The pharmaceutical industry, insurers and the Obama administration all want prescription drugs to be included in determinations about whether a certain pools of patients are riskier than others.
The determinations are important because insurers who take on riskier sets of patients are eligible to receive compensation under Obamacare. Right now, those determinations are made using just medical claims.
Drug companies and insurers generally agree that prescription drugs should be included in the risk adjustment models. They currently are not.
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