Milliman concluded that the reconciliation methodology for Assura is “an appropriate methodology and that the calculations reviewed from Abarca follow the prescribed methodology and are actuarially appropriate.” In addition, Milliman stated that “the arrangement provides transparency and predictability while including a straightforward methodology for reconciliation.” To read the full report, click here.
Through a competitive national network and formulary management ‘lowest net cost rebate’ program, we help plans keep unit costs under control for health payers in a simpler and more predictable way.
Abarca’s technology platform, Darwin™, provides the highest levels of business intelligence and visibility into costs and trends. Our medication therapy management, chronic disease, and other clinical programs provide members the care they need to stay adherent and healthy, while also controlling plan costs.
We are driven to lower the cost of pharmacy for our clients without increasing the burden on their members. With our guaranteed price model, Abarca makes quarterly reconciliation payments and provides full reporting.
By implementing this new cost model, plans will be better positioned to budget their drug spend into the future with confidence. Abarca makes quarterly payments under the guarantee and provides full reconciliation and reporting.
Abarca then goes to work and develops a new, straightforward, and understandable net cost model that protects the plan from the most common sources of cost increases, including drug mix, inflation, and other factors. This model excludes utilization changes resulting from shifts in the disease burden of the population.
Abarca will utilize the plan’s claims history, eligibility, plan design, and utilization strategies to calculate a per script guarantee. Our pricing option continues to put the plan in control: the plan maintains the choice of plan design and utilization management rules.
Bringing Predictability & Accountability in Drug Spend Management. To protect health benefit payers from the risks of high-cost medications and drug mix changes, Abarca has created a better way to help manage pharmacy benefit costs. Through Assura, Abarca will guarantee the net cost of drugs, including specialty medications, by offering an annual fixed per script […]