The primary objective of the study is to evaluate how engaging ACO beneficiaries in the appointment based model for one year impacts medication adherence and healthcare costs compared to usual care.

The American Pharmacists Association (APhA) Foundation has partnered with a federally qualified health center (FQHC), a supermarket community pharmacy, and an accountable care organization (ACO) to participate in this ABM for ACO Beneficiaries initiative. The FQHC, El Rio Community Health Center pharmacy, and supermarket pharmacy, Fry's Pharmacy, will serve as implementing pharmacy study sites and will implement the ABM for beneficiaries of the ACO who utilize their pharmacies for medication refill services. The ABM involves synchronizing all medications to come due on the same day of the month and the individual receives a pre-appointment phone call from the pharmacy staff to review medications and identify any changes. The ACO will provide medical and claims data on enrolled subjects as well as a control group for the intervention population. The APhA Foundation will aggregate intervention, prescription fill, and economic data from the 3 partners in an effort to evaluate the impact of the ABM on healthcare costs and medication adherence. The APhA Foundation has an a priori intent to publish the project results.

Inclusion Criteria: Individuals eligible to be enrolled in the study include those who:

• Are beneficiaries of the partnering ACO;
• Are receiving medical care at El Rio and have been since before May 1, 2013;
• Are taking 2 or more medications that are refilled on 30, 60, or 90 day schedules;
• Speak English or Spanish;
• Are at least 18 years of age; and
• Are not institutionalized (i.e., residents of nursing homes, psychiatric institutions, or prisons).

Exclusion Criteria:

• Use of a legal authorized representative