{"doi":"10.1377/hlthaff.2016.0258","title":"Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor","abstract":null,"journal":"Health Affairs","year":2016,"id":603476,"datarank":0.4335557636844247,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"self_citation_contribution":0.4335557636844247,"citation_network_contribution":0.0,"self_endowment_contribution":0.4335557636844247,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1548063,"name":"Franklin B. Hendrick","orcid":null,"position":1,"is_corresponding":false},{"id":679871,"name":"Xian Shen","orcid":"0000-0003-3331-1676","position":2,"is_corresponding":false},{"id":1280643,"name":"Mingliang Dai","orcid":"0000-0002-6926-2514","position":3,"is_corresponding":false},{"id":305001,"name":"Sarah E. Tom","orcid":"0000-0003-0094-5138","position":4,"is_corresponding":false},{"id":1548064,"name":"J. Samantha Dougherty","orcid":null,"position":5,"is_corresponding":false},{"id":1548065,"name":"Laura M. Miller","orcid":null,"position":6,"is_corresponding":false},{"id":1547142,"name":"Bruce Stuart","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor","abstract":"Medicare Part D prescription drug plans must offer medication therapy management to beneficiaries with multiple chronic conditions and high drug expenditures. However, plan sponsors have considerable latitude in setting eligibility criteria. Newly available data indicate that enrollment rates in medication therapy management among stand-alone prescription drug plans and Medicare Advantage drug plans averaged only 10 percent in 2012. The enrollment variation across plan sponsors-from less than 0.2 percent to more than 57.0 percent-was associated with the restrictiveness of their eligibility criteria. For example, enrollment was 16.4 percent in plans requiring two chronic conditions versus 9.2 percent in plans requiring three, and 12.7 percent in plans requiring the use of any Part D drug versus 4.4 percent in plans requiring the use of drugs in specific classes. This variation represents inequities in access to medication therapy management across plans and results in missed opportunities for interventions that might improve therapeutic outcomes and reduce spending. The new Part D Enhanced Medication Therapy Management model of the Centers for Medicare and Medicaid Services has the potential to significantly increase the impact of medication therapy management by aligning financial incentives with improvements in medication use and encouraging innovation.","is_dataset_classified":null,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"27605635","pmcid":null,"openalex_id":"https://openalex.org/W2508239177","authors":[],"funders":[],"total_grants":0,"fwci":0.9171,"citation_percentile":0.76239316,"influential_citations":0,"citation_trend":[{"year":2017,"count":1},{"year":2019,"count":2},{"year":2020,"count":3},{"year":2021,"count":2},{"year":2022,"count":3},{"year":2023,"count":1},{"year":2024,"count":4},{"year":2025,"count":1}],"oa_status":"closed","license":null,"oa_locations":[{"url":"http://www.healthaffairs.org/doi/10.1377/hlthaff.2016.0258","host_type":"publisher"},{"url":"https://doi.org/10.1377/hlthaff.2016.0258","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/27605635","host_type":"repository"}],"fields_of_study":["Medication Adherence and Compliance","Pharmaceutical Economics and Policy","Pharmaceutical Practices and Patient Outcomes"],"mesh_terms":["Aged","Eligibility Determination","Female","Humans","Insurance, Pharmaceutical Services","Male","Quality Assurance, Health Care","Retrospective Studies","United States","Centers for Medicare and Medicaid Services, U.S.","Program Evaluation","Databases, Factual","Risk Assessment","Medicare Part D","Medication Therapy Management"],"keywords":["Medicaid","Medication therapy management","Medicare Part D","Medicare Advantage","Medicine","Prescription drug","Medical prescription","Utilization management","Incentive program","Drug Utilization Review","Psychological intervention","Prior authorization","Incentive","Family medicine","Pharmacy","Nursing","Health care","Pharmacist","Medicare","Medicine/clinical Issues"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Industry, innovation and infrastructure"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-29T22:02:35.506294Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}