Making fair decisions about financing care for persons with AIDS

Area of Science:

• Public Health
• Health Economics
• Healthcare Policy

Background:

• Acquired immunodeficiency syndrome (AIDS) affects a significant population, with 40% receiving care through Medicaid.
• Medicaid expenditure for AIDS care is substantial and projected to increase dramatically.
• The Health Care Financing Administration (HCFA) administers the Medicaid Program, a joint federal and state funded initiative.

Purpose of the Study:

• To address the rising cost burden of acquired immunodeficiency syndrome (AIDS) care within the Medicaid Program.
• To propose policy principles for fair, responsive, and efficient financing of AIDS treatment.
• To integrate AIDS care financing into the existing healthcare system.

Main Methods:

• Analysis of Medicaid spending on AIDS care.
• Development of four policy principles for AIDS treatment financing.
• Consideration of state-level flexibility and healthcare professional obligations.

Main Results:

• Medicaid spending on AIDS care was estimated between $700-$750 million in FY1988.
• Projected Medicaid spending on AIDS care could reach $2.4 billion by FY1992 (excluding zidovudine costs).
• Four policy principles were proposed to manage the financial impact of AIDS on Medicaid.

Conclusions:

• Treating AIDS as a serious disease without a specific entitlement program is recommended.
• Integrating AIDS treatment financing into the mainstream healthcare system, with shared responsibility and initiatives like high-risk insurance pools, is advised.
• State flexibility in providing home and community-based care, alongside encouraging professional care for AIDS patients, are key recommendations.