Why the dividing line is reporting versus closing
Three medication adherence measures, covering diabetes drugs, RAS antagonist blood pressure drugs, and statins, are each triple weighted in the CMS Star Ratings, so they move a Part D contract's rating more than almost anything else (CMS Part C and D performance data). All three use the Pharmacy Quality Alliance Proportion of Days Covered (PDC) method, where a member counts as adherent at 80 percent or higher (PQA measures). For a deeper walkthrough, see our PDC math guide and the PDC glossary entry.
Because the weight is so high, most adherence software is built to measure and surface PDC: ingest pharmacy claims, compute days covered, and show which members are below or trending below 80 percent. That is necessary and not the same as moving the rate. At our flagship customer, a physician-led IPA in New York, the work of actually reaching pharmacies and prescribers, not just listing the at-risk members, reached 96 to 98 percent medication adherence on the three triple-weighted measures. The single most useful question when comparing tools is whether the software reports the gap or closes it.
How to choose
1. PDC measurement and stratification
The baseline is accurate PDC on the three triple-weighted measures, computed against the 80 percent threshold, with members stratified by who is closest to falling below the line. Confirm the tool handles the measurement-year 2026 addition of sociodemographic status risk adjustment to these measures, and that it can flag a member while a save is still possible rather than after the year closes. A few percentage points of PDC can separate a 3-star measure from a 5-star one, which is why early, ranked at-risk lists matter.
2. Reports PDC or closes the gap
This is the dividing line. Reporting tools render a dashboard of non-adherent members. Closing the gap is a different job: calling the pharmacy to chase a late or stalled refill, contacting the prescriber for a renewal or a therapeutic alternative, and following up with the member until the medication is in hand. A useful test is to ask a vendor what happens after a non-adherent member is identified. If the answer ends at a worklist for your staff, that is reporting. If the platform places the outreach and works it to resolution, that is closing.
3. MTM, CMR, and clinical depth
Adherence sits next to Medication Therapy Management. Comprehensive Medication Reviews, drug-drug interaction checks, and deprescribing are clinical work that needs a pharmacist in the loop and, in some cases, dispensing and adherence packaging. Decide whether you need a clinical MTM and pharmacy-care partner, a measurement platform, an execution layer that does the outreach, or a combination. Many plans run more than one.
4. Compliance and integration posture
Any tool touching pharmacy data and placing outreach needs a signed Business Associate Agreement, a clear audit trail on automated actions, and clean ingestion of pharmacy claims (PDE), EHR, and lab feeds. For autonomous outreach, confirm how actions are logged and where a human reviews or takes over.
Vendor comparison
The table groups representative vendors in the medication adherence, MTM, and Part D Stars space by what they are built to do. Categories are descriptive, not pejorative: a measurement platform, a clinical MTM provider, and an execution layer solve different problems, and many teams run more than one.
| Vendor | Category and what it is best at | Reports PDC or closes the gap | Best fit |
|---|---|---|---|
| AdhereHealth | Plan-side adherence analytics, member stratification, MTM and CMR completion, telephonic clinical outreach | Reports, plus its own clinical call-center outreach | Medicare Advantage plans running adherence and MTM programs at scale |
| Arine | AI medication management and pharmacist decision support; flags and resolves medication-related problems | Reports and recommends; clinical actions run through pharmacists | Plans and groups wanting clinical MTM and medication optimization |
| AnewHealth (Tabula Rasa HealthCare) | Clinical pharmacy, MedWise technology, MTM and CMR delivery, dispensing and PBM | Closes via pharmacist care and dispensing, by service | Complex, polypharmacy members needing hands-on pharmacy care |
| Pharmacy Quality Solutions (EQuIPP) | PQA-based PDC measurement and benchmarking through the EQuIPP platform | Reports (the measurement standard) | Plans and pharmacies needing standardized PDC measurement and benchmarks |
| Mosaic Pharmacy Service | Mail-order pharmacy with adherence packaging, med sync, and pharmacist support for complex patients | Closes through the dispensing model itself | Medically complex, polypharmacy members managing many drugs at home |
| Innovaccer | Population health data and analytics; integrated provider and pharmacy quality reporting | Reports (analytics and gap identification) | Plans wanting unified quality analytics across provider and pharmacy |
| Reveleer | AI quality and risk platform; care gap closure analytics and Star Ratings reporting | Reports (gap identification and abstraction) | Payers unifying risk and quality reporting on one platform |
| Pelica | Execution layer: one canonical record plus a Pharmacy and Part D copilot with voice AI outreach | Closes the gap by calling pharmacy and prescriber and following up | Risk-bearing IPAs, ACOs, and groups that need the work done, not just reported |
AdhereHealth
AdhereHealth's strength is plan-side adherence at scale. Its Adhere platform uses health-plan and consumer data to stratify at-risk members in near real time across adherence, HEDIS, social determinants, and MTM, and its Optimize MTM offering supports Comprehensive Medication Review completion through software and a nationwide clinical team. For a Medicare Advantage plan running adherence and MTM programs across a large membership, AdhereHealth is an established, focused choice. Its center of gravity is the plan's own outreach and clinical workflow rather than autonomous, multi-party gap resolution.
Arine
Arine pairs AI-driven medication management with pharmacist decision support. The platform triangulates medical and pharmacy claims, lab results, and EHR data to generate medication recommendations grounded in clinical guidelines, and flags medication-related problems before they escalate. For plans and groups that want clinical medication optimization and MTM, Arine is a strong fit. Its design point is surfacing and recommending the right clinical action, with execution running through pharmacists rather than autonomous outreach to every pharmacy and prescriber.
AnewHealth (Tabula Rasa HealthCare)
AnewHealth, the combined ExactCare and Tabula Rasa HealthCare organization, delivers hands-on clinical pharmacy. Its MedWise technology personalizes regimens, and its MedWiseRx contact centers run MTM programs including Comprehensive Medication Reviews, alongside full-service dispensing and PBM. For medically complex, polypharmacy members who need pharmacist care and medication delivery, AnewHealth closes adherence through the pharmacy-care model itself. It is a clinical services and dispensing partner rather than a measurement dashboard or a cross-team execution layer.
Pharmacy Quality Solutions (EQuIPP)
Pharmacy Quality Solutions operates EQuIPP, the platform most plans and pharmacies use to measure PDC and other PQA quality measures and to benchmark performance. PQS develops measure specifications from PQA and NCQA standards, which makes EQuIPP a shared reference point for how adherence is scored across the industry. EQuIPP is intentionally a measurement and benchmarking layer. It tells you where PDC stands, which is exactly the reporting half of the job, and leaves the outreach that moves the number to the plan or pharmacy.
Mosaic Pharmacy Service
Mosaic Pharmacy Service is a mail-order pharmacy built for medically complex, polypharmacy patients. Members receive monthly home delivery, medication synchronization, easy-to-use adherence packaging, and pharmacist calls before each shipment to review changes and check for interactions. For a population that struggles to manage many medications at home, that model raises adherence directly through dispensing. It is a pharmacy-care service rather than a software platform that works gaps across your existing pharmacy network and prescribers.
Innovaccer and Reveleer
Innovaccer and Reveleer are population-level quality platforms. Innovaccer is a widely recognized population health data and analytics platform whose integrated quality reporting spans provider and pharmacy measures and tracks performance against CMS Star Rating targets. Reveleer unifies risk, quality, and member management with AI-driven care gap closure analytics and Star Ratings reporting. Both are strong when the priority is identifying gaps and reporting performance across a large population. For Part D adherence specifically, their design point is computing and surfacing the gap; reaching the member, pharmacy, and prescriber sits with your team.
When to pick a competitor
None of these tools is wrong, and the honest answer depends on what you are missing. If you have no standardized way to measure PDC, start with Pharmacy Quality Solutions. If your members are medically complex and struggle to manage many drugs at home, a clinical pharmacy partner like AnewHealth or Mosaic Pharmacy Service may move adherence more than any software. If you need clinical medication optimization and pharmacist-led MTM, Arine or AdhereHealth fit well. If you want unified quality analytics across provider and pharmacy measures, Innovaccer or Reveleer are established choices. Pick the layer you are missing, not the longest feature list.
Where an AI execution layer fits
Most adherence programs do not fail for lack of a dashboard. They know which members are below 80 percent. The work that moves the rate, calling the pharmacy about a stalled refill, reaching the prescriber for a renewal or an affordable alternative, and following up with the member until the fill happens, is where staff time disappears, especially when a small team owns a large panel.
Pelica is the execution layer. One canonical record per member, built from pharmacy claims (PDE), EHR, lab, and payer feeds, sits under a Pharmacy and Part D copilot. On top of it is an action layer: voice AI that calls the pharmacy and the prescriber, resolves refill gaps, prior authorizations, and affordability barriers, follows up repeatedly, and escalates to a pharmacist or coordinator only when a human is genuinely needed. The copilot prioritizes the members whose PDC is most at risk of crossing the 80 percent line while a save is still possible. The point is not to show the work. It is to do it.
At our flagship customer, a physician-led IPA in New York running risk on roughly 175,000 patients, the platform reached 100 percent team adoption and 96 to 98 percent adherence on the three triple-weighted Part D measures. That is the trade most pharmacy and quality teams are weighing: another PDC dashboard, or a layer that closes the adherence gaps the dashboard surfaces. For the operational playbook, see how to improve Part D adherence and the triple-weighted adherence measures explained.
A PDC dashboard tells you who is below 80 percent. The number only moves when someone makes the call.
If you are also comparing quality and Stars tooling more broadly, see our guides to the best HEDIS and Stars software, the best value-based care software head-to-head comparison, and the longer-form value-based care software buyer's guide. If your team already knows which members are non-adherent and the outreach is not getting done at volume, an execution layer is the purchase that moves the rate, and it deploys in weeks rather than quarters.