coordinating group would provide guidance to the agencies producing the measure and suggest changes in methodology or appropriate data sets. The leadership of agencies with contributions to make to the construction and implementation of the measure could constitute such a group. The panel also suggests that one or two members of the coordinating group be chosen from outside government with relevant expertise in the measurement of poverty and financial burden of health care. Having one or more outside members would enhance the transparency and credibility of the process as well as provide the government with the latest thinking from the scholarly community outside the government.

Based on these findings and conclusions the panel provides the following recommendations for implementation:

Recommendation 6-1: Because technical and cross-departmental efforts such as the construction and maintenance of a measure of medical care economic risk (MCER) require both political and resource support, the panel recommends that the secretaries of the U.S. Departments of Health and Human Services and Commerce be jointly responsible for developing and reporting measures of MCER (and burden) on an annual basis with involvement of the U.S. Office of Management and Budget chief statistician. This effort should coincide with the production and release schedule for the Supplemental Poverty Measure.

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. Census Bureau, and the U.S. Office of Management and Budget to provide oversight and make suggestions for needed improvements.

Recommendation 6-3: The panel recommends that funding for the current data collection efforts be maintained at a level to ensure that rigorous, accurate calculations of measures of medical care economic burden and risk can be made.



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