A Better Experience

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.”


The revolution starts here.


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


Lissette Lorenzo makes innovative clinical operations a real treat


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


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 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 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, PRAbarca 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.