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.
Design Articles
Milliman Review: Evaluation of Net Cost Guarantee Arrangement Calculations
April 29th, 2022 by Abarca NewsBetter Analytics & Clinical Programs.
October 15th, 2021 by Abarca NewsAbarca’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.
A “Client First” Approach.
October 15th, 2021 by Abarca NewsWe 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.
Total Predictability.
October 15th, 2021 by Abarca NewsBy 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.
A Straightforward & Understandable Financial Model.
October 14th, 2021 by Abarca NewsAbarca 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.
How It Works: A Partnership.
October 13th, 2021 by Abarca NewsAbarca 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.