Examining risk classification strategies for the development of a measure of medical care economic risk in the United States

In a 1995 the National Research Council released a report that critically examined poverty measurement in the United States and recommended the development of a measure of medical expenditure related economic risk; a 2012 report continued support for such a measure. This study uses the Medical Expenditure Panel Survey to examine two alternative strategies for classifying individual-level risk for purposes of developing a loss modeling-based measure of medical care economic risk (MCER). Examining the use of self-perceived health and a DxCG risk score to classify individuals into five levels of risk, the study finds substantial differences in cell-level classification and attributed expenditure risk based on these two strategies. It is suggested that future work in this field move forward with the use of a risk score classification strategy to operationalize the MCER measure.