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Medication adherence star ratings measures, health care resource utilization, and cost.
Poonawalla, Insiya B; Chung, Linda; Shetler, Sarah; Pearce, Heather; Dixon, Suzanne W; Racsa, Patrick.
Afiliación
  • Poonawalla IB; Humana Healthcare Research, Inc, 500 W Main St, Louisville, KY 40202. Email: ipoonawalla@humana.com.
Am J Manag Care ; 30(5): 210-217, 2024 05.
Article en En | MEDLINE | ID: mdl-38748928
ABSTRACT

OBJECTIVE:

To examine the association between missed CMS Star Ratings quality measures for medication adherence over 3 years for diabetes, hypertension, and hyperlipidemia medications (9 measures) and health care utilization and relative costs. STUDY

DESIGN:

Retrospective cohort study.

METHODS:

The study examined eligible patients who qualified for the diabetes, statin, and renin-angiotensin system antagonist medication adherence measures in 2018, 2019, and 2020 and were continuously enrolled in a Medicare Advantage prescription drug plan from 2017 through 2021. A total of 103,900 patients were divided into 4 groups based on the number of adherence measures missed (3 medication classes over 3 years) (1) missed 0 measures, (2) missed 1 measure, (3) missed 2 or 3 measures, and (4) missed 4 or more measures. To achieve a quality measure, patients had to meet the Pharmacy Quality Alliance 80% threshold of proportion of days covered during the calendar year.

RESULTS:

The mean age of the cohort was 71.1 years, and 49.9% were female. Compared with patients who missed 0 of 9 adherence measures, those who missed 1 measure, 2 or 3 measures, and 4 or more measures experienced 12% to 26%, 22% to 42%, and 24% to 50% increased risks, respectively, of all-cause and diabetes-related inpatient stays and all-cause and diabetes-related emergency department visits (all  P  values < .01). Additionally, patients who missed 1, 2 or 3, and 4 or more adherence measures experienced 14%, 19%, and 20% higher monthly medical costs, respectively.

CONCLUSIONS:

Missing Star Ratings quality measures for medication adherence was associated with an increased likelihood of health care resource utilization and increased costs for patients taking medications to treat diabetes, hypertension, and hyperlipidemia.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aceptación de la Atención de Salud / Diabetes Mellitus / Cumplimiento de la Medicación / Hiperlipidemias / Hipertensión Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Manag Care Asunto de la revista: SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aceptación de la Atención de Salud / Diabetes Mellitus / Cumplimiento de la Medicación / Hiperlipidemias / Hipertensión Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Manag Care Asunto de la revista: SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos