A Better Experience

Abarca Named Power 100 Company by Caribbean Business

Abarca is honored to be selected by Caribbean Business as a Power 100 company. We strive to be a PBM that is unlike any other organization, with a smarter technology platform, a better experience to consumers and healthcare payers, and a higher standard of transparency.

“I’m thrilled that Abarca was selected as a Power 100 company,” said Abarca CEO Jason Borschow. “We work hard every day to make healthcare awesome.”

“Whether it is building client partnerships, serving healthcare consumers, contracting with drug makers, or caring for our employees, we are totally committed to finding it.” continued Borschow.

Caribbean Business recognizes each year the top 100 companies, brands, and executives that have a positive impact on the economic development of Puerto Rico and its immediate surroundings. Read more about the Power 100 list by Caribbean Business.

Comprehensive Script Management Chooses Abarca’s Smarter PBM Platform for Better Operations, Analytics, and Member Experience

Newtown Square, PA — Abarca, a company that is upending the pharmacy benefit management industry with an entirely new approach to technology and business practices, announced that it had signed an agreement to provide Comprehensive Script Management (CSM) with Darwin, its smarter PBM platform.

“We engineered Darwin to be smarter, cloud-based, secure, flexible, and unimaginably efficient,” said Jason Borschow, Abarca’s Chief Executive Officer. “We are thrilled to be providing CSM with customized solutions that deliver streamlined operations, business-changing analytics and better member experience.”

CSM, headquartered outside of Philadelphia, is a privately held, physician-led, full-service pharmacy benefit manager specializing in workers compensation programs. CSM’s mission is to bring its customers innovative technology and adaptive solutions through a clinical lens. CSM is proud to be a woman-owned-and-run business. As the only physician-built PBM, CSM is clinically focused and committed to improving patient outcomes and supporting evidence-based care. CSM works to ensure medication use is clinically appropriate, safe, and cost effective.

Darwin integrates claims processing, pharmacy network, prior authorizations, formulary management, regulatory compliance, rebate management, and other critical PBM work streams into a single, fast, friendly interface. Abarca’s solution to support CSM’s First Fill program allows the capture and processing of the first script and beneficiary information, real time, even before compensability is determined. Abarca developed this and more custom solutions, implementing CSM on Darwin in under 60 days.

“This is one of the smoothest implementations I’ve worked on” said Jennifer M Dragoun, MD, CSM President and CEO. “Abarca, offers the depth and flexibility needed to deliver on the CSM commitment. The result of our effort is a more highly managed drug spend, that decreases financial risk for our customers while improving patient outcomes.”

“Flexibility isn’t something people expect from PBM their platform, and we don’t believe it needs to be this way,” concluded Borschow. “Darwin ends the drains on accuracy, productivity, and morale and we are proud to partner with CSM to provide a much higher level of service to its clients’ members.”

A Better Way in Drug Prescription Population Health Management

At the 2018 AMCP Annual Conference, there was a lot of discussion about important trends in healthcare. Here are two particularly noteworthy examples:

The Rise of Value-Based Agreements

There are many individual components that determine the pieces of information that can feed into the value of a drug. However, value-based agreements break down those silos by providing a comprehensive picture of a patient’s health, thus creating a cohesive care continuum, and empowering the parties involved to make evidence-based health decisions.

Value-based agreements are gaining interest in the industry because, among other reasons, they offer the potential for a win-win-win for manufacturers, payers and, most importantly, patients. Generally, these contracts are based on whether a drug works as promised. If it doesn’t, then the drug maker refunds all or part of the cost of treatment.

There was quite a lot of buzz about value-based agreements at AMCP, and while some companies are thinking about these approaches, at Abarca, we are all in. Recently, we announced agreements with Amgen and Biogen for value-based programs, and we expect to be announcing others soon.

The Impact of the Health Transformation Alliance (HTA)

Formed by more than three dozen companies, the HTA seeks to transform the corporate healthcare benefit marketplace by focusing on four areas: marketplace efficiency, learning from data, employee education, and breaking bad habits.

Though still in its early stages, this group is poised to be a major force for change in healthcare with the potential to significantly impact health plans, PBMs, and providers. One of the HTA initiatives we anticipate seeing come to fruition is direct contracts with drug manufacturers–which, if done successfully, could create a healthcare model that makes people healthy while saving money.

At Abarca, we believe change and innovation in healthcare is important, and we applaud HTA participants for outside the box thinking and bold action. Does the HTA have the potential to be disruptive to a large swath of the healthcare industry? It sure does. Cause if the goal is to lower costs and improve outcomes for patients, we say it’s worth exploring.

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This blog was written by David Capó.

David Capó, MD, MPH, is a Clinical Epidemiologist for Abarca Health providing value-based medicine counsel and population health management intelligence to address risk patterns and support health economics & outcomes research (HEOR). Before joining Abarca, Dr. Capó worked for the Center for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), as a Preventive Medicine and Public Health Fellow. He received his medical degree in 2007 and a master’s in public health with a concentration in epidemiology, in 2009, from the University of Puerto Rico (UPR). As part of a postdoctoral research fellowship in the Division of Cancer Epidemiology Genetics, National Cancer Institute, National Institutes of Health (NIH), he worked on the etiology and progression of lung cancer.

AMCP Nexus Recap

Last month, members of the Abarca team attended AMCP Nexus. We spent three exhilarating days meeting with attendees, conducting demos, and sharing the Abarca story with the best and brightest in the industry.

Didn’t have a chance to stop by our booth? Check out our video and photos from the event:

Abarca home base at AMCP Nexus, ready for the conference to begin

Call him a CEO for discussion purposes, but Jason Borschow does it all

When we say we’re coming out swinging, we mean it!

VP, Client & Pharmacy Partnerships, Rebecca Sabnani: “When you view your clients as partners and consider their success your own, you can accomplish unimaginable things together. It’s all about commitment.”

Samir Mistry leveraged his pharmacy industry experience to make meaningful connections with AMCP Nexus attendees

Thanks to our Abarca team for a great conference!

The Academy of Managed Care Pharmacy (AMCP) is the nation’s leading professional association dedicated to increasing patient access to affordable medicines, improving health outcomes and ensuring the wise use of health care dollars. This year’s AMCP Nexus explored perhaps the most transformative change taking place in health care: how we pay for health care – and the emergence of value as the defining factor and goal.

Carving Out Prescription Benefits

THE CHALLENGE

A division of a Fortune 200 drug maker relied on a respected health plan for both medical and pharmacy benefits for several years. But as the group grew and the cost of drug benefits increased, they considered contracting separately, or carving out, the pharmacy component of the benefit. A carve-out would give the company more clarity and greater control over benefits and costs. It could also give it a better view into the utilization of its employee population and, in doing so, shed light on ways to bend the cost curve down.

But on the HR team, there were skeptics. Would this add to their workload? Would the health plan and PBM effectively communicate with each other? Were they inviting administrative headaches? How would they handle employee/member phone calls about exceptions, denials, and other problems? Could the labor involved in prior authorizations alone derail other initiatives?

Carve out proponents in the company prevailed. After considerable due diligence and a competitive process, the company selected Abarca.

THE APPROACH

The analytics team at Abarca completed a careful analysis of the client’s claims data and found significant opportunities for savings without member disruption. Abarca assigned a team with the skills and resources necessary to design a pharmacy benefit that would keep costs down, and provide a stellar member experience, all without adding to the workload of the HR team. But, to convince skeptics, Abarca committed to guaranteeing a cap in the low single digits for inflation for the average prescription cost. This approach is something unheard of in the industry.

THE RESULTS

The new solution was implemented in only 45 days, quickly moving to adding value. Abarca’s call center efficiently handled inquiries from employees, providers, and pharmacies, allowing the client HR team to focus on other business priorities. The HR department received detailed financial analyses through an easy to understand dashboard and business intelligence tools. And through a combination of formulary management, pharmacy network design, channel management, and negotiations with pharmaceutical companies, Abarca effectively kept inflation to 3% or less for the next two years.

The skeptics were won over. Managing the program was as easy as ever, and savings and satisfaction grew thanks to better tools and a partner that was transparent, trustworthy and 100% committed to finding a better way.

Download the case study.

Head of Pricing Strategies for Abarca Is Panelist at Reimbursement & Access 2017

Philadelphia, PA— The market access, pricing, and reimbursement landscape is rapidly evolving as stakeholders shift to a value-based healthcare system. The transition to a value-based healthcare system, coupled with increasing drug pricing scrutiny and mounting uncertainty related to potential repeal or replacement of the Affordable Care Act, creates tremendous challenges for biopharma manufacturers to overcome.

Samir Mistry, Vice President of Rebates and Pricing Strategies for Abarca Health, will advise pharmacy leaders on the shift to a value-based as a panelist in for Reimbursement & Access 2017, the most important conference related market access, pricing, and reimbursement in the United States. Other participants include Rashmi Agarwal, Assistant Director of the U.S. Government Accountability Office, Ira Klein, Senior Director at Johnson & Johnson, Gergana Zlateva, Vice President of Payer Insights and Access at Pfizer, among other leaders.

Join Samir in Philadelphia this August 16-17 at fifth annual Reimbursement and Access 2017. Hundreds of leaders in access, reimbursement, managed markets and commercial operations will benefit from this highly-acclaimed event which arms attendees with best practices and practical strategies during a time of unprecedented uncertainty on complex issues.

Abarca Expands the Rollout of RxTarget Quality Network

San Juan, PR – Abarca is pleased to announce the extended rollout of the RxTarget Quality Network, a specially selected network of quality pharmacy providers dedicated to using information technology to improve health outcomes in their communities.

By partnering with Abarca, network pharmacies can now leverage the RxTarget predictive analytics dashboard to support plan sponsors in improving medication adherence across their member populations. With access to real-time patient targeting, web-based intervention documentation, and daily performance tracking, providers now have the information they need to achieve superior patient interactions and better health outcomes. Payers are able to help providers focus their interventions on those members with the highest potential for impact, and to compensate them based on achieving meaningful results. Since payers utilize the same platform to perform and document their own interventions, they are now better able to coordinate their efforts with pharmacies to avoid unnecessary duplication, monitor best practices, provide additional support when necessary, and inform further outreach to prescribers and other caregivers.

“We have been talking about pay for performance and pay for outcomes for a long time, but it has been challenging to build patient intervention models that are efficient, coordinated, fair and accountable,” remarked Jason Borschow, CEO of Abarca. “The RxTarget Quality Network is really a unique technology-empowered program that aligns the interests of payers and pharmacy providers with the needs of patients. We all know that time and resources are limited, yet healthcare quality improvement is an increasingly important priority.”

“The key is being able to rely on data-driven algorithms to inform those interventions that will have maximize the outcome per every resource invested,” added Luis A. Pérez, Senior Vice President.

RxTarget Quality Network was launched in May 2014 and enrollment has been increasing steadily. During the coming weeks Abarca will be providing specialized adherence intervention training to over 50 new RxTarget Quality Partners, with the next major onboarding event taking place at the Annual Convention of the Asociación de Farmacias de Comunidad de Puerto Rico (AFCPR) on July 18 and 19 at the Ritz-Carlton Hotel in Isla Verde, Puerto Rico. The rollout follows the successful launch of the RxTarget predictive analytics dashboard for payers in late 2013. Payers and pharmacies interested in partnering through the network can visit Abarca’s booth or register via www.abarcahealth.com/pharmacyregistration or rxtarget@abarcahealth.com.

About RxTarget

RxTarget offers plan sponsors a web-based patient targeting and intervention management platform that helps them maximize outcomes per resource invested. It incorporates Abarca’s proprietary clinical decision-making algorithms to build tailored workflows of priority-ranked beneficiaries and prescribers, updated daily. RxTarget also integrates additional clinically relevant information to support a more informed intervention. Medicare Part D Plans leverage RxTarget to focus their clinical outreach efforts and limited resources on those beneficiaries and prescribers of highest value in meeting CMS Star Rating Adherence and High-Risk Medication (HRM) avoidance targets. Currently there are over 145,000 Medicare Part D members benefiting from access to RxTarget.