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Higher Predictive Value Positive for MMA Than ACA MTM Eligibility Criteria Among Racial and Ethnic Minorities: An

Yanru Qiao1, Christina A Spivey1, Junling Wang1

  • 11 The University of Tennessee Health Science Center, Memphis, USA.

Inquiry : a Journal of Medical Care Organization, Provision and Financing
|September 4, 2018
PubMed

Insights

The Medicare Modernization Act (MMA) better identified medication issues in Black and Hispanic patients than the Affordable Care Act (ACA). This highlights disparities in medication management criteria across racial groups.

Area of Science:

  • Health Services Research
  • Pharmaceutical Policy
  • Health Equity

Background:

  • Medication Therapy Management (MTM) aims to optimize drug therapy and improve health outcomes.
  • Eligibility criteria for MTM programs under Medicare Modernization Act (MMA) and Affordable Care Act (ACA) may impact patient identification.
  • Racial and ethnic disparities in healthcare access and outcomes are a significant concern.

Purpose of the Study:

  • To evaluate the positive predictive value (PPV) of MTM eligibility criteria in identifying patients with medication utilization issues.
  • To compare the PPV of MMA and ACA criteria across different racial and ethnic groups.

Main Methods:

  • Analysis of Medicare beneficiary data from 2012-2013 (n=2,213,594).
  • Identification of medication utilization issues using Pharmacy Quality Alliance measures.
  • Statistical analysis comparing PPV of MMA and ACA criteria across non-Hispanic Black, Hispanic, and non-Hispanic White populations.

Main Results:

  • The MMA criteria demonstrated a higher PPV than ACA criteria in identifying patients with medication utilization issues.
  • Specifically, MMA showed a higher PPV among non-Hispanic Blacks and Hispanics compared to non-Hispanic Whites.
  • Odds ratios indicated MMA was associated with 9% and 17% higher PPV than ACA for Blacks and Hispanics, respectively, relative to Whites.

Conclusions:

  • The MMA eligibility criteria appear more effective than ACA criteria in identifying medication utilization issues among minority populations.
  • Findings suggest potential inequities in MTM program identification based on current eligibility standards.
  • Further research is needed to refine MTM criteria for equitable patient identification and care.
Keywords:
Hispanic AmericansMedicare Prescription Drug and Modernization Act of 2003Patient Protection and Affordable Care Actcontinental population groupsdrug utilizationefficiencyethnic groupsmedication therapy managementpredictive value of tests

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