Adherence Communication Types
- Refill reminders: Automated reminders when a refill is due
- Adherence alerts: Alerts when a member has not refilled a medication on time
- Side effect support: Information and support for managing medication side effects
- Cost-sharing assistance: Information about cost-sharing assistance programs
- Clinical support: Connection to health coaching or disease management programs
- Physician communication: Alerts to prescribers when patients are non-adherent
Proactive Non-Adherence Outreach
Proactive outreach to non-adherent members — members who have not refilled a medication on time — is the most effective adherence intervention. Identify members with a refill gap of 7+ days for chronic medications and contact them to understand the barrier to adherence. Common barriers: cost, side effects, and forgetting. Address the specific barrier to improve adherence.
Adherence Communication ROI
IQ Insight
Adherence communication programs that improve adherence by 10% for chronic disease medications reduce hospitalizations by 5–10% for those conditions. For a plan with 100 diabetic members, a 10% improvement in diabetes medication adherence that prevents 5 hospitalizations ($30,000 each) saves $150,000 — far exceeding the cost of the adherence communication program.