care reform is implemented and other relevant public- and private-sector changes occur.

The panel met face to face three times. The first meeting focused on planning the workshop as called for in the study contract, including development of an agenda and identification of potential participants. To avail ourselves of expert and detailed analysis of key issues beyond the time and resources of our members and as called for in the study contract, the panel commissioned three background papers from experts in the subject areas, which appear in Part III:

  • “Conceptual Framework for Measuring Medical Care Economic Risk” by Sarah Meier and Barbara Wolfe;
  • “Incorporating Data on Assets into Measures of Financial Burdens of Health” by Jessica S. Banthin and Didem Bernard; and
  • “An Assessment of Data Sources for Measuring Medical Care Economic Risk” by John L. Czajka.

The workshop on Developing a Measure of Medical Care Economic Risk was held on September 8, 2011, and a summary prepared by the rapporteur is included in Part II. The second meeting of the panel was held immediately following the workshop to deliberate on the workshop discussions and to reach agreement on a preliminary outline of the final report. The third and final meeting was devoted to reviewing the draft chapters and reaching consensus on the panel’s findings and recommendations.

Scope and Limitations

The scope of the study is complex, covering a wide range of issues from concepts and definitions to issues of thresholds and resources, sources of needed data, methods, implementation, and application in assessing program performance. Many other issues relevant to the broad subject areas of health and health care exist. Although the panel recognizes their importance, their discussion is beyond the scope of this study. Within the constraints of time and available resources, the panel did not address every issue but covered those areas specifically called for in the contract charge. For example, we addressed medical care and not all aspects of health and health care; we addressed issues of financial risk of medical care and not all medical care risks; and we focused on survey data rather than on modeling issues. The panel also did not examine the impact of various insurance plans on out-of-pocket spending or address the appropriate treatment of medical care benefits and costs in measures of inequality.

More broadly, time and resources did not permit the panel to carry out the original analysis that will be necessary to construct and refine spe-



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