Important: Patient Advocate Foundation’s TotalAssist program launches on July 1. Whether you’re a new patient, or you’re currently receiving assistance from Patient Advocate Foundation or PAN Foundation, visit our TotalAssist.org website to learn more about next steps, get helpful information, and access your portal account. Starting July 1, the call center can be reached by calling toll free, 866-512-3861 from 8:30am to 5:30pm ET.

Health Affairs: Smoothing Part D out-of-pocket costs under the Inflation Reduction Act

Information about this website: Following the March 2026 merger of Patient Advocate Foundation and the PAN Foundation, this website is now a part of Patient Advocate Foundation and remains active during our website transition.

Where to find information during our transition:

Following the passage of the Inflation Reduction Act of 2022, which included several historic Medicare reforms, media coverage has often focused on the $2,000 annual cap on out-of-pocket prescription costs. But one key reform has been missing from the headlines: smoothing.

This article, published in Health Affairs Forefront, discusses the importance of smoothing—the option to evenly distribute Part D prescription costs throughout the year with monthly payments. It also includes key recommendations for the Centers for Medicare and Medicaid Services as they design, implement, and promote the program. Cap and smoothing, which will both take effect in 2025, will have a major impact on medication adherence and affordability.

Amy Niles, Chief Advocacy and Engagement Officer at the PAN Foundation, co-authored this article with Jalpa A. Doshi, PhD, Professor of Medicine at the Perelman School of Medicine. The two have been at the forefront of smoothing research and advocacy for years.