Historical trend of disparity implications of Medicare MTM eligibility criteria

Abstract

Background: Non-Hispanic Blacks (Blacks) and Hispanics have a lower likelihood of being eligible for medication therapy management (MTM) services than do non-Hispanic Whites (Whites) based on Medicare MTM eligibility criteria.

Objectives: To determine whether MTM eligibility criteria would perform differently over time, this study examined the trend of MTM disparities from 1996-1997 to 2007-2008.

Methods: The study populations were Medicare beneficiaries from the Medical Expenditure Panel Survey. Proportions and the odds of MTM eligibility were compared between Whites and ethnic minorities. The trend of disparities was examined by including in logistic regression models interaction terms between dummy variables for the minority groups and 2007-2008. MTM eligibility thresholds for 2008 and 2010-2011 were analyzed. Main and sensitivity analyses were conducted to represent the entire range of the eligibility criteria.

Results: This study found no statistical significant racial or ethnic disparities associated with the MTM eligibility criteria for 2008 among the Medicare population during 1996-1997. However, racial disparities associated with 2010-2011 MTM eligibility criteria were significant according to multivariate analyses among the Medicare population during 1996-1997. During 2007-2008, both racial and ethnic disparities associated with both 2008 MTM eligibility criteria and 2010-2011 eligibility criteria were generally significant. Disparity patterns did not exhibit a statistically significant change from 1996-1997 to 2007-2008.

Conclusions: Racial and ethnic disparities in meeting MTM eligibility criteria may not decrease over time unless MTM eligibility criteria are changed.

Keywords: Eligibility criteria; Ethnicity; Health disparities; Historical trend; Medication therapy management services; Race.