Disparity implications of Medicare eligibility criteria for medication therapy management services.
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.


METHODS
Secondary data analyses of the Medical Expenditure Panel Survey (2004-2005).


METHODS
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.


RESULTS
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.
Wang
Junling
J
Department of Pharmaceutical Sciences, University of Tennessee College of Pharmacy, 847 Monroe Avenue, Room 205R, Memphis, TN 38163, USA. jwang26@uthsc.edu
Mullins
C Daniel
CD
Brown
Lawrence M
LM
Shih
Ya-Chen Tina
YC
Dagogo-Jack
Samuel
S
Hong
Song Hee
SH
Cushman
William C
WC
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D014487:Centers for Medicare and Medicaid Services, U.S.; D016001:Confidence Intervals; D004608:Eligibility Determination; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008297:Male; D054539:Medication Therapy Management / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D055553:Prescription Drugs / Q000191:economics*; D012189:Retrospective Studies; D014481:United States; D044465:White People
D055553:Prescription Drugs