title: Potential effects of racial and ethnic disparities in meeting Medicare medication therapy management eligibility criteria.
abstract: OBJECTIVE
  Medication therapy management (MTM) has the potential to play an instrumental role in reducing racial and ethnic disparities in health care. However, previous research has found that Blacks and Hispanics are less likely to be eligible for MTM. The purpose of the current study was to examine the potential effects of MTM eligibility criteria on racial and ethnic disparities in health outcomes.
  
  
  METHODS
  The current study is a retrospective cross-sectional analysis of the Medicare Current Beneficiary Survey Cost and Use files for the years 2007 and 2008. A difference-in-differences model was used to compare disparities in outcomes between ineligible and eligible beneficiaries according to MTM eligibility criteria in 2010. This was achieved by including in regression models interaction terms between dummy variables for Blacks/Hispanics and MTM eligibility criteria. Interaction terms were interpreted on both multiplicative and additive terms. Various regression models were used depending on the types of variables.
  
  
  RESULTS
  Whites were more likely to report self-perceived good health status than Blacks and Hispanics among both MTM-eligible and MTM-ineligible populations. Disparities were greater among MTM-ineligible than MTM-eligible populations (e.g., on additive term, difference in odds=1.94 and P<0.01 for Whites and Blacks; difference in odds=2.86 and P<0.01 for Whites and Hispanics). A few other measures also exhibited significant patterns.
  
  
  CONCLUSIONS
  MTM eligibility criteria may exacerbate racial and ethnic disparities in health status and some measures of health services utilizations and costs and medication utilization. Future research should examine strategies to remediate the effects of MTM eligibility criteria on disparities.
authors.affiliation: Health Outcomes and Policy Research & Interim Graduate Program Co-Director, Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 881 Madison Avenue, Room 221, Memphis, TN 38163, , , jwang26@uthsc.edu.
authors.forename: Junling
authors.initials: J
authors.lastname: Wang
authors.affiliation: Health Outcomes and Policy Research, Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 881 Madison Avenue, Room 212, Memphis, TN 38163, , , yqiao1@uthsc.edu.
authors.forename: Yanru
authors.initials: Y
authors.lastname: Qiao
authors.affiliation: Section of Hospital Medicine, Department of Medicine & Director, Program in the Economics of Cancer, University of Chicago, 5841 S. Maryland Ave., MC 5000, Office W306, Chicago, IL 60637, , , tshih@medicine.bsd.uchicago.edu.
authors.forename: Ya-Chen
authors.initials: YC
authors.lastname: Tina Shih
authors.affiliation: Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 881 Madison Avenue, Room 258, , , cspivey3@uthsc.edu.
authors.forename: Christina A
authors.initials: CA
authors.lastname: Spivey
authors.affiliation: Division of Endocrinology, Diabetes & Metabolism Director, Clinical Research Center, University of Tennessee Health Science Center, 920 Madison Avenue, Suite 300A, Memphis, TN 38163, , , sdj@uthsc.edu.
authors.forename: Samuel
authors.initials: S
authors.lastname: Dagogo-Jack
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline, Suite 633, Memphis, TN 38163, , , jwan@uthsc.edu.
authors.forename: Jim Y
authors.initials: JY
authors.lastname: Wan
authors.affiliation: Consortium for Health Education, Economic Empowerment and Research (CHEER), Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 881 Madison Avenue, Room 202, Memphis, TN 38163, , , swhiteme@uthsc.edu.
authors.forename: Shelley I
authors.initials: SI
authors.lastname: White-Means
authors.affiliation: Department of Preventive Medicine and Medicine, University of Tennessee College of Medicine & Chief, Preventive Medicine Section, Veterans Affairs Medical Center, 1030 Jefferson Avenue, Room 5159, Memphis, TN 38104, , , william.cushman@va.gov.
authors.forename: William C
authors.initials: WC
authors.lastname: Cushman
authors.affiliation: University of Tennessee College of Pharmacy, 881 Madison Avenue, Room 264, Memphis, TN 38163, , , mchisho3@uthsc.edu.
authors.forename: Marie A
authors.initials: MA
authors.lastname: Chisholm-Burns
keywords: Medicare; eligibility criteria; ethnicity; medication therapy management services; race