HIV and Medicare: A Survey of the HIV Medicare Population
June 2025
Authors
David Walters, ASA, MAAA
Senior Consulting Actuary
Wakely Consulting Group, an HMA Company
Lucretia Hydell, ASA, MAAA
Senior Consulting Actuary
Wakely Consulting Group, an HMA Company
Description
This report provides a comprehensive overview of the HIV-positive population enrolled in Medicare, with an emphasis on trends, healthcare utilization, and cost patterns. It aims to better understand how this population is aging into Medicare and how their needs may differ from the broader Medicare population.
Demographic
The study compares HIV-positive and non-HIV-positive members across medical and pharmacy services to identify potential gaps in care and inform program design. It also highlights key considerations for policymakers, actuaries, and healthcare providers managing this unique population.
By presenting data-driven insights, the report serves as a foundation for future research and policy development to ensure equitable, effective care for HIV-positive Medicare beneficiaries.
Material
Acknowledgments
The researchers’ deepest gratitude goes to those without whose efforts this project could not have come to fruition: the Project Oversight Group and others for their diligent work overseeing questionnaire development, analyzing and discussing respondent answers, and reviewing and editing this report for accuracy and relevance.
Project Oversight Group members:
Nathan Cornwell, FSA MAAA
Sophie (Lemeng) Feng, FSA, FCIA, CERA
Bill Frentzas, ASA, MAAA
Kim Gordon, FSA
Kar Khin Mok, FSA, CERA, ACIA
Sudha Shenoy, FSA, MAAA, CERA
Jingcheng Yu, FSA, CERA
At the Society of Actuaries:
Achilles Natsis, FSA, MAAA, FMLI, Health Research Actuary
Korrel Crawford, Senior Research Administrator
Barbara Scott, Senior Research Administrator
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