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Social determinants predict whether Medicare beneficiaries are offered a Comprehensive Medication Review
Merton Lee1, Barbara J Zarowitz1, Karen Pellegrin2
1University of Maryland, School of Pharmacy, 20 N. Pine St., Baltimore, MD, 21201, USA.
Research in Social & Administrative Pharmacy : RSAP
|October 10, 2022
Summary
Social determinants like geography and low income affect access to Medicare
Area of Science:
- Health Services Research
- Health Disparities
- Social Determinants of Health
Background:
- Medicare's Medication Therapy Management (MTM) program offers medication reviews.
- MTM aims to improve patient outcomes and reduce healthcare costs.
- Current MTM design may not fully address social determinants of health (SDOH).
Purpose of the Study:
- To investigate how SDOH influence the likelihood of Medicare beneficiaries being offered Comprehensive Medication Review (CMR).
- To identify specific social and demographic factors associated with not receiving an offered CMR.
Main Methods:
- Retrospective, cross-sectional analysis of the 2016 Medicare Part D MTM Data File.
- Linked data from Medicare Master Beneficiary Summary File.
- Used SAS Studio 3.8 for descriptive statistics to identify associations.
Main Results:
- Eligibility for CMR but not being offered one was linked to residence in Louisiana (OR 1.79).
- Low Income Subsidies (LIS) receipt (OR 1.76) and dual Medicare-Medicaid eligibility (OR 1.25) increased odds of not receiving CMR.
- Black race was also associated with higher odds of not receiving CMR (OR 1.19).
Conclusions:
- SDOH, particularly geography and low-income status, predict non-offer of CMR despite eligibility.
- Race remains a significant factor in unequal access to MTM services.
- Addressing SDOH in MTM program design is crucial for equitable access and outcomes.
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