# Reducing Racial/Ethnic Disparities in Alzheimer's-Type Dementia with MTM Services

> **NIH NIH R01** · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · 2020 · $380,000

## Abstract

Compared to non-Hispanic Whites (Whites), racial/ethnic minorities suffer from higher prevalence of
Alzheimer’s disease (AD) and some associated vascular conditions, exhibit lower medication adherence, and
incur higher healthcare costs. A critical barrier for resolving racial/ethnic disparities among AD patients is the
lack of effective strategies to improve medication utilization among this population. Our Parent R01 examines
the effects of medication therapy management (MTM) programs in the Medicare prescription drug benefit (Part
D) on racial/ethnic disparities, but our original plan did not include AD-specific analysis mainly because of small
sample size. With newly granted access to data for 100% Medicare beneficiaries, we now propose to examine
the effects of MTM on medication utilization and health services utilization/costs among AD patients. The
Centers for Medicare & Medicaid Services (CMS) established MTM in 2006 to improve pharmacotherapy
outcomes, but because of program design issues, CMS decided to modify MTM and launched a demonstration
of the Enhanced MTM Model in 2017. While the existing MTM has been shown to lead to higher medication
adherence among patients with vascular conditions, based on an interim report from 10/2019, Enhanced MTM
failed to exert a positive impact on utilization of medications or health services. Our study will thus provide
timely information when CMS ponders MTM policy options after completing the Enhanced MTM demonstration
in 2022. Our long-term goal is to improve the health status of older adults among diverse populations by
reducing racial/ethnic disparities in medication utilization and health outcomes. We will analyze 100% Medicare
Parts A/B/D data (2016-2017) linked to Area Health Resources Files. For medication utilization, we will
measure initiation/discontinuation/persistence of antidementia medication and will apply utilization measures of
medications, including those for vascular conditions, in Part D Star Ratings, a federal health-plan-quality
evaluation system. Our expected outcomes include new information on: (1) effects of MTM on study outcomes
among AD patients; (2) effects of MTM on racial/ethnic disparities in study outcomes among AD patients; and
(3) measures of MTM utilization that exhibit disparity patterns among AD patients. Aim 1: Test the hypothesis
that MTM services have improved quality of medication utilization and reduced health services utilization/costs
among AD patients. Aim 2: Test the hypothesis that MTM has reduced racial/ethnic disparities in medication
utilization and health services utilization/costs among AD patients. Aim 3: Test the hypothesis that racial/ethnic
minorities received fewer/delayed MTM services than Whites among AD patients. Impact: Our results will
provide empirical evidence to guide CMS policy-making for MTM, improve AD management, and assist the
NIA/NIH in its strategic goals of “develop(ing) strategies to improve the health status of older adults in...

## Key facts

- **NIH application ID:** 10121850
- **Project number:** 3R01AG040146-05S1
- **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:** 2020
- **Award amount:** $380,000
- **Award type:** 3
- **Project period:** 2011-09-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10121850

## Citation

> US National Institutes of Health, RePORTER application 10121850, Reducing Racial/Ethnic Disparities in Alzheimer's-Type Dementia with MTM Services (3R01AG040146-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10121850. Licensed CC0.

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