The Inflation Reduction Act of 2022 introduced changes to help lower out-of-pocket (OOP) costs for Medicare Part D medications. One of those changes, the Medicare Prescription Payment Plan, is a program launched in 2025 that offers Medicare Part D patients the option to spread their OOP prescription drug costs throughout the remainder of the year as capped monthly payments, instead of paying one larger sum at the first prescription fill.
However, as of December 2025, less than 1% of all Medicare patients had opted into the program, signaling limitations. Such a low participation rate points to underlying challenges that could be diagnosed and resolved using Six Sigma, a well-established process improvement model. Six Sigma is a disciplined, data-driven methodology designed to improve processes by eliminating defects and reducing variability. Originally developed for manufacturing, its tenets have been successfully applied in healthcare, finance, and other industries to boost efficiency and improve customer satisfaction.
In this paper, we outline five potential innovations to the Medicare Prescription Payment Program, informed by Six Sigma’s principles:
- Deploy an awareness campaign through providers
- Create a point-of-sale opt-in mechanism
- Shift from decentralized to centralized program onboarding
- Make “opt in” the program default
- Auto-deduct payments from Social Security