OBJECTIVES : Substantial literature has documented inequalities between minorities and Whites in meeting eligibility criteria for the Medicare Part D medication therapy management (MTM) program. Even though the Centers for Medicare & Medicaid Services attempted to relax the eligibility criteria, a critical barrier to effective MTM reform is the lack of stronger evidence about the actual effects of MTM on minorities’ health outcomes. The objective of this study was to examine the effects of comprehensive medication review (CMR), an MTM core component, on racial and ethnic disparities in adherence to diabetes, hypertension, and hyperlipidemia medications among Medicare beneficiaries aged 65 years or above.

METHODS : The study used 2017 Medicare Parts A/B/D claims, including MTM data, linked to the Area Health Resources Files. Medication non-adherence was compared across racial/ethnic groups between propensity score matched CMR recipients and non-recipients. To determine changes in racial/ethnic disparities after receiving CMR, a difference-in-differences framework was applied by including in logistic regressions interaction terms between dummy variables for CMR receipt and each minority race/ethnicity.

RESULTS : Compared to CMR non-recipients, there were lower racial/ethnic disparities among CMR recipients in non-adherence to medications of interest. For example, among patients on hypertension medications, odds ratio for the interaction terms between CMR and minority race/ethnicity (Blacks, Hispanics, Asians and Other) were 0.92 (95% CI=0.88-0.96), 0.82 (95% CI=0.78-0.86), 0.84 (95% CI=0.77-0.91), and 0.91 (95% CI=0.85-0.98), respectively.

CONCLUSIONS : CMR was found to have reduced racial/ethnic disparities in adherence to diabetes, hypertension, and hyperlipidemia medications. More racial/ethnic minorities should be enrolled in MTM to further realize this program’s potential.