Case Studies

Quality Improvement

PROGRAM DESCRIPTION  The U.S. Centers for Medicare and Medicaid Services (CMS) requires Medicare Part D sponsors to have Medication Therapy Management Programs (MTMP) to ensure that qualified beneficiaries use safe and appropriate medications for their medical conditions. Under CMS guidelines,...

3-7-2018

Seeing Opportunity

THE CHALLENGE Even in the best of times, state health and welfare programs face increasing demands and tight budgets. In this case, the pressure was extreme. Abarca was approached by a state Medicaid program that had the unfortunate distinction of...

10-18-2017

medicaid state health and welfare

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 the drug benefits increased, they considered...

10-13-2017

prescription benefits