023 outcomes from OMAS at the county level, a small area estimation (SAE) methodology was implemented for select variables, decided by the sponsoring agencies and the OMAS executive Committee.
2023 County-Level Small Area Estimation Maps & Tables
For select variables, to increase the precision of key outcomes from OMAS at the county level, a small area estimation (SAE) methodology was implemented-- these variables were selected by the sponsoring agencies and the OMAS Executive Committee. - Coming Soon!
Design and Methods
The 2023 OMAS used an address-based sampling (ABS) frame for the main sample and included a second smaller sample of Medicaid enrollees ages 19-64 years from Ohio Medicaid administrative data. The Medicaid sample was included in the 2023 OMAS to target Medicaid enrollees more efficiently and to allow for estimates by Medicaid eligibility group. Sample members in the ABS and Medicaid frames were administered the same base questionnaire—however, sample from the Medicaid frame were asked slightly different questions about their health insurance due to their known health insurance status, and only ABS members were invited to complete the child section. Members of the ABS sample were invited to complete the survey by web or by paper, with the option of calling the study team to complete the survey by phone if needed. A combination of mail, text messages, and phone calls were used to invite members of the Medicaid frame to complete the survey by web or by phone, with no option for a paper survey.
The target population for the 2023 OMAS was all residents of Ohio. The OMAS sampling plan was a probability-based design with known probabilities of selection at each stage of selection. The general sample design was a stratified dual-frame design with an oversampling of key populations of interest. The ABS sample design consisted of primary and secondary strata. Primary strata consisted of the 88 counties in Ohio. The secondary strata identified Census block groups with high concentration of key demographic characteristics of interest. The Medicaid administrative sample was stratified based on the enrollment type of each enrollee. Final weights for the survey were constructed separately for the ABS and Medicaid list portions and then blended. To correct for any coverage deficiencies, poststratification adjustments were made to ensure the final weights for the ABS sample align with population totals from the 2020 5-year American Communities Survey and that the Medicaid population totals from the ABS and Medicaid samples match. See the 2023 methodology report for full details.
2023 Methodology Report
OMAS County Types
OMAS assigns counties to one of four mutually exclusive county types - rural Appalachian, rural non-Appalachian, metropolitan, and suburban. OMAS defines these county types in accordance with federal definitions, as follows: (1) Appalachia is defined using the Appalachian Regional Commission (ARC) standard; (2) Metropolitan is defined using US Census Bureau definitions incorporating urban areas and urban cluster parameters; (3) rural is defined by the Federal Office of Rural Health Policy at the Health Resources and Services Administration (HRSA), excluding Appalachian counties; (4) suburban is defined by the US Census Bureau and is characterized as a mixed-use or predominantly residential area within commuting distance of a city or metropolitan area.
These designations were originally set by the Ohio Department of Health in 1997 for the 1998 Ohio Family Health Survey (OFHS) and were slightly adjusted in 2004 and again adjusted in 2010 to include Ashtabula and Trumbull counties as Appalachian, in accordance with a federal re-designation. Guidance for these categories was provided by National Research Council's Committee on Population and Demography staff - for original designations and revisions.
2023 Estimation Guidelines
Proper estimation of the 2023 OMAS data must account for its complex survey design and consider the correct analytic weights. Analysts should use the final adjusted survey weights for analyses of the adult or child (aged 18 or younger) population of Ohio residents. The adult adjusted survey weight (WT_A) is based on the combined ABS and Medicaid frame samples. As only ABS members were invited to complete the child section, the child adjusted survey weight (WT_C) is based only on the ABS frame sample.
For guidance on the use of the analytic weights and example analyses in select statistical software, please see Appendix K of the 2023 Methodology Report.
Research and Reports
Below is a list of chartbooks that address key findings from the 2023 OMAS. The analyses completed for these chartbooks were exploratory and are meant to be descriptive in nature. Because they were not driven by specific research questions, no statistical testing was conducted and the precision of provided estimates is assessed using confidence intervals. The provided confidence intervals should not be used to conduct “ad-hoc” testing to compare differences between groups. For any research using data from the 2023 OMAS, a research plan should be specified that includes primary hypotheses and corresponding statistical analysis strategies.
Please continue to check back regularly as we post these chartbooks.