Obesity Drugs Cost Concerns Not Yet Impacting HHS Risk Adjustment Models

Individual and small group plans in the commercial insurance market are not seeing ‘a large enough change in clinical indications or practice patterns to warrant a change to the current mapping of GLP-1 drugs,’ final rule states.

weight-scale-with-a-tight-belt
Insurance plans worry they will need to tighten their belts because of GLP-1 spending. • Source: Shutterstock

The final HHS Notice of Benefit and Payment Parameters for 2025 is not offering any immediate relief to Individual and small group plans in the commercial insurance market worried about increasing costs from GLP-1 drugs.

In response to comments received urging a modifications in the HHS risk adjustment models used by plans to calculate risk...

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