New study finds community pharmacist services improve medication adherence for Pa. Medicaid members

— Study of Highmark Wholecare members showed pharmacist-provided adherence services helped improve health outcomes.

PITTSBURGH (August 25, 2026) — A new study published in the Journal of the American Pharmacists Association found that community pharmacist-provided medication adherence services delivered through a Pennsylvania Medicaid managed care payor program were associated with meaningful improvements in how consistently members took medications used to manage cardiovascular disease, cholesterol and diabetes. The findings add Pennsylvania-based evidence to a broader national case that helping people take medicines as prescribed can improve health outcomes, decrease complications from chronic disease and reduce cost of care.

The research evaluated a collaboration between Highmark Wholecare, the University of Pittsburgh School of Pharmacy and the Pennsylvania Pharmacists Care Network (PPCN), the Pennsylvania chapter of CPESN USA. The program enabled pharmacists at 89 participating community pharmacies to provide and document adherence-focused services for Highmark Wholecare members, including medication synchronization, medication reconciliation, medication adherence packaging and home medication delivery.

Medication adherence remains a persistent challenge for people managing chronic conditions, particularly when patients face transportation barriers, complex medication schedules or other social and logistical challenges. By engaging community pharmacists — trusted, accessible health care professionals embedded in neighborhoods — the program was designed to help members overcome common barriers and stay on therapy.

“These findings highlight the vital role community pharmacists play in helping Medicaid members to effectively manage chronic conditions, achieve critical health outcomes, and lead healthier, more fulfilling lives,” said Kelsey Linn, Pharmacy Care Manager, Highmark Wholecare. “Through sustainable payor partnerships, pharmacists are elevated to perform at their best, delivering practical, patient-centered services that deeply engage members, improve medication adherence, and simplify complex health routines.”

Study Links Pharmacist Services with Improved Quality Measures

The new study analyzed 1,361 Medicaid members who received at least one adherence service and had prescription fills in both the baseline and intervention periods. Nearly 19,000 adherence services were provided.

Researchers measured medication adherence using proportion of days covered, a standard quality measure commonly used to evaluate whether patients have access to their medications over time. The analysis focused on three medication classes aligned with widely used quality metrics: renin angiotensin system antagonists, statins and non-insulin diabetes medications.

Across all three medication classes, average adherence increased significantly during the intervention period. Among patients who were not adherent at baseline, average adherence rose to at least 80% in each class, a commonly used threshold for adherence. In total, 64% of baseline nonadherent patients across the three medication classes became adherent during the intervention period.

The improvements were especially notable among patients who started the study below the adherence threshold. For these members, average adherence increased from 62.7% to 80% for renin angiotensin system antagonists, from 59.5% to 84.3% for statins and from 62% to 80.1% for non-insulin diabetes medications. Those gains matter because the same medication classes are commonly used to prevent serious complications such as heart attack, stroke, kidney disease progression and diabetes-related complications.

“For many patients, adherence is not simply a matter of remembering to take a pill,” said Stephanie McGrath, Executive Director, PPCN. “Adherence may depend on whether medications are coordinated and reconciled after changes in care, packaged in a usable way, and hand delivered to the patient when needed. Community pharmacists are well positioned to address these real-world needs — and when they do, the right patient gets the right medication at the right time.”

The findings also point to the potential impact of medication adherence packaging. Baseline nonadherent patients taking renin angiotensin system antagonists who received adherence packaging were 2.2x more likely to reach the 80% adherence threshold during the intervention period. Baseline nonadherent patients taking statins who received adherence packaging were 4.3x more likely to reach that threshold.

The statistically significant improvements across the targeted medication classes align with national evidence showing that adherence is associated with better chronic disease management and lower use of acute care.

Benefits of Medication Adherence

Research has long shown that medication nonadherence negatively impacts quality, cost and member / patient health. National analyses cited in an August 2023 report from The Menges Group estimate that poor medication adherence contributes to approximately 125,000 deaths annually and roughly $300 billion in annual healthcare costs, much of it tied to preventable emergency department visits and hospitalizations. In Medicaid, challenges can be especially pronounced because beneficiaries may face transportation barriers, unstable housing, health literacy challenges, behavioral health needs or interruptions in coverage that make it harder to fill prescriptions and take medicines consistently.

Recent national Medicaid research reinforces the value of adherence. A 2026 Milliman analysis commissioned by PhRMA found that Medicaid beneficiaries with asthma, chronic obstructive pulmonary disease or mental health conditions who adhered to prescribed medication regimens generally had fewer inpatient and emergency department encounters than peers who were nonadherent or not using medication. The report also found adherence rates remained low, with fewer than half of Medicaid beneficiaries adhering to their regimens across the conditions analyzed—underscoring the opportunity for practical, community-based interventions.