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Objectives Racial/ethnic disparities have been found in prior literature examining enrolment in Medicare medication therapy management programs. However, those studies were based on various eligibility scenarios because enrolment data were unavailable. This study tested for potential disparities in enrolment using actual MTM enrolment data. Methods Medicare Parts A&B claims, Medication Therapy Management Data Files, and the Area Health Resources File from 2013 to 2014 and 2016 to 2017 were analysed in this retrospective analysis. An adjusted logistic regression compared odds of enrolment between racial/ethnic minorities and non-Hispanic Whites (Whites) in the total sample and subpopulations with diabetes, hypertension, or hyperlipidaemia. Trends in disparities were analysed by including interaction terms in regressions between dummy variables for race/ethnic minority groups and period 2016-2017. Key Findings Disparities in MTM enrolment were detected between Blacks and Whites with diabetes in 2013-2014 (Odds Ratio = 0.78, 95% Confidence Interval = 0.75-0.81). This disparity improved from 2013-2014 to 2016-2017 for Blacks (Odds Ratio=1.08, 95% Confidence Interval = 1.04-1.11) but persisted in 2016-2017 (Odds Ratio = 0.84, 95% Confidence Interval = 0.81-0.87). A disparity was identified between Blacks and Whites with hypertension in 2013-2014 (Odds Ratio = 0.92, 95% Confidence Interval = 0.89-0.95) but not in 2016-2017. Enrolment for all groups, however, declined between periods. For example, in the total sample, the odds of enrolment declined from 2013-2014 to 2016-2017 by 22% (Odds Ratio=0.78, 95% Confidence Interval=0.75-0.81). Conclusions Racial disparities in MTM enrolment were found between Blacks and Whites among Medicare beneficiaries with diabetes in both periods and among individuals with hypertension in 2013-2014. As overall enrolment fell between periods, concerns about program enrolment remain.

Background Evidence is sparse on the effects of Medicare medication therapy management on racial/ethnic disparities in medication adherence among patients with Alzheimer’s disease and related dementias. The objective of this study was to examine the Medicare medication therapy management program’s effects on racial/ethnic disparities in the adherence to antidementia medications among patients with Alzheimer’s disease and related dementias. Methods This is a retrospective analysis of 2016 and 2017 Medicare Parts A, B, and D data linked to Area Health Resources Files. The study outcome was nonadherence to antidementia medications, and intervention was defined as new medication therapy management enrollment in 2017. Propensity score matching was conducted to create intervention and comparison groups with comparable characteristics. A difference-in-differences model was employed with a logistic regression, including interaction terms of dummy variables for the intervention group and racial/ethnic minorities. Results Unadjusted comparisons revealed that Black, Hispanic, and Asian/Pacific Islander (Asian) patients were more likely to be nonadherent than non-Hispanic White (White) patients in 2016. Differences in odds of nonadherence between Black and White patients were lower in 2017 than in 2016 by 27% (odds ratios [OR]: 0.73, 95% confidence interval [CI]: 0.65–0.82). The same difference was also lower between Hispanic and White patients by 26% (OR: 0.74, 95% CI: 0.63–0.87). The MTM enrollment was associated with reduced disparities for Black-White patients of 33% (OR: 0.67, 95% CI: 0.57–0.78) and Hispanic-White patients of 19% (OR: 0.81, 95% CI: 0.67–0.99). Conclusions Medicare medication therapy management program was associated with lower disparities between Black and Hispanic patients with Alzheimer’s disease and related dementias than their White counterparts. Expanding the medication therapy management program may particularly benefit racial/ethnic minorities in Alzheimer’s disease and related dementias care.