title: Expenditures for Persons Living With HIV Enrolled in Medicaid, 2006-2010.
abstract: Costs of care for persons living with HIV have been high historically. Cost estimates based on data from 1 health care site may underestimate total expenditures; using insurance claims avoids this limitation. We used Medicaid claims data to comprehensively assess payments for care for persons living with HIV between 2006 and 2010.
  
  
  
  Five sites from the HIV Research Network (HIVRN) provided information on patients with Medicaid coverage. Medicaid data were obtained from the sites' states (MD, NY, and MA) and 3 surrounding states and matched to HIVRN medical record-based data. Individuals less than 18, those with Medicare, and those in Medicaid managed care plans were excluded. Medicaid and HIVRN data were compared to ascertain concordance in capturing any inpatient event and any antiretroviral (ART) medication use.
  
  
  
  Of 6892 unique HIVRN identifiers, 6196 (90%) were linked to Medicaid data. The analytic sample included 11,341 person-years of Medicaid claims data from 3695 individuals in fee-for-service (FFS) programs. The mean annual FFS payment for all services was $47,434; mean annual FFS payment for only medical services was $38,311. Concordance between Medicaid and HIVRN data was excellent for ART use, but HIVRN data did not record a substantial proportion of years in which Medicaid recorded inpatient use.
  
  
  
  Estimated Medicaid payment amounts in this study are higher than some previous estimates. More complete capture of expensive inpatient hospitalizations in Medicaid data may partially explain this finding. Although inpatient care and ART medications contribute the most, expenditures for nonmedical services are substantial.
authors.affiliation: *Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD; †Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD; and ‡Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: John A
authors.initials: JA
authors.lastname: Fleishman
authors.forename: Anne K
authors.initials: AK
authors.lastname: Monroe
authors.forename: Cindy C
authors.initials: CC
authors.lastname: Voss
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Gebo
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000191:economics; D018588:Fee-for-Service Plans; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D005102:Health Expenditures; D006302:Health Services Research; D006760:Hospitalization; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents