A transformative year in healthcare

This year, healthcare organizations have (finally) made significant progress in the evaluation and integration of AI and machine learning to improve administrative processes. For PBMs, we see a particular opportunity to use this technology to generate greater value from healthcare data for payers, providers, and patients. 

Abarca is already leveraging machine learning and AI to improve efficiency, accuracy, and scalability of our PBM operations. We were also recently recognized by Computerworld as one of the best places to work in IT for our approach and culture. 

For years, payers, government bodies, and lawmakers have raised concerns over a lack of transparency from PBMs. However, thanks to regulatory pressures and other factors, this may soon change. At Abarca, we say it is about time. 

This pivot towards more transparency comes at a crucial time for pharmacies–which have faced a number of challenges in recent years. But we also see this as a great opportunity. Pharmacists play a critical role in the healthcare ecosystem, and now is the time for the industry to recognize and build upon the contributions they can make to improve member health.

At the same time, after many years of anticipation, biosimilars are now gaining significant market share. We’ve been collaborating closely with health plans to help them develop strategies to incorporate these drugs into their formularies and to continue studying the impact of these therapies.

And, of course, we cannot understate the impact of GLP-1s. While this year has been marked by an unprecedented demand for these drugs, they are no passing fad. However, they are not an all-encompassing solution for weight management either. As such, organizations need to forge holistic approaches to weight management that facilitate meaningful and lasting change for the people they serve. 

As these forces converge, we will continue to challenge payers to think beyond the traditional PBM model. For some, that may mean pursuing a Virtual PBM–but no single approach suits every organization. And we are looking forward to continuing to work with our clients to find the approaches that work best for them.

In the spring, we hosted our third annual Abarca Forward. This two-day forum featured speakers and attendees from leading organizations–like Blue Shield of California, Blue Cross of Idaho, GoodRx, Walgreens, Evio, Health Mart & Health Mart Atlas, Outcomes, Welldoc, PerformRx, FRESH Medicine, Gemini Health, and Medtronic–and included a co-creation session and deep dive into AI led by Microsoft and Xtillion. For the latest on Forward 2025, keep an eye on our website.

Next year also marks Abarca’s 20th anniversary. In the coming months we want to celebrate everything that we have been able to accomplish together thus far–and where we want to go next. Stay tuned for more details.