KFF estimates Medicare will spend about $13.4 billion on the Medicare Advantage Quality Bonus Program in 2026, a level set against ongoing scrutiny of the program. The Quality Bonus Program adjusts star ratings into bonus payments for plans, meaning the dollars flow can influence plan investment decisions and utilization management. For biotech companies selling to payers and health systems, the decision environment matters because Quality Bonus outcomes can affect coverage policies, network strategy, and performance metrics tied to care delivery. The estimate also provides a planning anchor for stakeholders tracking bonus dynamics amid continued oversight debates. Overall, the estimate points to sustained financial leverage embedded in Medicare Advantage performance structures during 2026.