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Appendix
Workshop Agenda and Presenters
AGENDA
Workshop on Developing a Measure of Medical Care Economic Risk
September 8, 2011
8:30–9:15am OPENING SESSION
Welcome and Call to Order
Michael O’Grady, NORC Chair
Welcoming Remarks on Behalf of the National Academies
Constance Citro, CNSTAT, DBASSE
Sponsor’s Perspectives
Don Oellerich, ASPE
Context for the Workshop—The New Supplemental
Poverty Measure
Kathleen Short, Census Bureau
9:15–10:45am SESSION ONE
Moderator
David Betson, University of Notre Dame
Measuring Medical Care Economic Risk—What is the
c
oncept? Why do we need it? What are the criteria for a
217
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218 MEDICAL CARE ECONOMIC RISK
useful measure? How do we measure adverse medical event
risk? How do we measure subsequent economic hardship?
Pros and cons of retrospective and prospective measures.
Overview of the background paper by Sarah Meier and
Barbara Wolfe—A conceptual framework for measuring
medical care economic risk.
Presenters
Barbara Wolfe and Sarah Meier,
University of Wisconsin–Madison
Discussants
Pamela Short, Penn State University
Gary Burtless, Brookings Institution
Richard Bavier, Retired from OMB
Floor Discussion and Comments
10:45–11:00am Coffee Break
11:00am–12:30pm SESSION TWO
Moderator
Wilhelmine Miller, NORC
Issues in the Development of Thresholds—Should thresh-
olds vary for different population groups? How to cap-
ture variability of risk across populations including geo-
graphic variations in exposure to medical care economic
risk; and vulnerability of population groups by insurance
status, age, income, chronic health conditions; how to
update the thresholds?
Tracking geographic variations in exposure to medi-
cal care economic risk—moving beyond one national
estimate.
Presenter
Sara Collins, The Commonwealth Fund
Trends in persistent financial burden of medical out-
of-pocket expenditures resulting from chronic health
conditions.
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PART II: APPENDIX 219
Presenter
Peter Cunningham, Center for Studying Health System
Change
Trends in insurance coverage—insured and uninsured—
and their impact on medical out-of-pocket expenses, in-
cluding insurance premiums.
Presenter
Gary Claxton, Kaiser Family Foundation
Discussant
James Ziliak, Director, University of Kentucky Center for
Poverty Research
Floor Discussion and Comments
12:30–1:15pm Working Lunch
1:15–2:45pm SESSION THREE
Moderator
Cathy Schoen, The Commonwealth Fund
Issues in Defining Resources—What is included in in-
come in determining medical care economic risk in terms
of ability to pay for insurance and for medical out-of-
pocket expenses? How to treat assets in addition to
income; what constitutes income for the self-employed?
How do the elderly and other groups finance medical
care?
Overview of background paper by Jessica Banthin
and Didem Bernard: Using Income and Asset Data
from the Medical Expenditure Panel Survey, Assess
the Distribution of Resources and Different Ways
of Measuring Resources Available to Retired, Self-
Employed, and Employed Families for Medical Expenses,
Including Insurance Premiums.
Presenter
Jessica Banthin, CBO
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220 MEDICAL CARE ECONOMIC RISK
Changes over time on how the elderly finance medical
care—findings from the Health and Retirement Study.
Presenter
Michael Hurd, RAND
Financial burden of medical care among the elderly in
transitioning to long-term care.
Presenter
Eric Stallard, Duke University
Discussant
Marilyn Moon, AIR
Floor Discussion and Comments
2:45–3:00pm Coffee Break
3:00–4:00pm SESSION FOUR
Moderator
Emmett Keeler, UCLA
Implementation Issues—What data are available now?
What relevant data will become available under health
care reform? What data quality concerns are there?
What about timeliness? Can the medical care risk index
be released at the same time as the Supplemental Poverty
Measure?
Overview of background paper, Measuring Medical Care
Economic Risk: An Assessment of Data Sources
Presenter
John L. Czajka, Mathematica Policy Research
Floor Discussion and Comments
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PART II: APPENDIX 221
4:00–5:00pm SESSION FIVE
Moderator
Michael O’Grady
Recap of Issues, Needed Research, and Potential
Solutions for Developing a Measure of Medical Care
Economic Risk
Presenters
Pamela Short
Sara Collins
James Ziliak
Floor Discussion and Comments
5:00–5:15pm CLOSING REMARKS
Constance Citro
Michael O’Grady
5:15pm Adjourn
Presenters
Jessica S. Banthin is a senior advisor in the Health and Human Resources
Division of the Congressional Budget Office.
Richard Bavier is retired fronm the U.S. Office of Management and
Budget.
Gary Burtless is senior fellow, Economic Studies, The John C. and Nancy
D. Whitehead Chair at the Brookings Institution.
Constance F. Citro is director of the Committee on National Statistics
in the Division of Social and Behavioral Sciences and Education,
National Research Council.
Gary Claxton is vice president and director, Health Care Marketplace
Project at Henry J. Kaiser Family Foundation.
Sara Collins is vice president, Affordable Health Insurance at The
Commonwealth Fund.
Peter Cunningham is senior fellow and director of quantitative research
at the Center for Studying Health Systems Change.
John L. Czajka is senior fellow at Mathematica Policy Research in
Washington, DC.
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222 MEDICAL CARE ECONOMIC RISK
Michael Hurd is senior economist and director, RAND Center for the
Study of Aging, RAND Corporation.
Emmett Keeler is senior mathematician and professor of health services,
Pardee RAND Graduate School at the UCLA School of Public
Health.
Sara Meier is a Ph.D. student, Department of Population Health Sciences
at the University of Wisconsin–Madison.
Wilhelmine Miller is senior fellow at NORC at the University of Chicago.
Marilyn Moon is senior vice president and director, Health Programs at
the American Institutes for Research.
Donald T. Oellerich is deputy chief economist, Office of the Assistant
Secretary for Planning and Evaluation at the Department of Health
and Human Services.
Cathy Schoen is senior vice president for Research, Policy and Evaluation
at The Commonwealth Fund.
Kathleen F. Short is senior research economist in the Social, Economic,
and Housing Statistics Division at the U.S. Census Bureau.
Pamela Farley Short is professor of health policy and administration and
director of the Center for Health Care and Policy Research at the
Pennsylvania State University.
P.J. Eric Stallard is research professor, Department of Sociology, and
associate director, Center for Population Health and Aging, Duke
Population Research Institute at Duke University.
Barbara Wolfe is professor of economics, population health services, and
public affairs, and faculty affiliate, Institute for Research on Poverty
at the University of Wisconsin–Madison.
James Ziliak is Carol Martin Gatton chair in microeconomics and
director, Center for Poverty Research at the University of Kentucky.
