دورية أكاديمية
أعرض في EDS

Comprehensive Medication Review Completion Rates and Disparities After Medicare Star Rating Measure.

التفاصيل البيبلوغرافية
العنوان: Comprehensive Medication Review Completion Rates and Disparities After Medicare Star Rating Measure.
المؤلفون: Hung A; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.; Duke-Margolis Center for Health Policy, Durham, North Carolina.; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina., Wilson L; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina., Smith VA; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina.; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina., Pavon JM; Division of Geriatrics, Department of Medicine, Duke University School of Medicine, Durham, North Carolina.; Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina.; Geriatrics Research, Education, and Clinical Center, Durham Veterans Affairs Health Care System, Durham, North Carolina., Sloan CE; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.; Duke-Margolis Center for Health Policy, Durham, North Carolina.; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina., Hastings SN; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina.; Division of Geriatrics, Department of Medicine, Duke University School of Medicine, Durham, North Carolina.; Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina.; Geriatrics Research, Education, and Clinical Center, Durham Veterans Affairs Health Care System, Durham, North Carolina., Farley J; Department of Pharmaceutical Care & Health Systems, University of Minnesota College of Pharmacy, Minneapolis., Maciejewski ML; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.; Duke-Margolis Center for Health Policy, Durham, North Carolina.; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina.; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina.
المصدر: JAMA health forum [JAMA Health Forum] 2024 May 03; Vol. 5 (5), pp. e240807. Date of Electronic Publication: 2024 May 03.
نوع المنشور: Journal Article; Observational Study; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101769500 Publication Model: Electronic Cited Medium: Internet ISSN: 2689-0186 (Electronic) Linking ISSN: 26890186 NLM ISO Abbreviation: JAMA Health Forum Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2020]-
مواضيع طبية MeSH: Healthcare Disparities*/statistics & numerical data , Healthcare Disparities*/ethnology, Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Ethnicity/statistics & numerical data ; Interrupted Time Series Analysis ; Medicare/statistics & numerical data ; Medicare Part D/statistics & numerical data ; United States ; Asian ; Black or African American ; Hispanic or Latino ; White
مستخلص: Importance: Comprehensive medication reviews (CMRs) are offered to qualifying US Medicare beneficiaries annually to optimize medication regimens and therapeutic outcomes. In 2016, Medicare adopted CMR completion as a Star Rating quality measure to encourage the use of CMRs.
Objective: To examine trends in CMR completion rates before and after 2016 and whether racial, ethnic, and socioeconomic disparities in CMR completion changed.
Design, Setting, and Participants: This observational study using interrupted time-series analysis examined 2013 to 2020 annual cohorts of community-dwelling Medicare beneficiaries aged 66 years and older eligible for a CMR as determined by Part D plans and by objective minimum eligibility criteria. Data analysis was conducted from September 2022 to February 2024.
Exposure: Adoption of CMR completion as a Star Rating quality measure in 2016.
Main Outcome and Measures: CMR completion modeled via generalized estimating equations.
Results: The study included a total of 561 950 eligible beneficiaries, with 253 561 in the 2013 to 2015 cohort (median [IQR] age, 75.8 [70.7-82.1] years; 90 778 male [35.8%]; 6795 Asian [2.7%]; 24 425 Black [9.6%]; 7674 Hispanic [3.0%]; 208 621 White [82.3%]) and 308 389 in the 2016 to 2020 cohort (median [IQR] age, 75.1 [70.4-80.9] years; 126 730 male [41.1%]; 8922 Asian [2.9%]; 27 915 Black [9.1%]; 7635 Hispanic [2.5%]; 252 781 White [82.0%]). The unadjusted CMR completion rate increased from 10.2% (7379 of 72 225 individuals) in 2013 to 15.6% (14 185 of 90 847 individuals) in 2015 and increased further to 35.8% (18 376 of 51 386 individuals) in 2020, in part because the population deemed by Part D plans to be MTM-eligible decreased by nearly half after 2015 (90 487 individuals in 2015 to 51 386 individuals in 2020). Among a simulated cohort based on Medicare minimum eligibility thresholds, the unadjusted CMR completion rate increased but to a lesser extent, from 4.4% in 2013 to 12.6% in 2020. Compared with White beneficiaries, Asian and Hispanic beneficiaries experienced greater increases in likelihood of CMR completion after 2016 but remained less likely to complete a CMR. Dual-Medicaid enrollees also experienced greater increases in likelihood of CMR completion as compared with those without either designation, but still remained less likely to complete CMR.
Conclusion and Relevance: This study found that adoption of CMR completion as a Star Rating quality measure was associated with higher CMR completion rates. The increase in CMR completion rates was achieved partly because Part D plans used stricter eligibility criteria to define eligible patients. Reductions in disparities for eligible Asian, Hispanic, and dual-Medicaid enrollees were seen, but not eliminated. These findings suggest that quality measures can inform plan behavior and could be used to help address disparities.
التعليقات: Erratum in: JAMA Health Forum. 2024 Jun 7;5(6):e241508. doi: 10.1001/jamahealthforum.2024.1508. (PMID: 38848091)
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تواريخ الأحداث: Date Created: 20240503 Date Completed: 20240503 Latest Revision: 20240706
رمز التحديث: 20240706
مُعرف محوري في PubMed: PMC11069085
DOI: 10.1001/jamahealthforum.2024.0807
PMID: 38700854
قاعدة البيانات: MEDLINE
الوصف
تدمد:2689-0186
DOI:10.1001/jamahealthforum.2024.0807