Wednesday, October 16, 2019

Triple-S selects PBM Abarca for its commercial, Medicare businesses

By on September 6, 2018

SAN JUAN – Triple-S Salud, which provides health insurance coverage to about a quarter of Puerto Rico’s population, announced it has entered into a three-year agreement with Abarca Health, a leading pharmacy benefits manager (PBM) on the island, to “consolidate the management” of its medication benefit programs for its commercial and Medicare Advantage (MA) business lines. The agreement comes into effect Jan. 1.   

Abarca currently serves as Triple-S’ Medicare Advantage PBM, and the insurer said their current collaboration “has been essential to achieving” a five-star rating in the Part D component of Triple-S’s health maintenance organization (HMO) product “each of the past two years and contributing to the PPO [preferred provider organization] product’s overall four-star rating.”

Under the new agreement, Abarca will provide prescription-drug claim processing, pharmacy network management and support or delivery of clinical programs for Triple-S’s commercial and Medicare Advantage members.

(Courtesy)

“The agreement will benefit approximately 568,000 Triple-S members, representing close to $600 million in annual drug spending,” and the “collaboration is expected to improve Triple-S’s care management and create operational efficiencies, ultimately reducing expenses and generating long-term value for both customers and shareholders,” Triple-S wrote in the accord’s announcement.

“After a thorough selection process, we chose to expand our current relationship with Abarca based on their outstanding track record of providing Triple-S with excellent pharmacy benefits and customer service,” Triple-S Salud President Madeline Hernández-Urquiza said.

“In an environment where new drugs are constantly entering the market and price fluctuations are ever-present, our agreement with Abarca allows for a true partnership. We expect to further leverage their innovative technology to deliver continuous high-quality care focused on safety and clinical outcomes, while utilizing rigorous analytics to improve pharmacy and medical management. In the end, our customers should benefit from better integration and coordination of pharmacy services, which should result in an improved overall experience, while we more efficiently manage expenses,” she said.

“We have been working side-by-side with Triple-S for the past six years and have accomplished incredible things together, including five-star ratings in Medicare Part D for the past two years,” Abarca Chief Executive Officer Jason Borschow added. “As we deepen our partnership with Triple-S, we look forward to deploying game-changing improvements to the customer experience for Triple-S members, providers, and other key stakeholders. We’re just getting started.”

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