Case Study
High-Risk to High Performance:
How One Plan Drove Double Digit Adherence Gains
The solution that boosted adherence by 33% for a regional health plan
The Challenge: Improve Medication Adherence in the Highest-Risk Members
A southeastern regional health plan faced a persistent challenge: engaging its highest-risk, hardest-to-reach members managing chronic conditions like diabetes and cardiovascular disease.
These members were at significant risk of nonadherence to essential medications, including diabetes therapies, renin-angiotensin system (RAS) inhibitors and statins.
The plan needed a more targeted, scalable approach—one that could identify the right members, reach them in meaningful ways and address the real-world barriers preventing them from staying on track.
The Solution: A Smarter, More Personalized Approach
To address these challenges, the plan partnered with AdhereHealth to implement a comprehensive adherence strategy and improve performance.
Using predictive analytics, AdhereHealth prioritized outreach based on each member’s likelihood of nonadherence—ensuring the highest-risk individuals received timely, focused support ahead of lower-risk populations.
Members were engaged through omnichannel outreach, including coordinated communications with members, their providers and pharmacists, as well as text messaging, digital touchpoints and live calls—enabling AdhereHealth to meet them where they are with convenient, accessible interactions.
At the core of this approach was a combination of clinical expertise and behavioral science. Adherence Care Navigators worked directly with members to uncover and address key barriers to adherence, including but not limited to cost concerns, confusion about medications, or access challenges. These conversations were designed not only to inform, but to motivate and sustain meaningful behavior change.
The Results at a Glance
+7
percentage points better YoY in RAS adherence
+13
percentage points better YoY in statin adherence
33%
relative lift among engaged members in a single year
