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Triple-S Salud selects Abarca as PBM for commercial, Medicare lines

Triple-S Salud announced it has entered into a three-year agreement with Abarca Health, LLC, a pharmacy benefits manager (PBM) in Puerto Rico, to consolidate the management of its prescription drug benefit programs for its commercial and Medicare business lines.

The agreement with Abarca is effective Jan. 1, 2019.

Abarca currently serves as Triple-S’ Medicare Advantage PBM. The current collaboration between Triple-S and Abarca has been essential to achieving a five-star rating in the Part D component of Triple-S’s HMO product each of the past two years and contributing to the HMO product’s overall four-star rating, the insurer said.

Under the new agreement:

  • Abarca will provide prescription drug claim processing, pharmacy network management, and support or delivery of clinical programs for Triple-S commercial and Medicare Advantage members.
  • The agreement will benefit approximately 568,000 Triple-S members, representing close to $600 million in annual drug spending.
  • 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.

“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,” said Madeline Hernández-Urquiza, president of Triple-S Salud.

“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,” she said. “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, Triple-S 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,” Hernández-Urquiza 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,” said Abarca CEO Jason Borschow.

“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,” he said.

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