Prescription Drug Pricing

Over the past week, CMS finalized key 2027 Medicare Advantage and Part D regulations, clarifying policy and rate updates that directly affect drug pricing for Medicare and care delivery transformation for plan sponsors—establishing crucial parameters for ACOs and risk-bearing entities. The agency also delayed implementation of the Part D component of the BALANCE Model, postponing expanded GLP-1 access through prescription drug benefit changes and fueling tensions among stakeholders focused on chronic disease management and health equity via value-based care structures. For VBC organizations, these developments signal both opportunity and ongoing uncertainty in managing pharmacy spend and integrating costly therapies into accountable care programs. See [Crowell & Moring summary](https://news.google.com/rss/articles/CBMi2AFBVV95cUxOQ2NaZF9rVlRwVllnUWlfamQtX05BeDZpYkdJdEJraTJ1alNWRFNsRE9Ca0E1ZlUtZlp1ZDlPLXBxUkMxT3NMb2FLeFg3bklfNjdiMjNOYlR1Qm5yVFVTSmFLSUsyLW9GOHB3RDJPRG54ay1QUjhJcTZXOWlBaW1Mck9jTlk1Tk55OEdsMWE3aHhzMk0xNldWZzFSY0pDV2FyM1Rm