The Inflation Reduction Act’s $2,000 cap on out-of-pocket costs for prescription drugs is expected to change Medicare beneficiaries’ use of medications, potentially leading to different utilization patterns that plans must learn to navigate.

Plans must now absorb costs that previously fell to members, creating sustainability challenges while they continue to maintain competitive coverage across service areas, Jackie Jacobson, senior director of the Government Programs Center of Excellence at Prime Therapeutics, said in a recent interview.

“The Inflation Reduction Act is moving a lot more of the liability onto health plans,” she said. “Once somebody has hit their out-of-pocket max and they no longer have cost sharing, there may be different behaviors for members if they don’t have any cop

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