Impact of Environmental Factors on Differences in Quality of Medication Use: An Insight for the Medicare Star Rating System

• DOI: 10.18553/jmcp.2016.22.7.779
• Publication Date: 2016-06-27T15:57:28Z
• Authors: Vibha Desai; David Nau; Mark Conklin; Pamela C. Heaton
• Keywords: Medicare Advantage

The Medicare star ratings system incentivizes health plan sponsors based on their performance across a measurement that contains quality measures related to medication use. As seek further engage network providers, specifically pharmacies, improve these measures, it is important consider the effect of environmental factors pharmacies.To determine pharmacy as measured by (a) adherence for noninsulin diabetes medications, (b) renin angiotensin receptor antagonists (RASA), (c) cholesterol medications (statins), and (d) use high-risk (HRM) in elderly.The EQuIPP database, which information pharmacies nationwide sample beneficiaries, was used this analysis. Environmental included regions or characteristics community county. County-level data obtained from Area Health Resource Files, resource product available Resources & Service Administration. A logistic regression model developed with dependent variable independent variables. Performance county characteristics, such proportion patients an age group, race, income, number outpatient visits, were classified high low median cutoff scores.A total 28,950 For most low-performing significantly higher East South Central, Mid-Atlantic, Mountain, Pacific, West Central regions. Pharmacies counties elderly population (aged > 84 years), who white Hispanic, males, urban less likely have performance, whereas those African Americans density more (P < 0.05-0.0001).This study found region, including sociodemographic explained regional variation patient populations served pharmacies. This evaluation serves inform discussion regarding case-mix adjustment provides may be refine intervention strategies pharmacists serve certain populations. Additionally, greatest need support improvement are predominantly income American.Desai's postdoctoral fellowship funded Pharmacy Quality Solutions conducting writing manuscript. Nau Conklin employed Solutions. An earlier version research presented poster at Annual Meeting Academy Managed Care Pharmacy; San Diego, CA; April 7-10, 2015. Study concept design contributed Conklin, Nau, Desai, Heaton. Desai took lead collection, assisted manuscript primarily written Heaton, assistance Nau. All authors interpretation revision.