Things to know about rising Medicare spending in the USA

Two fact sheets were published recently by the Kaiser Family Foundation. These outlined a number of key points regarding the role Medicaid and Medicare play in the treatment of people with HIV.


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HIV Spending Represents Just 2% of Overall Spending

In the fiscal year 2011, average spend on Medicaid beneficiaries who were HIV positive was $26,807 per capita, which compared to Medicaid beneficiaries overall is nearly five times greater the average spend of $5,790. Even so, for the fiscal year 2016, the total spent by Medicaid on HIV represented under 2% of the total spending by Medicaid.

In the 2016 fiscal year, $10 billion was spent on HIV by Medicare. While this represented 51% of the federal spend on HIV, it was again just 2% of the total spent by Medicare.

Increasing Spending

Despite a fall in the number of people being diagnosed with HIV, over the course of the last few years, the amount spent on HIV by Medicare has grown. This is in line with the introduction of prescription drug benefit Part D and as the number of beneficiaries has increased. As with Medicare, Medicaid has increased its HIV-related spending, reflecting the growing cost of care and the rising numbers of beneficiaries.

As a result of Part D, FY 2006 saw spending by Medicare become the biggest source of HIV care federal financing. According to the data, this was the first time it has surpassed the federal funding by Medicaid. However, this was in part as a result of drug costs being shifted from Medicaid to Medicare for those patients who are beneficiaries of both.

Clinical trial services, such as those provided by, are an integral part of the healthcare system and contribute to the ongoing improvement and progression of healthcare.

Income Divide

At $34,555, the average Medicare spending in 2014 was significantly lower for non-low-income HIV-positive beneficiaries when compared to that of average spending for low-income HIV-positive beneficiaries, which was $50,262.

In FY 2016, federal spending on HIV by Medicare was estimated to be 30 % of the total federal spend on HIV. After Medicare, Medicaid is the next biggest public funding source in the US for care of HIV when combined with the estimated $3.5 billion state spending on Medicaid for 2016.


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