A Smarter Platform

What’s all the fuss about prior authorizations?: FAQs

Over the past few years, prior authorizations (PAs) have been in the headlines, examined by Federal and state governments, and hotly debated in the industry. Here’s the background: What is a prior authorization? Prior authorizations are a methodology used by...

7-7-2021

What’s all the fuss about prior authorizations: FAQs

Javier Gonzalez discusses value-based agreements on MedCity INVEST panel

This month, Javier Gonzalez, PharmD, Abarca’s Chief Growth Officer, was selected to speak about value-based agreements on a panel at the MedCity INVEST Conference. The panel, “The Opportunities and Challenges in Value-Based Contracting,” was led by Delphine O’Rourke, Partner at...

4-29-2021

Javier Gonzalez discusses value-based agreements on MedCity INVEST panel

Recapping AMCP 2021

Last week,  our team joined leaders from across healthcare at the AMCP 2021 virtual conference. This year, the event focused on the future of managed care pharmacy in the rapidly changing healthcare landscape. In particular, the sessions examined topics ranging...

4-19-2021

Abarca Health: Emerging trends from AMCP 2021

How to prepare for a CMS audit

CMS audits assess Medicare plan sponsors’ compliance with a number of core program requirements, chief among them is the plan’s ability to provide its members with access to medically necessary services and prescription drugs. Audit scores and enforcement actions resulting...

4-8-2021

Abarca Health: How health plans can prepare for a CMS audit

How Abarca approaches ePA and RTBTs

Beginning January 1, U.S. Centers for Medicare & Medicaid Services (CMS) mandated certain capabilities be available for Part D plans. Here’s what you need to know: Real-Time Benefit Tool (RTBT)1 What is RTBT? Often, a member is not aware if...

2-9-2021

How Abarca approaches ePA and RTBTs

Marking Abarca’s fifteenth anniversary

Remember 2005? Nickelback and The Black Eyed Peas dominated the charts. We had only seen the first four Harry Potter films. Facebook had just been launched, but Twitter and Instagram did not exist. And no one had heard of a...

12-10-2020

Marking Abarca’s fifteenth anniversary

Common conditions impacting Medicare beneficiaries

As of 2018, nearly 60 million Americans are enrolled in Medicare. Most beneficiaries are age 65 or older, but younger members can qualify if they have certain disabilities or end-stage renal disease. Given their age and pre-existing conditions, members of...

11-4-2020

Abarca Health: Common conditions impacting Medicare beneficiaries

Care Management in the times of COVID-19

In today's new healthcare environment transformed by the COVID-19 outbreak, the patient's needs have inherently changed, making care management more critical than ever before. At present, it's estimated that 1 in 4 Americans live with multiple chronic conditions, making the...

9-2-2020

Abarca Health: Care Management in the times of Covid-19