# Equity and Economic Effects of MTM Services

> **NIH NIH R01** · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · 2021 · $215,950

## Abstract

Drug-related morbidity and mortality cost the United States over $177.4 billion annually and are especially
daunting among the elderly. To improve pharmacotherapy outcomes and reduce costs, the Centers for
Medicare & Medicaid Services (CMS) established medication management therapy (MTM) programs as part of
the Medicare prescription drug benefits (Part D) in 2006. Unfortunately, MTM enrollment has fallen below CMS
targets mainly due to issues in MTM program design. Further, based on our previous policy scenario analysis,
primarily supported by an NIA R01, MTM eligibility criteria may be too restrictive for racial/ethnic minorities and
may perpetuate racial/ethnic disparities in health outcomes, because MTM eligibility is based on utilization of
medications, which minorities tend to use less. CMS attempted to relax MTM eligibility thresholds, citing our
research, but potential disparities remain with the utilization-based eligibility criteria. A critical barrier to
effective MTM reform is the lack of stronger information about the actual effects of MTM on minorities'
outcomes, utilization of MTM by minorities, and the cost-effectiveness of MTM. We will fill this knowledge gap
through our proposed research with newly available MTM data. Our long-term goal is to improve the health
status of older adults among diverse populations by improving medication utilization and reducing racial/ethnic
disparities in medication utilization and health outcomes. We will analyze Medicare Parts A/B/D data (2015-
2016), linked to Area Health Resources Files. Our expected outcomes include new information on: (1) effects
of MTM on racial/ethnic disparities in medication utilization, utilization/costs of health services, and mortality;
(2) measures of MTM utilization, such as MTM delivery methods, that exhibit disparity patterns; and (3) cost-
effectiveness of MTM from the perspectives of Medicare and health system. We will measure medication
utilization using evidence-based statin prescribing and other measures primarily developed by Pharmacy
Quality Alliance and adopted by Star Ratings, a health-plan-quality evaluation system tied to CMS bonus
payments to Part D plans. Utilization/costs of services include those of physician visits, emergency room visits,
and hospitalizations (e.g., hospitalizations originating from ambulatory care sensitive conditions). We will apply
multivariate regression models, a difference-in-difference strategy and negative benefit regression models
using frequentist and Bayesian approaches. Aim 1: Test the hypothesis that MTM programs have reduced
racial/ethnic disparities in quality of medication utilization, and health services utilization and costs. Aim 2: Test
the hypothesis that non-Hispanic Blacks and Hispanics receive fewer and delayed MTM services than Whites.
Aim 3: Test the hypothesis that MTM is a cost-effective program. Impact: Our results will provide much-
needed empirical evidence to guide MTM policy-making by CMS, and assist t...

## Key facts

- **NIH application ID:** 10075208
- **Project number:** 5R01AG040146-06
- **Recipient organization:** UNIVERSITY OF TENNESSEE HEALTH SCI CTR
- **Principal Investigator:** Junling None Wang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $215,950
- **Award type:** 5
- **Project period:** 2011-09-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10075208

## Citation

> US National Institutes of Health, RePORTER application 10075208, Equity and Economic Effects of MTM Services (5R01AG040146-06). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10075208. Licensed CC0.

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