back to all sectors

Medicare and Commercial Health Plans

Achieving 5-stars in Part D requires the right clinical programs, formulary, and rebate management, finely tuned quality measurement, and worry-free CMS compliance and audit support. Our award-winning track record in Part D plans speaks for itself.

Here’s how we do it:


Flexible plan designs.

Abarca’s smarter technology platform offers commercial and Medicare plans the ability to implement new and creative benefit designs and maintain  those plan and formulary benefits on the fly. In fact, today, we manage nearly 2,000 unique plan designs. This level of customization also allows Medicare plans to take advantage of the latest strategies to manage trend while maintaining compliance with regulatory requirements.

Honestly better analytics.

PBMs are often long on promises about their analytics, but short on providing meaningful data in simple way. Our easy-to-interpret dashboards are in a different class. Understand your cost drivers down to condition and member. Know which members are impactable and how to improve outcomes and reduce costs.

Redundant and rock solid.

Our platform has been tested under the most challenging conditions and stood strong.


Reimagined clinical programs.

A small percentage of members with relatively few conditions can drive a plan’s total costs. Targeting these members with adherence programs, condition-specific strategies, and innovative approaches to member engagement has allowed us to help clients improve outcomes and bend the cost curve sharply down.

A pharmacy field army.

Abarca’s relationship with our pharmacy network is unique. Pharmacies are our partners. We work with them – often one-on-one – to improve the health and costs for members, and we engage them in ways that create win-win opportunities.

Bending the cost curve down.

Skeptical of PBM claims about how good they are at managing cost trends? Don’t take our word for it, ask our clients. Whether it is gaining control of specialty costs, aggressively negotiating rebates and passing them through, or designing custom member engagement programs, we have the resources and know-how to help plans get a handle on runaway drug benefit costs.

Worry-free compliance.

The compliance requirements that come with Medicare programs can be daunting. It doesn’t need to be this way. We provide the information plan sponsors need to meet reporting and audit requirements, and we closely track changing requirements, so you remain compliant in the future.

The right technology, analytics, pharmacy network, clinical expertise, and compliance programs are essential, but we never forget that pharmacy benefits are about people. So, while our technical, clinical, and regulatory expertise is as good or better than anyone in the industry, our commitment to creating a better experience for members truly sets us apart.

Read our case study.

Contact us

Our Core Values 04
like family /

be one.

Care for each other’s success as deeply as if it were your own.



Why can’t healthcare be awesome? We say it can. And we are making it awesome for millions of consumers across America and the plan administrators that serve them. Visit to learn more.

Contact us