Potential health implications of racial and ethnic disparities in meeting MTM eligibility criteria

Background: Previous studies found that racial and ethnic minorities would be less likely to meet the Medicare eligibility criteria for Medication Therapy Management (MTM) services than their non-Hispanic White counterparts. Objectives: To examine whether racial and ethnic disparities in health status, health services utilization/costs, and medication utilization patterns among MTM-ineligible individuals differed from MTM-eligible individuals. Methods: This study analyzed Medicare beneficiaries in 2004-2005 Medicare Current Beneficiary Survey. Various multivariate regressions were employed depending on the nature of dependent variables. Interaction terms between the dummy variables for Blacks (and Hispanics) and MTM eligibility were included to test whether disparity patterns varied between MTM-ineligible and MTM-eligible individuals. Analyses were conducted to cover the ranges of MTM eligibility thresholds for 2006 and 2010. Results: Based on the main analysis for 2006 MTM eligibility criteria, the proportions for self-reported good health status for Whites and Blacks were 82.82% vs. 70.75%, respectively (P<0.05), among MTM-ineligible population; and 56.98% vs. 52.14%, respectively (P>0.05), among MTM-eligible population. The difference between these differences was 7.23% (P<0.05). In the adjusted logistic regression for this measure, the interaction effect for Blacks and MTM eligibility had an OR of 1.57 (P=0.06) on multiplicative term and 2.38 (P<0.01) on additive term. Analyses for disparities between Whites and Hispanics also found similar disparity patterns. Analyses of other measures did not find similar patterns. Conclusions: Disparities in MTM eligibility may aggravate existing racial and ethnic disparities in health status measures. Future studies should examine the effects of Medicare Part D on these disparities.