Disparity implications of proposed 2015 Medicare eligibility criteria for medication therapy management services

• Published in: Journal of pharmaceutical health services research Vol. 7; no. 4; pp. 209 - 215
• Main Authors: Wang, Junling, Qiao, Yanru, Spivey, Christina A., Li, Christine, Clark, Caroline, Deng, Yuewen, Liu, Flora, Tillman, Jeffrey, Chisholm-Burns, Marie
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-12-2016; Wiley Subscription Services, Inc
• Subjects: Cultural differences; Drug therapy; eligibility; ethnicity; Hispanic people; Medicare; medication therapy management services; Multivariate analysis; Race; Racial differences; medication therapy management services; eligibility; Medicare; ethnicity; Race
• ISSN: 1759-8885; 1759-8893
• DOI: 10.1111/jphs.12142

Objectives
Previous studies found that racial and ethnic minorities may be less likely than non‐Hispanic whites (whites) to meet existing Medicare medication therapy management (MTM) eligibility criteria. To address these issues, the Centers for Medicare & Medicaid Services (CMS) proposed alternative Medicare MTM eligibility criteria for 2015. Due to opposition to other Part D reforms proposed simultaneously by various stakeholders, CMS rescinded all proposed reforms. This study was conducted to determine whether non‐Hispanic blacks (blacks) and Hispanics have lower likelihood of meeting the proposed 2015 Medicare MTM eligibility criteria.
Methods
This retrospective observational analysis used Medical Expenditure Panel Survey data (2010–2011). The final study sample was comprised of 2721 whites (weighted to 37 185 896), 917 blacks (weighted to 4 665 644) and 538 Hispanics (weighted to 3 532 882). Chi‐squared tests were used to examine racial and ethnic disparities in meeting proposed 2015 MTM eligibility criteria and each component of proposed 2015 MTM eligibility criteria. In multivariate analysis, a logistic regression model was used to control for population socio‐demographic and health‐related characteristics.
Key findings
Compared to whites with a proportion of MTM eligibility of 58.82%, the eligible proportion was 57.09% (P = 0.20) for blacks, and 48.97% (P < 0.0001) for Hispanics respectively. According to multivariate logistic regression, odds ratios of meeting MTM eligibility for blacks and Hispanics compared to whites were 0.74 (95% CI, confidence interval 0.62 to 0.88) and 0.53 (95% CI 0.43 to 0.67) respectively.
Conclusions
The proposed 2015 MTM eligibility criteria would not eliminate racial and ethnic disparities in MTM eligibility. Alternative MTM eligibility criteria should be devised.