Best Part D adherence software for 2026.

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.

That headline carries one asterisk, and you want it in hand before you set a 2026 budget. The three measures are weight 3 for the 2026 and 2027 Star Ratings. For the 2028 Star Ratings only, which reflect measurement year 2026, they carry a weight of 1. CMS treats the sociodemographic-adjusted version as a new measure, and new measures enter the program at weight 1 before moving up. From the 2029 Star Ratings onward they are back at weight 3 as intermediate outcome measures. CMS put it plainly in the CY2025 final rule: the first year the updated adherence measures are in the Star Ratings they will have a weight of 1, and beginning with the following Star Ratings year the weight increases to 3.

The practical read is that the work does not change, only the arithmetic for one rating year. A plan that lets adherence slip in 2026 because the weight dropped will be rebuilding a habit in 2027 that counts triple again.

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 sociodemographic status risk adjustment that applies to these measures from January 1, 2026 and first appears in the 2028 Star Ratings. It adjusts for age, gender, low-income subsidy and dual-eligible status, and disability status, and it also removes the three measures from the Categorical Adjustment Index. Ask as well whether the tool can flag a member while a save is still possible, not 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.

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.

PQS by Innovaccer (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. One detail an earlier version of this page missed: PQS has been part of Innovaccer since March 2024. Its boilerplate reads "PQS by Innovaccer," its releases publish on Innovaccer's domain, and EQuIPP now sits in Innovaccer's product menu alongside an EQUIPP Copilot. At the time of the acquisition PQS reported coverage of 95% of community pharmacies and up to 60 million lives. EQuIPP itself is still a measurement and benchmarking layer. It tells you where PDC stands, which is the reporting half of the job, and leaves the outreach that moves the number to the plan or pharmacy.

RxAnte

Most comparisons of this kind skip RxAnte. It builds predictive models that rank which members will fall below the PDC threshold and why, then delivers interventions through its own pharmacy services arm rather than handing the list back. The company states it manages Part D Stars for 70% of lives in 5-Star MAPD plans nationally, which is a vendor claim rather than an independently verified figure. RxAnte also appears on NCQA's MY2026 measure certification vendor list. For a plan that wants targeting and a delivered pharmacy intervention from the same partner, it is a serious option. The trade is the same one that runs through this page: the intervention happens inside RxAnte's pharmacy channel, not across the pharmacies and prescribers your members already use.

Arcadia

Arcadia is a data platform rather than an adherence tool, and it earns a place here for one reason. Its October 2025 partnership with Surescripts on First-Fill Abandonment gives near-real-time visibility into new prescriptions that were never picked up, positioned explicitly against HEDIS and Star Ratings medication adherence. First-fill abandonment sits upstream of PDC, and a member who never picked up the first fill will not show as non-adherent for months. That signal is genuinely useful. Somebody still has to call the 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's integrated quality reporting spans provider and pharmacy measures and tracks performance against CMS Star Rating targets, its Galaxy platform took 2026 Best in KLAS for payer data analytics at 90.5 against a category average of 87.2, and it owns PQS as described above. Reveleer has moved well past reporting since our first version of this page: it acquired Curation Health in October 2024 and Novillus in April 2025 for care gap management and provider engagement, launched EVE Hybrid AI for prospective suspecting in January 2026, and in April 2026 introduced a Clinical Data Repository it describes as a unified member-level clinical record across risk, quality, RADV, and care management. Both are strong when the priority is identifying gaps and reporting performance across a large population. For Part D adherence specifically, the pharmacy and prescriber calls still sit with your team.

Who dials the pharmacy

Innovaccer's own HEDIS comparison lists community pharmacies as one of its gap-closure channels, which is the closest anyone in this market comes to the argument this page makes. Listing the pharmacy as a channel is not the same as calling it. The question to ask is who dials the pharmacy when a refill stalls on day 12, and what happens when nobody picks up the first time.

Four questions separate a channel list from a working channel, and they apply to us as much as to anyone here:

• Who operates the channel. Your pharmacy techs and coordinators, or the software.
• Time from event to first contact. A stalled refill is a dated event. Ask for the window in hours, the way care management buyers now ask about ADT-triggered outreach latency.
• Where the evidence lands. The fill, the prior authorization outcome, and the prescriber's answer all have to write back to the record that computes PDC.
• One queue or many. Cross-payer gap consolidation means a member gets one call, not a pharmacy call on Monday and a quality call on Tuesday for the same visit.

One structural fact sits under all of this. The platform most plans use to measure PDC has belonged to Innovaccer since March 2024, and Innovaccer also publishes the comparison pages arguing that platforms should close gaps rather than count them. Measurement and execution are converging under one roof. That sharpens the question of who calls the pharmacy.

When to pick a competitor

None of these tools is wrong, and the honest answer depends on what you are missing. With no standardized way to measure PDC, start at PQS by Innovaccer and EQuIPP. For members who 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 will. Arine and AdhereHealth fit teams that need clinical medication optimization and pharmacist-led MTM. RxAnte is built for plans that want predictive targeting and want the intervention delivered by the same partner. Innovaccer and Reveleer are the established choices for unified quality analytics across provider and pharmacy measures. Buy 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.

Sources

• CMS: Part C and D performance data and Star Ratings
• Pharmacy Quality Alliance: PDC adherence measures
• Federal Register: CY2025 Medicare Advantage and Part D final rule (adherence measure weighting, 89 FR 30638)
• Federal Register: CY2024 final rule (sociodemographic status risk adjustment, applicable for the 2028 Star Ratings)
• CMS: 2027 Star Ratings measures and weights
• Pharmacy Quality Solutions: PQS acquired by Innovaccer (March 2024)
• RxAnte: adherence solutions for health plans (vendor-stated figures)
• Surescripts: First-Fill Abandonment with Arcadia (October 15, 2025)
• Reveleer: EVE Hybrid AI (January 20, 2026)