be valuable for monitoring the implementation of health care reform. The report will include a summary of the workshop and commissioned papers.

As expressed by the sponsor, much work has been done on a new income poverty measure, the Supplemental Poverty Measure, but the medical care economic risk measure is a separate measure and needs to move forward.

In response to this request, the NRC’s Committee on National Statistics, in collaboration with the IOM’s Board on Health Care Services, appointed a panel of nine members representing a range of expertise related to the scope of the study.

Study Approach

Developing a measure of medical care economic risk presents many difficult issues relating to defining risk, resources, and financial burden. Such issues include

  • considering basic concepts, such as prospective versus retrospective measures, the difference between measures of incurred financial burden and expected financial risk, and the unit of analysis (family or individual);
  • categorizing and estimating health risks (acute, chronic, catastrophic) for population groups and the associated costs;
  • establishing thresholds for medical care affordability;
  • determining adequacy of health insurance benefit plans;
  • determining if and how to adjust components of the measure for people living in different geographic areas or other factors;
  • deciding on what to count as resources to meet medical care expenditure needs (specifically, whether and how to count assets in addition to income); and
  • determining how best to achieve operational feasibility, data quality, and timeliness of the resulting medical care economic risk measure.

The panel executed its charge to “critically examine the state of the science in the development and implementation of a new measure of medical care economic risk as a companion measure to the new Supplemental Poverty Measure” through the conduct of a workshop, panel meetings, and background research. The panel’s goal was to advance the development of a measure to inform policy that is feasible to collect and estimate and that will monitor changes in medical care economic risk as health



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