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.
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