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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.