KFF Analysis Estimates 3.8 Million Medicare Beneficiaries Eligible for GLP-1 Bridge Based on 2023 Population Data, CMS Medicare Director Chris Klomp Expects Participation in the 'Single-Digit Millions' at First, Centene Confirms Bridge Participation Despite Medicare Advantage Pilot Delay
KFF (formerly Kaiser Family Foundation) published an analysis estimating 3.8 million Medicare beneficiaries could have qualified for the Medicare GLP-1 Bridge in 2023 based on the three BMI-and-comorbidity eligibility tiers (BMI ≥35 no paired condition; BMI ≥30 with heart failure, uncontrolled hypertension, or chronic kidney disease; BMI ≥27 with pre-diabetes, prior MI, prior stroke, or symptomatic peripheral artery disease). CMS Medicare Director Chris Klomp told reporters on the launch call that the agency expects participation to run in the 'single-digit millions' at first, with volume ramping through Q3 and Q4 2026 as prescriber and pharmacy familiarity grows. Centene confirmed participation in the Bridge program despite the parallel delay in its Medicare Advantage pilot. The Bridge operates outside standard Part D risk pools; Part D plan sponsors do not carry risk for eligible GLP-1 drugs under the Bridge. Net drug pricing runs $245/month with CMS covering $195 and the patient paying the $50 copay.