Prescription Drugs & Pricing
Expert articles and analysis related to prescription drugs & pricing.
AI Summary — Last 30 Days
Synthesis:
Over the past 30 days, CMS has finalized significant structural changes to Medicare Advantage and Part D through the 2027 Rate Announcement and rulemaking, including codifying Part D redesign, updating risk adjustment, and further separating payments between MA-PDs and PDPs—moves that will directly impact plan strategy, risk management, and incentives for medication adherence within value-based care models [summary, Avalere Advisory]. Simultaneously, roll-out delays and ongoing adjustments to the BALANCE model—which expands GLP-1 access for obesity—reflect operational challenges in scaling innovative drug access and integrating pharmacy spend into population health contracts, heightening the need for VBC stakeholders to realign around evolving medication management incentives and quality measures [KFF on BALANCE].
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