Addressing racial/ethnic disparities associated with Medicare Part D Star Ratings among population with Alzheimer's disease and related dementias.

BACKGROUND:Previous studies noted that racial/ethnic minority groups were less likely than non-Hispanic White beneficiaries to be included in the assessment of medication utilization measures of Medicare Part D Star Ratings due to restrictive inclusion criteria for measure calculation. This study explored whether adding a measure with less stringent inclusion criteria to Star Ratings can reduce disparities in measure assessment among beneficiaries with Alzheimer's disease and related dementias (ADRD). METHODS:This cross-sectional study utilized 2017 Medicare databases linked to Area Health Resources Files. Multivariable logistic regression was used to compare disparities before and after adding the new measure. RESULTS:By adding the new measure, disparities in the odds for assessment inclusion between non-Hispanic White beneficiaries and Black, Hispanic, Asian, and Other beneficiaries were respectively reduced by 97% (odds ratio, or OR = 1.97, 95% Confidence Interval or CI = 1.89-2.05), 72% (OR = 1.72, 95% CI = 1.58-1.87), 115% (OR = 2.15, 95% CI = 1.87-2.46), and 44% (OR = 1.44, 95% CI = 1.28-1.62). CONCLUSIONS:To improve the selection of medication utilization measures in Star Ratings among beneficiaries with ADRD, policymakers should investigate the optimal composition of measures to better align the interests of patients, providers, and health plans.