and Prevention (CDC) as an HIV surveillance tool that would supplement the National HIV Surveillance System (NHSS) by providing detailed and nationally representative information about the care experiences and needs of adults ≥18 years with diagnosed HIV who are in care.

MMP collects data on dimensions of care that correspond to major components of health care reform, such as source of health coverage and the distribution of different sources of coverage; access to HIV care and unmet need for supportive services (including for people with different types of coverage); the quality and comprehensiveness of care; receipt of recommended clinical and preventive interventions (e.g., screenings and immunizations); and the organizational context and structure of care (e.g., where care is provided, who is providing that care, and whether care is occurring in the context of new organizational models intended to improve service coordination [e.g., patient-centered medical homes, accountable care organizations]). In addition, MMP captures clinical data needed to estimate indicators of care quality within the context of the ACA. Along with the Ryan White HIV/AIDS Program, MMP is one of only a few data systems that can be used to assess unmet need for housing, food, and transportation assistance for people with HIV. Due to MMP’s repeated (annual) cross-sectional design, there is regular opportunity for questions to be added to the data collection instruments should information needs change as the ACA is implemented. Collection of data through patient interview, abstraction of patients’ medical records, and extraction of core surveillance data on each patient through the NHSS allows for corroboration of data and the collection of at least minimal data for most patients (CDC, 2012a,b).

Despite its promise, there are aspects of MMP that the committee concludes need to be improved before MMP can be used to generate nationally representative estimates of health care coverage and utilization for all people with diagnosed HIV. One concern is MMP’s current patient response rate. Although it has improved over time, the patient response rate in 2010, the most recent year for which data are available, was 56 percent. Another concern is that MMP’s current population of inference does not include the people living with diagnosed HIV who are not in care and who stand to benefit from ACA provisions that will improve access to health care coverage. CDC is pilot testing the use of the NHSS for patient sampling which would expand the study population to include individuals who are not in care. If redesigned in this way, MMP can provide data on characteristics of HIV-diagnosed adults who are not in care and on the availability and accessibility of health care coverage and utilization to these individuals (CDC, 2012a,b).

MMP also does not include, or lacks adequate representation of, particular subgroups for whom it is critical to monitor access to care and care coverage. For example, black/African American MSM (men who have sex



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