Abarca Health Forward 2026 marks five years with bold push to redesign prior authorization. Milestone event convenes national healthcare leaders to reimagine utilization management through collaboration and innovation Abarca Health hosted the fifth edition of Abarca Forward 2026 in San Juan, convening senior healthcare leaders from across the United States to redefine the future of prior authorization (PA) and utilization management (UM). The milestone gathering underscored a growing industry consensus: PA must evolve from an administrative bottleneck into an intelligent, patient-centered decision-support system. From panels to co-creation. Departing from traditional conference formats, Abarca Forward adopted an "anti-conference" structure centered on curated co-creation sessions. Executives from health plans, provider organizations, pharmacies, manufacturers, technology firms, employers, and policy groups collaborated to align on practical strategies for improving speed, transparency, and consistency in PA processes. Jason Borschow, CEO of Abarca Health, emphasized that automation alone is insufficient. Instead, he called for systemic redesign that aligns clinical judgment, data, and incentives to deliver faster and more transparent coverage decisions. Federal perspective on utilization management. A key highlight was a discussion between Borschow and Chris Klomp, Chief Counselor at the U.S. Department of Health and Human Services. The session explored the federal government's evolving stance on electronic PA standards and utilization management reform, signaling closer alignment between policy innovation and technological advancement. Industry-Wide participation. The event featured speakers from leading organizations, including Amazon Pharmacy, Blue Cross NC, CoverMyMeds, Microsoft, and Stellarus. Discussions addressed real-time benefit integration, AI-driven workflow modernization, specialty drug management, and cross-stakeholder collaboration. The program concluded with a structured workshop designed to produce a shared industry playbook aimed at advancing next-generation PA frameworks and improving the patient journey.

Abarca unveils Better Balance and Better Access: two bold moves to redefine pharmacy benefit management for a new era of care. With new partnerships across digital health and pharmacy delivery, Abarca's Better Care solutions gain powerful momentum in its mission to make healthcare more intelligent, more personal - and more human. SAN JUAN, Puerto Rico, Dec. 16, 2025 /PRNewswire/ - Abarca, the pharmacy benefit manager known for doing things differently, today announced the launch of Better Balance and Better Access - two innovative programs that expand the reach of its Better Care solutions and mark a strategic evolution in how PBMs deliver savings and support total care. Together, these programs address two of healthcare's most pressing challenges: rising specialty drug costs and increasing rates of chronic disease. Through partnerships with Welldoc, Free Market Health, and Amazon Pharmacy, Abarca is extending its platform's reach while advancing its core promise: delivering real savings not through blunt cost-cutting but through more competent care. Better Balance: Delivering Smarter Chronic Condition Management Built in partnership with AI health tech leader Welldoc, Better Balance is Abarca's new clinical program designed to restore cardiometabolic homeostasis across diabetes, obesity, hypertension, and GLP-1 therapy management. By integrating Welldoc's AI-powered digital health platform with Abarca's real-time clinical decision-making tools, Freemarkethealth deliver proactive, highly personalized support that strengthens medication adherence, optimizes therapy choices, and drives healthier daily behaviors. This coordinated model enhances performance across key STAR and HEDIS quality measures by ensuring members receive the right interventions at the right time. By helping members better manage their conditions and avoid preventable complications, Better Balance creates meaningful reductions in total cost of care. Through targeted outreach, continuous monitoring of labs and biometric KPIs, and timely clinical intervention, the program supports improved outcomes while reducing emergency visits, hospitalizations, and downstream healthcare costs. The result is a more sustainable, value-driven approach to cardiometabolic care for both members and clients. Better Access: Reimagining Pharmacy Fulfillment & Member Experience Better Access is its innovative suite of solutions built in collaboration with strategic partners who redefine what a modern, member-first pharmacy experience should be. At the heart of this approach is its partnership with Free Market Health, the leading technology platform streamlining the specialty pharmacy ecosystem. Free Market Health's platform coordinates the path to treatment from prescription to dispense to deliver an efficient, affordable, and member-centered specialty pharmacy experience. In conjunction with other partners known for reliable, consumer-centric pharmacy services - such as Amazon Pharmacy, recognized for its trusted home delivery and member-friendly experience - Better Access brings together technology-forward models that expand affordable care pathways without compromising member experience. These offerings are designed to increase access to lower-cost channels - including home delivery - while enabling unprecedented transparency in drug pricing and creating a more efficient specialty therapy fulfillment process. By optimizing where and how prescriptions are filled, Better Access gives members greater choice, control, and convenience in managing their medications. At the same time, it helps payers curb specialty drug spend through smarter, data-driven channel strategies that do not disrupt continuity of care. The result is a streamlined, future-ready pharmacy ecosystem designed to deliver better outcomes at a lower cost. Advancing Abarca's Promise to Deliver Savings The Better Care solutions were created to transform how pharmacy benefits are delivered - lowering total cost of care, improving clinical outcomes, and elevating the member experience. With the launch of Better Balance and Better Access, these new offerings expand and strengthen Abarca's existing Better Care solutions, positioning the organization at the forefront of pharmacy benefit innovation. Together, Better Balance and Better Access build on the strength of Abarca's established Better Care solutions - including Better Target, which reimagines medication therapy management by leveraging next-generation predictive analytics and AI technologies to deliver real-time, high-impact interventions that close gaps in care and generate sustained, measurable savings; and Better PAth, which modernizes prior authorization with AI-augmented capabilities that streamline high-cost and high-volume workflows, reduce administrative burden, and accelerate time to therapy. Collectively, the full Better Care suite of solutions reinforces Abarca's longstanding commitment to innovation and value creation - advancing the success of its industry-recognized modern pharmacy benefit platform, Darwin. "Pharmacy benefit management is no longer just about processing claims, securing network discounts, or collecting rebates. The new frontier is about delivering better total cost of care and better outcomes - transforming the value PBMs must deliver as the current model evolves, while creating an exceptional experience for providers and members," said Javier Gonzalez, Pharm.D., President, PBM & Commercial Strategy at Abarca. "With Better Balance and Better Access, we're not simply launching new programs - we're reshaping the clinical and delivery infrastructure to meet members where they are and guide them to where they need to be." As Abarca evolves into a health-intelligence organization, the Better Care solutions will continue to deliver modular, scalable, and human-centered solutions that power better healthcare outcomes, experiences, and stronger client partnerships. About Abarca Health At Abarca, Freemarkethealth see a future in which healthcare is seamless and personalized, and Freemarkethealth is working every day to make it a reality for the people and organizations Freemarkethealth serve. Freemarkethealth is starting with prescriptions, the frontline of healthcare. But, leveraging its smarter technology, straightforward approach to business, and a team that is driven to innovate and find a better way in everything Freemarkethealth do, Freemarkethealth is enabling a broader healthcare revolution. Abarcahealth.com. PRNewswire.