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Comparative Effectiveness of Medication Therapy Management Eligibility Criteria Across Racial/Ethnic Groups

Christina A Spivey1, Yanru Qiao2, Junling Wang2

  • 1Department of Clinical Pharmacy and Translational Science, University of Tennessee College of Pharmacy, Memphis, Tennessee.

Journal of the American Geriatrics Society
|January 24, 2019
PubMed
Abstract

Insights

The Affordable Care Act (ACA) criteria for medication therapy management (MTM) better identify older adults needing care than Medicare Modernization Act (MMA) criteria. ACA MTM identifies more minority patients with medication issues.

Area of Science:

  • Gerontology
  • Health Services Research
  • Health Disparities

Background:

  • Previous research indicates Medicare Modernization Act (MMA) criteria for medication therapy management (MTM) services are racially/ethnically biased and ineffective.
  • These criteria fail to identify patients with significant medication utilization issues.

Purpose of the Study:

  • To compare the effectiveness of MTM eligibility criteria under the Affordable Care Act (ACA) versus the MMA.
  • To determine how these criteria identify patients with medication utilization issues across different racial/ethnic groups.

Main Methods:

  • Compared ACA and MMA MTM eligibility criteria using Medicare data (2012-2013).
  • Utilized medication safety/adherence measures to define medication utilization issues.
  • Employed multinomial logistic regression and need/demand-based analyses to assess disparities.

Main Results:

  • ACA MTM eligibility criteria identified a higher proportion of patients needing MTM compared to MMA criteria.
  • In 2013, ACA criteria would make 99.7% of patients eligible versus 26.2% for MMA criteria (p < .001).
  • Demand-based analysis showed ACA criteria were more effective in identifying MTM needs among Black and Hispanic patients compared to non-Hispanic Whites.

Conclusions:

  • ACA MTM eligibility criteria are more effective than MMA criteria for identifying older patients requiring MTM.
  • These ACA criteria show particular effectiveness in identifying needs among minority populations.
Keywords:
Affordable Care ActMedicare Modernization Actmedication therapy management

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