Racial and ethnic disparities in meeting Part D MTM eligibility criteria among the non-Medicare population
Junling Wang; Lawrence M. Brown; Song Hee Hong
J Am Pharm Assoc (2003) 2012;52:e87-e96. doi:10.1331/JAPhA.2012.11146


Objective  To determine whether racial and ethnic minorities were less likely to meet the Medicare Part D eligibility criteria for medication therapy management (MTM) services compared with whites among the adult non-Medicare population, because some non-Medicare health plans have followed the Medicare example.

Design  Cross-sectional observational study.

Setting  United States, 2007–08.

Patients  16,691 white, 5,923 black, and 9,242 Hispanic adults (>17 years) among the non-Medicare population.

Intervention  Analysis of the Medical Expenditure Panel Survey. MTM eligibility criteria used by Part D plans in 2008 and 2010–11 were examined. Main and sensitivity analyses were conducted to represent the entire range of the eligibility thresholds used by Part D plans. Analyses also were conducted among individuals with heart disease, diabetes, and hypertension.

Main outcome measures  Proportions and odds of patients meeting Part D MTM eligibility criteria.

Results  According to the main analysis examining 2008 eligibility criteria, whites had a higher proportion of eligible individuals than did blacks (3.73% vs. 2.57%) and Hispanics (1.53%, P < 0.05 for both comparisons). According to survey-weighted logistic regression adjusting for patient characteristics, blacks and Hispanics had odds ratios for MTM eligibility of 0.60 (95% CI 0.46–0.79) and 0.54 (0.40–0.72), respectively, compared with whites. Sensitivity analyses, analyses examining 2010–11 eligibility criteria, and analyses among individuals with heart disease, diabetes, and hypertension produced similar findings.

Conclusion  Racial and ethnic minorities have lower odds for meeting Part D MTM eligibility criteria than whites among the adult non-Medicare population. MTM eligibility criteria need to be modified to address these disparities.

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