What Do Risk Adjustment Model Updates Mean for Part D Plans?

What Do Risk Adjustment Model Updates Mean for Part D Plans?

The Inflation Reduction Act (IRA) introduced several policies that shift financial liability for prescription drug costs across manufacturers, plans, beneficiaries, and the Centers for Medicare  & Medicaid Services (CMS). As of 2025, under the Part D redesign, beneficiary out-of-pocket (OOP) costs are capped at $2,000, while plan and manufacturer liability increase in the catastrophic phase. The IRA also established the Medicare Drug Price Negot…