The Importance of Medication Adherence

Consistent and accurate use of prescribed medications is one of the most powerful drivers of better health outcomes. Yet, non-adherence remains one of the largest barriers to effective chronic care management.

It’s estimated that nearly 50% of Americans do not take their long-term medications as prescribed. For individuals with chronic conditions such as hypertension, diabetes, or asthma, missed doses or discontinued therapy can lead to increased hospitalizations, worsening disease progression, and higher overall medical costs.

At HLTHWorks, our consulting teams partner with health plans, provider groups, and pharmacies to build customized adherence programs that connect clinical data, behavioral insights, and community support—helping patients stay on therapy and improving quality and risk scores.

Strategies for Medication Adherence

1. Create Support Systems to Stay on Track

HLTHWorks helps design and implement adherence programs such as “Fill My Prescriptions”, which align refill schedules, reduce administrative burden, and promote proactive outreach. Health plans using similar structured refill programs have achieved 100% medication access for all therapies within defined populations.

2. Educate and Empower Patients

Understanding one’s condition and treatment plan is the foundation of adherence. HLTHWorks develops education frameworks that leverage virtual learning, text engagement, and care team outreach—ensuring members understand why their medication matters and how it supports their long-term health.

3. Personalize Interventions

No two patients are alike. HLTHWorks builds predictive adherence models and segmented outreach strategies that identify who is at risk of non-adherence and what interventions work best—reminders, pharmacist check-ins, motivational coaching, or provider follow-up. Personalized engagement leads to measurable increases in satisfaction and adherence persistence.

4. Address Financial Barriers

Cost is a leading cause of prescription abandonment. HLTHWorks’ consultants help organizations design financial-assistance pathways, optimize formulary management, and connect patients with savings programs. Studies show that when out-of-pocket costs exceed $250, nearly 70% of patients discontinue therapy—a gap that can be closed with smarter program design.

5. Enhance Access and Transparency

Access to real-time pharmacy and benefit information helps patients make better decisions. HLTHWorks helps health plans and provider networks integrate patient portals and mobile applications that simplify refill tracking, benefit verification, and pharmacist communication.

How HLTHWorks Can Help

HLTHWorks partners with health plans, ACOs, and provider organizations to build enterprise medication adherence strategies that:

• Improve quality and risk scores (HEDIS and Star Measures such as Medication Adherence for Hypertension, Diabetes, and Cholesterol)
• Reduce avoidable utilization and cost of care
• Enhance pharmacy and care management collaboration
• Strengthen member satisfaction and retention

By combining clinical insight, operational design, and data analytics, HLTHWorks delivers a measurable impact on adherence and health outcomes.