The frequency and severity of natural disasters appears to be increasing. In 2017 alone, the U.S. experienced 16 separate billion-dollar disasters. These natural disasters can devastate communities and make prescription medications inaccessible to patients that rely on them.
In September 2017, Hurricane Maria hit Puerto Rico and Abarca’s approach to disaster planning, response, and recovery was put to the test.
- Preparing the infrastructure. We developed a highly redundant infrastructure, with data and call center operations routed through at least three different facilities across the U.S. All of the data centers have multiple connections to the central pharmacy switches. Data is continuously replicated across backup data centers, and virtual call centers allow calls to be handled from any location with internet connectivity.
- Getting the team in place. Being ready for natural disasters begins by cultivating a culture of awareness and preparedness. We have a cross-functional business continuity team that trains the staff and conducts drills throughout the year. A sophisticated internal communications program is also in place that allows us to check on the wellbeing of our team members and their families, and to alert them of organizational activities.
- Ensuring the availability of medications. In the immediate aftermath of Hurricane Maria, there were only a couple dozen pharmacies open, making it almost impossible for members to get their needed medications. Abarca assisted pharmacies in serving members by processing claims over the phone and visiting more than 200 retail locations. By deploying clinical and operations teams across the island and into the community, we were able to gather critical information about which pharmacies had inventory and were able to serve customers.
- Maintaining Medication Therapy Management (MTM) programs are particularly important for people with chronic diseases. After natural disasters, clinical teams are often unable to reach members by phone to conduct comprehensive medical reviews or track adherence. To overcome this, our clinicians visited prescribers in person. We then worked with the prescribers and pharmacies to identify patients in greatest need of immediate intervention and contacted them using any available method to provide counsel and assist them in obtaining the medications they needed.
- Ongoing planning and learning. Building an organization and infrastructure that is ready in case of devastation from hurricanes, tornadoes, earthquakes, and other potentially catastrophic events requires constant review, analysis, and practice. New resources become available, best practices from other industries emerge, and each company’s risks change over time. At Abarca, we are continuously reevaluating our business continuity and disaster recovery programs in search of a better way.
In the aftermath of Hurricane Maria, Abarca experienced zero downtime in our ability to process claims and respond to calls from members, pharmacies, or physicians.
By sending clinicians and operations experts into the field, we created a database of pharmacies where patients could have prescriptions filled. The database also served as an official resource for the Government of Puerto Rico. Given the extent of the devastation and the length of time required for many pharmacies to resume normal operations, this directory was essential to keeping members with chronic conditions adherent.
By adapting our MTM program to include in-person visits to doctor’s offices and patient’s homes, Abarca was able to achieve a 5-star Comprehensive Medication Reviews (CMR) completion rate of 87% on average, despite most patients being without telephone service for nearly 3 months.