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Disparity Implications of Medicare Eligibility Criteria for Medication Therapy Management Services

Authors

  • Junling Wang,

    1. Department of Pharmaceutical Sciences, University of Tennessee College of Pharmacy, 847 Monroe Avenue, Room 205R, Memphis, TN 38163
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    • Address correspondence to Junling Wang, Ph.D., M.S., Assistant Professor in Health Outcomes and Policy Research, Department of Pharmaceutical Sciences, University of Tennessee College of Pharmacy, 847 Monroe Avenue, Room 205R, Memphis, TN 38163; e-mail: jwang26@uthsc.edu. C. Daniel Mullins, Ph.D., Professor, is with the Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD. Lawrence M. Brown, Pharm.D., Ph.D., Associate Professor and Song Hee Hong, Ph.D., Associate Professor, are with the Department of Pharmaceutical Sciences, University of Tennessee, Memphis, TN. Lawrence M. Brown, Pharm.D., Ph.D., is also the Director of Center for Medication Therapy Management Services, University of Tennessee, Memphis, TN. Ya-Chen Tina Shih, Ph.D., Associate Professor, is with the Department of Biostatistics, Section of Health Services Research, University of Texas, M.D. Anderson Cancer Center, Houston, TX. Samuel Dagogo-Jack, M.D., M.B.B.S., is Mullins Professor in Translational Research at the University of Tennessee College of Medicine, Memphis, TN. He is also Professor of Medicine and Chief for the Division of Endocrinology, Diabetes & Metabolism, University of Tennessee College of Medicine, Memphis, TN. William C. Cushman, M.D., Professor, is with the Department of Preventive Medicine and Medicine, University of Tennessee College of Medicine, Memphis, TN. He is also the Chief of the Preventive Medicine Section at Veterans Affairs Medical Center, Memphis TN.

  • C. Daniel Mullins,

    1. Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
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  • Lawrence M. Brown,

    1. Department of Pharmaceutical Sciences, University of Tennessee, Memphis, TN
    2. University of Tennessee, Memphis, TN
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  • Ya-Chen Tina Shih,

    1. Department of Biostatistics, Section of Health Services Research, University of Texas, M.D. Anderson Cancer Center, Houston, TX
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  • Samuel Dagogo-Jack,

    1. University of Tennessee College of Medicine, Memphis, TN
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  • Song Hee Hong,

    1. Department of Pharmaceutical Sciences, University of Tennessee, Memphis, TN
    2. University of Tennessee, Memphis, TN
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  • William C. Cushman

    1. Department of Preventive Medicine and Medicine, University of Tennessee College of Medicine, Memphis, TN
    2. Veterans Affairs Medical Center, Memphis TN.
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Abstract

Objective. To determine whether there would be racial and ethnic disparities in meeting eligibility criteria for medication therapy management (MTM) services implemented in 2006 for Medicare beneficiaries.

Data Sources/Study Setting. Secondary data analyses of the Medical Expenditure Panel Survey (2004–2005).

Study Design. Logistic regression and recycled predictions were used to test the disparities in meeting eligibility criteria across racial and ethnic groups. The eligibility thresholds used by health plans in 2006 and new thresholds recommended for 2010 were examined. Racial and ethnic disparities were examined by comparing non-Hispanic blacks (blacks) with non-Hispanic whites (whites) and comparing Hispanics with whites, respectively. Disparities were also examined among individuals with severe health problems.

Principal Findings. According to 2006 thresholds, the adjusted odds ratios for meeting eligibility criteria for blacks and Hispanics to whites were 0.36–0.60 (p<.05) and 0.13–0.46 (p<.05), respectively. Blacks and Hispanics would be 21–34 and 32–38 percent, respectively, less likely to be eligible than whites according to recycled predictions. Similar patterns were found using the 2010 eligibility thresholds and among individuals with severe health problems.

Conclusions. There would be racial and ethnic disparities in meeting MTM eligibility criteria. Future research is warranted to confirm the findings using data after MTM implementation.

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