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On April 21, 2026, the day after the application deadline for Medicare Part D plan sponsors to participate in the BALANCE Model, CMS announced that it would not be moving forward with implementation of the BALANCE Model in Medicare in 2027 and instead would be extending the Medicare GLP-1 Bridge to run through the end of 2027

Now serving 20 states: Arizona, Colorado, Connecticut, Florida, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, New Hampshire, New Mexico, New York, Oregon, Utah, Vermont, Washington, Wisconsin, and Wyoming

We estimated hazard ratios using Cox regression, with days since start of treatment as the underlying time scale

Which HRT delivery methods are affected Affected by GLP-1 medications (oral delivery): Oral estrogen tablets (conjugated equine estrogens, estradiol) Oral progesterone (micronized progesterone, such as Utrogestan) Oral progestins (norethisterone, medroxyprogesterone) Oral testosterone (testosterone undecanoate) NOT affected by GLP-1 medications (non-oral delivery): Transdermal estrogen patches Topical estrogen gels and creams Vaginal estrogen rings or suppositories Progesterone-releasing IUD (Mirena) Transvaginal progesterone Testosterone injections Testosterone pellets Testosterone patches or gels The distinction is simple

A GLP-1 RA with proven cardiovascular benefit is recommended in patients with T2D who have albuminuric diabetic kidney disease (DKD) if a SGLT2 inhibitor is contraindicated or not tolerated

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