Publications [#301153] of Kathryn Whetten

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Journal Articles

  1. Whetten, K; Zhu, CW. "Do Medicaid Medically Needy Programs Make Public Sense? The Case of HIV/AIDS." AIDS Care 16.6 (2004): 781-785. [15370065], [doi]
    (last updated on 2026/01/21)

    Abstract:
    Medicaid is a US government insurance programme designed primarily for poor individuals, with expenditures that rose more than 13% in 2002. Thirty-five states have programmes allowing individuals to incur medical expenses at a rate that would make them poor enough to meet Medicaid eligibility criteria. This paper examines the cost of providing care to those spending-down to Medicaid compared to those eligible without spending-down. This longitudinal cohort study compiled inpatient, outpatient and Medicaid data from three academic Infectious Diseases clinics serving approximately 40% of the reported HIV-positive population in North Carolina. Participants included all HIV-positive patients who received care in one of three clinics and received Medicaid coverage at any time from 1996 to 2000 (1,495 individuals). Overall, those who needed to spend-down to Medicaid incurred higher medical costs, following a distinctive pattern of high costs when initially qualified and when ending coverage, and low costs while on spend-down. US states may wish to consider expanding Medicaid's categorically eligible criteria or significantly reducing the frequency with which persons must spend-down to become eligible for Medicaid.

Kathryn Whetten

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