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Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
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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 concept? Why do we need it? What are the criteria for a
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
  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 thresholds vary for different population groups? How to capture variability of risk across populations including geographic 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 medical 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.
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
  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, including 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 income 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
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
  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
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
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.

Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×

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.

Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 217
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 218
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 219
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 220
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 221
Suggested Citation:"Appendix: Workshop Agenda and Presenters." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 222
Next: PART III: RESOURCES FOR THE STUDY: BACKGROUND PAPERS »
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The United States has seen major advances in medical care during the past decades, but access to care at an affordable cost is not universal. Many Americans lack health care insurance of any kind, and many others with insurance are nonetheless exposed to financial risk because of high premiums, deductibles, co-pays, limits on insurance payments, and uncovered services. One might expect that the U.S. poverty measure would capture these financial effects and trends in them over time. Yet the current official poverty measure developed in the early 1960s does not take into account significant increases and variations in medical care costs, insurance coverage, out-of-pocket spending, and the financial burden imposed on families and individuals. Although medical costs consume a growing share of family and national income and studies regularly document high rates of medical financial stress and debt, the current poverty measure does not capture the consequences for families' economic security or their income available for other basic needs.

In 1995, a panel of the National Research Council (NRC) recommended a new poverty measure, which compares families' disposable income to poverty thresholds based on current spending for food, clothing, shelter, utilities, and a little more. The panel's recommendations stimulated extensive collaborative research involving several government agencies on experimental poverty measures that led to a new research Supplemental Poverty Measure (SPM), which the U.S. Census Bureau first published in November 2011 and will update annually. Analyses of the effects of including and excluding certain factors from the new SPM showed that, were it not for the cost that families incurred for premiums and other medical expenses not covered by health insurance, 10 million fewer people would have been poor according to the SPM.

The implementation of the patient Protection and Affordable Care Act (ACA) provides a strong impetus to think rigorously about ways to measure medical care economic burden and risk, which is the basis for Medical Care Economic Risk. As new policies - whether part of the ACA or other policies - are implemented that seek to expand and improve health insurance coverage and to protect against the high costs of medical care relative to income, such measures will be important to assess the effects of policy changes in both the short and long term on the extent of financial burden and risk for the population, which are explained in this report.

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