What We Learned from a Category Five Hurricane

In 2017, Hurricane Maria shook Puerto Rico. The storm damaged at least 70,000 homes, tested the island’s infrastructure, and took too many lives. As one of the leading PBMs serving health plans in Puerto Rico, Abarca knew that we had at least two critical responsibilities: provide all the help we could and learn as much as possible.

Taking Action

While their families were without power, potable water, and other necessities, members of Abarca’s clinical and operations teams were deployed to the parts of the island that were among the most severely impacted by the storm. Their mission was to determine which pharmacies were functional—and to what degree. We also reached out to physicians in the area to verify which patients were in greatest need of support and let them know where they could go to have scripts filled.

Using the information gathered in the field, we developed a “Puerto Rico Network Status” site that would become an official resource for the Government of Puerto Rico. Updated up to three times a day, this tool informed physicians and consumers—regardless of whether Abarca managed their prescription benefits—which pharmacies were open for business and when, among other necessary resources.

Our teams on and off the island worked tirelessly to make sure that our systems experienced zero downtime—even as the storm ravaged the island. The table below illustrates Abarca’s system availability over the last three years, including during the hurricane:

2015 2016 2017
Darwin 99.943%% 99.959%% 99.995%%

 

What’s Next

The frequency and severity of natural disasters appears to be on the rise. During 2017 alone, the U.S. experienced 16 separate billion-dollar disaster events. That’s why we’re still studying Hurricane Maria’s impact on healthcare in Puerto Rico, and developing ways to prepare for what might come next.

Using the information we gathered from pharmacists and physicians, we were able to confirm important trends—and some of our worst fears. On the days immediately following Hurricane Maria there were virtually no claims submitted across the Island, leaving patients medically vulnerable in addition to the physical dangers they were facing. In the subsequent weeks, perhaps unsurprisingly, there was a falloff in adherence that directly tracked the storm’s path across the island. Our teams have begun working to determine how to use this information to improve preparations for any future disasters.

We are continuing to fortify our business continuity processes and disaster recovery policies. Our telecommunications system is now 100 percent cloud-based, allowing our customer service personnel to stay in constant contact with our clients. To augment this further, we have developed an internal alert system that, when triggered, will initiate steps to increase our call center capacity by 50 percent. We have also begun regular internal disaster recovery tests, both for our technology and employee communication capabilities.

While there is no way to stop a category five hurricane, we know that it doesn’t have to result in catastrophe for patients. There has to be a better way, and we are committed to finding it. By dissecting this data and understanding people’s real needs in the face of unpredictable situations, we can make sure access, adherence, and outcomes don’t suffer in the face of the storm.

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