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
Medication Therapy Management, Comprehensive Medication Review, Medicare Part D, Older Adults
Date of this Version
9-2020
Recommended Citation
Coe, Antoinette B.; ADEOYE-OLATUNDE, OMOLOLA A.; Pestka, Deborah L.; Snyder, Margie; Zillich, Alan; Farris, Karen B.; and Farley, Joel F., "Patterns and Predictors of Older Adult Medicare Part D Beneficiaries’ Receipt of Medication Therapy Management" (2020). Department of Pharmacy Practice Faculty Publications. Paper 10.
https://docs.lib.purdue.edu/phprpubs/10
Comments
This is the author-accepted manuscript version of:
Antoinette B. Coe, Omolola A. Adeoye-Olatunde, Deborah L. Pestka, Margie E. Snyder, Alan J. Zillich, Karen B. Farris, Joel F. Farley, Patterns and predictors of older adult Medicare Part D beneficiaries’ receipt of medication therapy management, Research in Social and Administrative Pharmacy, Volume 16, Issue 9, 2020, Pages 1208-1214,
Copyright Elsevier, it is made available here CC-BY-NC-ND, and the version of record is available at DOI: 10.1016/j.sapharm.2019.12.007.