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Tulsa's major health systems and physician groups are stregthening access to care across the region with the expansion of facilities and services. Physician groups also are participating in payment reform efforts driven by the Centers for Medicare and Medicaid services, increasing care coordination in the market. Pressure to contain costs under value-based models could promote greater adherence to drug regimens, which bodes well for pharma. However, Oklahoma’s new Medicaid drug pricing initiative, which enables the Oklahoma Health Care Authortiy to enter into outcomes-based contracts with drug makers, could give the state more leverage over pharmaceutical manufacturers.