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

ObjectivesPrevious 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 Due to opposition to other Part D reforms proposed simultaneously by various stakeholders, CMS rescinded all proposed reforms.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. MethodsThis 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 findingsCompared 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. ConclusionsThe proposed 2015 MTM eligibility criteria would not eliminate racial and ethnic disparities in MTM eligibility. Alternative MTM eligibility criteria should be devised.