Abstract
Background: Medicare Part D medication therapy management (MTM) includes an annual comprehensive medication review (CMR) as a strategy to mitigate suboptimal medication use in older adults. Objectives: To describe the characteristics of Medicare beneficiaries who were eligible, offered, and received a CMR in 2013 and 2014 and identify potential disparities. Methods: This nationally representative cross-sectional study used a 20% random sample of Medicare Part A, B, and D data linked with Part D MTM files. A total of 5,487,343 and 5,822,188 continuously enrolled beneficiaries were included in 2013 and 2014, respectively. CMR use was examined among a subset of 620,164 and 669,254 of these beneficiaries enrolled in the MTM program in 2013 and 2014. Main measures were MTM eligibility, CMR offer, and CMR receipt. The Andersen Behavioral Model of Health Services Use informed covariates selected. Results: In 2013 and 2014, 505,658 (82%) and 649,201 (97%) MTM eligible beneficiaries were offered a CMR, respectively. Among those, CMR receipt increased from 81,089 (16%) in 2013 to 119,181 (18%) in 2014. The mean age of CMR recipients was 75 years (±7) and the majority were women, White, and without low-income status. In 2014, lower odds of CMR receipt were associated with increasing age (adjusted odds ratio (OR) = 0.99 (95% confidence interval (CI) = 0.994–0.995), male sex (OR = 0.93, 95% CI = 0.926–0.951), being any non-White race/ethnicity except Black, dual-Medicaid status (OR = 0.64, 95% CI = 0.626–0.650), having a hospitalization (OR = 0.87, 95% CI = 0.839–0.893) or emergency department visit (OR = 0.67, 95% CI = 0.658–0.686), and number of comorbidities (OR = 0.90, 95% CI = 0.896–0.905). Conclusions: CMR offers and completion rates have increased, but disparities in CMR receipt by age, sex, race, and dual-Medicaid status were evident. Changes to MTM targeting criteria and CMR offer strategies may be warranted to address disparities.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1208-1214 |
| Number of pages | 7 |
| Journal | Research in Social and Administrative Pharmacy |
| Volume | 16 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2020 |
Bibliographical note
Funding Information:Dr. Coe is supported by the National Center for Advancing Translational Sciences,National Institutes of Health under award number KL2TR002241. Dr. Adeoye-Olatunde is supported by the Indiana Clinical and Translational Sciences Institute funded, in part by Award Number TL1TR001107 (A. Shekhar, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Farris is serving as a paid consultant for QuiO, New York, NY.
Funding Information:
Dr. Coe is supported by the National Center for Advancing Translational Sciences , National Institutes of Health under award number KL2TR002241. Dr. Adeoye-Olatunde is supported by the Indiana Clinical and Translational Sciences Institute funded, in part by Award Number TL1TR001107 (A. Shekhar, PI ) from the National Institutes of Health , National Center for Advancing Translational Sciences , Clinical and Translational Sciences Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Farris is serving as a paid consultant for QuiO, New York, NY. Dr. Snyder is serving as a paid consultant to Westat for an evaluation of the Centers for Medicare and Medicaid Services (CMS) Part D Enhanced Medication Therapy Management program.
Publisher Copyright:
© 2019 Elsevier Inc.
Keywords
- Comprehensive medication review
- Medicare Part D
- Medication therapy management
- Older adults
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural
