Nursing Homes Grapple With GLP-1 Costs, Dual-Eligible Coverage Gaps
Skilled Nursing News reports GLP-1 medications are increasingly common among nursing home admissions, with Venza Care seeing 30-40% of new residents arriving on these drugs for diabetes, weight loss, cardiovascular and metabolic conditions. Facilities face added clinical burdens including staff education, frailty monitoring, and dietitian oversight, alongside complex payment questions. CMS's bridge program covers certain GLP-1s under Medicare Part D for weight loss with a $50 monthly fee, but dual-eligible residents may lack funds to cover it, and the more permanent BALANCE program has been delayed indefinitely while the bridge program was extended through 2027. Residents on Medicare Part A with existing GLP-1 prescriptions shift the medication cost burden onto the nursing facility itself.