Patterns and predictors of older adult Medicare Part D beneficiaries' receipt of medication therapy management

Antoinette B Coe; Omolola A Adeoye-Olatunde; Deborah L Pestka; Margie E Snyder; Alan J Zillich; Karen B Farris; Joel F Farley

doi:10.1016/j.sapharm.2019.12.007

Patterns and predictors of older adult Medicare Part D beneficiaries' receipt of medication therapy management

Res Social Adm Pharm. 2020 Sep;16(9):1208-1214. doi: 10.1016/j.sapharm.2019.12.007. Epub 2019 Dec 9.

Authors

Antoinette B Coe¹, Omolola A Adeoye-Olatunde², Deborah L Pestka³, Margie E Snyder², Alan J Zillich², Karen B Farris⁴, Joel F Farley³

Affiliations

¹ University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI, 48109, USA. Electronic address: tonicoe@med.umich.edu.
² Purdue University College of Pharmacy, 575 Stadium Mall Drive, West Lafayette, IN, 47907, USA.
³ University of Minnesota College of Pharmacy, 308 SE Harvard Street, Minneapolis, MN, 55455, USA.
⁴ University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI, 48109, USA.

Abstract

Background: Medicare Part D medication therapy management (MTM) includes an annual comprehensive medication review (CMR) as a strategy to mitigate suboptimal medication use in older adults.

Objectives: To describe the characteristics of Medicare beneficiaries who were eligible, offered, and received a CMR in 2013 and 2014 and identify potential disparities.

Methods: This nationally representative cross-sectional study used a 20% random sample of Medicare Part A, B, and D data linked with Part D MTM files. A total of 5,487,343 and 5,822,188 continuously enrolled beneficiaries were included in 2013 and 2014, respectively. CMR use was examined among a subset of 620,164 and 669,254 of these beneficiaries enrolled in the MTM program in 2013 and 2014. Main measures were MTM eligibility, CMR offer, and CMR receipt. The Andersen Behavioral Model of Health Services Use informed covariates selected.

Results: In 2013 and 2014, 505,658 (82%) and 649,201 (97%) MTM eligible beneficiaries were offered a CMR, respectively. Among those, CMR receipt increased from 81,089 (16%) in 2013 to 119,181 (18%) in 2014. The mean age of CMR recipients was 75 years (±7) and the majority were women, White, and without low-income status. In 2014, lower odds of CMR receipt were associated with increasing age (adjusted odds ratio (OR) = 0.99 (95% confidence interval (CI) = 0.994-0.995), male sex (OR = 0.93, 95% CI = 0.926-0.951), being any non-White race/ethnicity except Black, dual-Medicaid status (OR = 0.64, 95% CI = 0.626-0.650), having a hospitalization (OR = 0.87, 95% CI = 0.839-0.893) or emergency department visit (OR = 0.67, 95% CI = 0.658-0.686), and number of comorbidities (OR = 0.90, 95% CI = 0.896-0.905).

Conclusions: CMR offers and completion rates have increased, but disparities in CMR receipt by age, sex, race, and dual-Medicaid status were evident. Changes to MTM targeting criteria and CMR offer strategies may be warranted to address disparities.

Keywords: Comprehensive medication review; Medicare Part D; Medication therapy management; Older adults.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Cross-Sectional Studies
Ethnicity
Female
Humans
Male
Medicare Part D*
Medication Therapy Management
United States
White People

Abstract

Publication types

MeSH terms

Grants and funding