TY - JOUR
T1 - Solving racial/ethnic disparities associated with Medicare Part D Star Ratings
AU - Dong, Xiaobei
AU - Tsang, Chi Chun Steve
AU - Browning, Jamie A.
AU - Sim, Yongbo
AU - Wan, Jim Y.
AU - Chisholm-Burns, Marie A.
AU - Dagogo-Jack, Samuel
AU - Cushman, William C.
AU - Wang, Junling
N1 - Publisher Copyright:
© 2023 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Objective: Medicare Part D Star Ratings are instrumental in shaping healthcare quality improvement efforts. However, the calculation metrics for medication performance measures for this program have been associated with racial/ethnic disparities. In this study, we aimed to explore whether an alternative program, named Star Plus by us that included all medication performance measures developed by Pharmacy Quality Alliance and applicable to our study population, would reduce such disparities among Medicare beneficiaries with diabetes, hypertension, and/or hyperlipidemia. Method: We conducted an analysis of a 10% random sample of Medicare A/B/D claims linked to the Area Health Resources File. Multivariate logistic regressions with minority dummy variables were used to examine racial/ethnic disparities in measure calculations of Star Ratings and Star Plus, respectively. Results: Adjusted results indicated that relative to non-Hispanic Whites (Whites), racial/ethnic minorities had significantly lower odds of being included in the Star Ratings measure calculations: the odds ratios (ORs) for Blacks, Hispanics, Asians, and Others were 0.68 (95% confidence interval [CI] = 0.66–0.71), 0.73 (CI = 0.69–0.78), 0.88 (CI = 0.82–0.93), and 0.92 (CI = 0.88–0.97), respectively. In contrast, every beneficiary in the sample was included in Star Plus. Further, racial/ethnic minorities had significantly higher increase in the odds of being included in measure calculation in Star Plus than Star Ratings. The ORs for Blacks, Hispanics, Asians, and Others were 1.47 (CI = 1.41–1.52), 1.37 (CI = 1.29–1.45), 1.14 (CI = 1.07–1.22), and 1.09 (CI = 1.03–1.14), respectively. Conclusions: Our study demonstrated that racial/ethnic disparities may be eliminated by including additional medication performance measures to Star Ratings.
AB - Objective: Medicare Part D Star Ratings are instrumental in shaping healthcare quality improvement efforts. However, the calculation metrics for medication performance measures for this program have been associated with racial/ethnic disparities. In this study, we aimed to explore whether an alternative program, named Star Plus by us that included all medication performance measures developed by Pharmacy Quality Alliance and applicable to our study population, would reduce such disparities among Medicare beneficiaries with diabetes, hypertension, and/or hyperlipidemia. Method: We conducted an analysis of a 10% random sample of Medicare A/B/D claims linked to the Area Health Resources File. Multivariate logistic regressions with minority dummy variables were used to examine racial/ethnic disparities in measure calculations of Star Ratings and Star Plus, respectively. Results: Adjusted results indicated that relative to non-Hispanic Whites (Whites), racial/ethnic minorities had significantly lower odds of being included in the Star Ratings measure calculations: the odds ratios (ORs) for Blacks, Hispanics, Asians, and Others were 0.68 (95% confidence interval [CI] = 0.66–0.71), 0.73 (CI = 0.69–0.78), 0.88 (CI = 0.82–0.93), and 0.92 (CI = 0.88–0.97), respectively. In contrast, every beneficiary in the sample was included in Star Plus. Further, racial/ethnic minorities had significantly higher increase in the odds of being included in measure calculation in Star Plus than Star Ratings. The ORs for Blacks, Hispanics, Asians, and Others were 1.47 (CI = 1.41–1.52), 1.37 (CI = 1.29–1.45), 1.14 (CI = 1.07–1.22), and 1.09 (CI = 1.03–1.14), respectively. Conclusions: Our study demonstrated that racial/ethnic disparities may be eliminated by including additional medication performance measures to Star Ratings.
KW - Disparities
KW - Medicare
KW - medication utilization
KW - performance measures
KW - ratings
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U2 - 10.1080/03007995.2023.2217654
DO - 10.1080/03007995.2023.2217654
M3 - Article
C2 - 37219396
AN - SCOPUS:85161544266
SN - 0300-7995
VL - 39
SP - 963
EP - 971
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 7
ER -