Ana Cristina Rivera, Esq. | 2024 Emerging Leaders in Healthcare

Ana Cristina Rivera, Esq.

I was born and raised in San Juan, Puerto Rico. My grandfather, a radiologist, used to show me X-rays when I was little, which sparked my interest in healthcare. I went to Cornell University for undergrad and obtained my law degree from the University of Puerto Rico School of Law.

I began my career as a commercial litigation attorney, counseling clients in matters related to healthcare. In early 2014, after having worked as external counsel for a large national health plan, I was appointed the chief operations officer during the start-up of its operations of an on-
island health plan. I later became associate vice president of government contracts, where I was the key liaison with the Puerto Rico Health Insurance Administration. This experience served as the foundation for my current role as vice president of legal and compliance at Abarca Health.

Please describe a turning point in your career — an event, a eureka moment, an encounter or a salient piece of advice from someone.

Having the opportunity to stand up a health plan and see it grow gave me a crash course on managed care operations and exposed me to parts of the business — clinical operations, claims, quality, compliance, actuarial, provider and member services, among others — that I wouldn’t have had as an attorney. My role also afforded me the opportunity to draft and present before the state legislature position papers on legislative bills benefiting enrollees and payers and spearhead initiatives to improve the Puerto Rico Medicaid program.

What are your top two priorities as a leader in your organization and healthcare?

As a legal and compliance leader at Abarca Health, one of my top priorities is enabling clients to succeed in this heavily regulated environment. The Inflation Reduction Act has brought significant changes to Medicare, while federal and state legislation related to pharmacy benefits has also increased. It’s my job to help our clients navigate this complex climate and to work with our team to develop solutions that deliver a seamless and personalized experience for members, payers and providers.

From an organizational perspective, Abarca is driven by our corporate culture. Our team is dedicated to finding a better way in everything we do, including how we work together. I am focused on fostering collaboration by opening lines of communication, executing effective promise management and providing feedback to others.

If you could change one thing about U.S. healthcare, what would it be?

Making healthcare more accessible and affordable should continue to be at the forefront of healthcare reform. I would begin by eliminating delivery models that reward quantity of services over quality of services. The U.S. healthcare system needs to accelerate its adoption of value-based models that reward whole-person and integrated care, improve patient outcomes and access to service and, ultimately, lower costs.

Name a book or article that everyone working in healthcare should read.

“The Emergency: A Year of Healing and Heartbreaking in a Chicago ER” by Thomas Fisher is a compelling memoir of an emergency room doctor working in South Side Chicago that poignantly addresses the topic of health equity and challenges of the U.S. healthcare system.

How do you strike the right work-life balance?

I like to begin my mornings with kickboxing or HIIT (high-intensity interval training) classes, which help me start the day with energy and focus. I also like to set “quiet time” at night during the week to read and take my mind off work. Weekends are my go-to time to spend some time with my family and friends. As the self-designated planner of my friend group, I like to coordinate outings to new restaurants and trips outside our hometown of San Juan. Traveling and immersing myself in new cultures is my top way for relaxing and disconnecting from work, including going to my happy place, St. John.

If you could have dinner with anyone, living or dead, who would it be and why?

Michelle Obama. Though I’ve always admired her poise, grace, intelligence and the work she did as the first lady (particularly with the Let’s Move initiative), the vulnerability she showed in her memoir, “Becoming,”took my admiration for her to a whole new level.I’d love to have dinner with her to have a heart-to-heart about her experiences.