Medication nonadherence significantly impacts patient health and increases healthcare costs
Effective medication therapy hinges on patients not only obtaining their medications but also adhering consistently to their prescribed regimens. The challenge to improve medication adherence intensifies for those requiring multiple medications or facing obstacles like high costs, side effects, limited availability or difficulties in accessing pharmacies.
The factors contributing to nonadherence vary widely and are often deeply personal. Addressing this issue requires a comprehensive approach that includes a variety of strategies tailored to individual needs, including awareness and use of medication adherence products. Equally crucial is a well-informed care team equipped to collaborate closely with patients, ensuring they improve medication adherence to achieve the best possible health outcomes.
Why Optum
Advanced propensity modeling
Our platform leverages advanced propensity modeling, machine learning and artificial intelligence (AI) to predict which patients are most likely to be nonadherent, making interventions timelier and more effective.
Quality measures management
Identify, prioritize and manage consistently nonadherent patients with HEDIS® measure drugs. Help your organization achieve high Stars ratings by effectively managing risk and improving patient outcomes.
HEDIS is a registered trademark of the National Committee for Quality Assurance
Single source of truth
PACM gathers information from disparate sources to provide a more up-to-date view of a patient’s medications, including real-time member eligibility-based drug pricing, point-of-sale member behavior, drug interactions, claims and more, helping pharmacists easily review and make changes.
Streamlined UI
The PACM streamlined user interface (UI) allows clients to easily navigate workflows and to report results.
Analytics reporting
Enable population health monitoring and modeling via custom reporting. Leverage application programming interfaces (APIs) to embed prescription pickup and propensity scores within existing applications.
Medications monitored
PACM currently monitors medications for several key conditions, including type 2 diabetes and congestive heart failure (CHF). These medications include, but are not limited to:
- Statins
- Antihypertensives
- Antibiotics
- Anticoagulants
- Anticonvulsants
- Inhalers
- Insulin
Key benefits
Improved medication adherence
Reconcile e-prescription data from the provider's EHR with point-of-sale data from the pharmacy. Equip your providers with real-time information on when patients pick up their medications, and identify opportunities to intervene when they don't.
Reduced total cost of care
Using AI-enabled propensity modeling, healthcare organizations can identify which patients are at risk of nonadherence and, once identified, these patients can be placed into early, personalized intervention programs.
Enhanced enterprise collaboration
Help direct patients at risk of nonadherence to the right care program by fostering collaboration between providers and care teams.
Our impact
- 49% more likely to pick up their medication*
- Reduction in inpatient admit*
- $229 per member per month lower medical costs*
- 83.4 net promoter score (NPS)
*Outcomes are from an OptumCare Advanced Analytics statistical evaluation conducted on engaged cohort members in March 2025.
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On-demand webinar
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Product information and resources
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Fact sheet
Overview of Prescription Adherence and Clinical Management
Identifying patients at risk of medication nonadherence and offering early intervention to improve patient outcomes.
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Placemat
Prescription Adherence and Clinical Management’s impact
Discover the impact of medication nonadherence and how PACM helped our clients develop an affordable treatment plan for their patients.