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Pages 1-12

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From page 1...
... The panel also recommended that the federal government develop a separate measure of medical care risk that would track the economic risk to families and individuals of lacking adequate health insurance coverage. 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)
From page 2...
... . Yet, although the SPM subtracts out-of-pocket medical care costs in the calculation of disposable income, it does not directly measure the burden of out-of-pocket medical care expenses nor does it address the medical care economic risk to the population in terms of the adequacy of their health insurance coverage to pay for their expected health care needs.
From page 3...
... The panel executed its charge through the conduct of a workshop, commissioning background papers, holding panel meetings, and reviewing research and other reports. The goal of the panel was to move forward toward developing measures to inform policy that are feasible to collect and estimate and that will monitor changes in medical care economic risk and burden as health care reform is implemented and other relevant public- and privatesector changes occur.
From page 4...
... The difference would be expressed by the extent to which families and individuals who are already poor in terms of having insufficient resources for their nonmedical needs are moved deeper into poverty because of their medical costs and the extent to which those who are not poor are moved into poverty or below a low multiple of poverty, such as 100 percent or 250 percent. Estimates of these effects should be provided separately for health insurance premiums and other expenses for medical care and should also take account of important features of the new national health care policy, which include a major role for states going forward, premium subsidies and other features of affordability that are linked explicitly to multiples of the poverty thresholds, and continued policy differences by age.
From page 5...
... To exclude all assets from the resources used to measure MCER, and in so doing make it a measure of income-related economic risk, ignores accumulating evidence on how families prepare for potentially high medical expenditures and how well they are able to absorb them. Consequently, the panel concludes that the resources component of a measure of MCER must take account of a portion of assets if the goal is to assess resources available to pay for medical care costs currently and over time.
From page 6...
... The share of liquid asset contribution derived in this manner should be added to disposable income to provide the measure of resources for evaluating medical care economic risk. Measures of MCER and Recommended Approach In addition to measuring retrospectively the financial burden from actual out-of-pocket medical care spending, the panel agrees with the 1995 NRC panel that it is important to develop a measure of medical care economic risk that can assess the exposure to, or potential for incurring, future
From page 7...
... population, it is necessary to calculate the probability for families with particular characteristics of having out-of-pocket premiums and spending on medical care services greater than their resources available for medical care spending. Ideally, the calculation would reflect the actual terms of family members' health insurance coverage, their age, gender, and health status, the income of the family, and the composition of the family for a large number of families.
From page 8...
... With its richer data on health conditions, distribution of spending by service type, and 2-year panel, MEPS offers the opportunity to learn much more about the interplay of health status, health insurance, income, and out-of-pocket medical care spending with respect to family finances. Over the next several years, as the landscape of health insurance coverage in the United States undergoes substantial change, understanding the underlying drivers of any shifts in the impact of out-of-pocket medical care spending on family financial resources will be extremely important.
From page 9...
... Recommendation 4-1: Given what limited work has been done in the field on issues in measuring medical care economic risk (MCER) p ­ rospectively, the panel recommends that appropriate federal ­ gencies -- a the Agency for Healthcare Research and Quality, the Office of the Assistant Secretary for Planning and Evaluation, or both -- perform a series of analyses using the Medical Expenditure Panel Survey to exam ine different prospective MCER measures.
From page 10...
... For production, in addition to MEPS, the panel considered the CPS ASEC, the National Health Interview Survey, the American Community Survey, and the Consumer Expenditure series quarterly survey. The CPS ASEC is the source of both the official poverty measure and the SPM, to which the MCER measure is intended as a companion.
From page 11...
... Recommendation 5-2: The panel recommends that the Census Bureau and the Agency for Healthcare Research and Quality assess the merits of adding items to both the Current Population Survey Annual Social and Economic Supplement and the Medical Expenditure Panel Survey to at least partially address the most critical data limitations identified for measuring medical care economic risk. Implementing Measures of MCER and Burden Throughout its review and deliberations, the panel has aimed to develop rigorous yet practical approaches to defining and measuring the financial burden and risk associated with out-of-pocket medical care costs.
From page 12...
... Recommendation 6-2: The panel further recommends the creation of a medical care economic risk coordinating group composed of senior officials from the U.S. Department of Health and Human Services, the U.S.


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