Medicare

More than six in 10 (62%) Medicare Advantage enrollees, or 18.2 million people, were enrolled in plans that are part of contracts that offered a reward or incentive for completing a health risk assessment in 2023. Insurers use health risk assessments to collect information about enrollees’ health status. But they are also a source of diagnoses codes used to calculate a person’s risk score, which affects federal payments to the insurer.

Also: Will the Trump Administration Fast Track the Privatization of Medicare?

Part of a recent executive order from President Trump directs the Secretary of HHS to work with Congress to implement a change in the Medicare Drug Price Negotiation Program to delay negotiation of so-called “small molecule” drugs beyond 7 years after FDA approval under current law.

If that timeframe had already been in place, more than half of the Part D drugs that were selected for price negotiation in the first or second rounds – 13 out of 25 – would not have been eligible at the time drugs were selected.

Medicare Advantage, the private plan alternative to traditional Medicare, covers nearly 33 million beneficiaries, or 54%, of the eligible Medicare population. A new analysis finds that the average Medicare beneficiary can choose among 34 Medicare Advantage plans with prescription drug coverage (MA-PDs), two fewer than last year, and among plans offered by eight firms. About 5% of current Medicare Advantage enrollees in individual MA-PDs are in a plan that has been terminated for 2025.

A companion analysis, Medicare Advantage 2025 Spotlight: A First Look at Plan Premiums and Benefits, provides an overview of premiums and benefits in Medicare Advantage plans for 2025, and key trends over time.