Your heart failure and AFib patients' medication adherence is on your scorecard.
CMS is moving specialty care toward full financial accountability for outcomes. The Ambulatory Specialty Model launches in selected markets in 2027. Even if Hattiesburg is not in the first wave, the direction is unmistakable: whether your patients stay on their anticoagulants is the outcome that matters. Fairview Pharmacy keeps those patients on therapy and documents every intervention along the way.
What it is costing your practice
Your staff is drowning in prior authorizations. Your patients are abandoning treatment while they wait.
Every week, a cardiology practice processes a heavy load of prior authorizations, and a meaningful share of the staff week disappears into that paperwork. Worse, patients abandon treatment while a prior authorization sits unresolved.
An Eliquis prescription stuck in limbo is a stroke risk that nobody is managing. The longer it sits, the worse the exposure, for the patient and for your scorecard.
Cardiology specific quality risk
Every unfilled anticoagulant moves your numbers.
Here is how medication adherence shows up in the quality measures CMS tracks for cardiology, and what each one means for your patients.
MIPS #326, AFib and oral anticoagulation
Are your AFib patients prescribed and actually taking an oral anticoagulant? If the prescription goes unfilled, your outcome scores can still be affected.
MIPS cost measures, readmissions
Non adherence is associated with strokes and hospitalizations. Those readmissions drive up your cost score.
Ambulatory Specialty Model for heart failure, starting January 2027
A mandatory CMS model rolling out in selected markets, moving toward full financial accountability for heart failure outcomes. Adherence is central.
Star Ratings PDC, triple weighted
Your patients' adherence is tracked by their health plan. The adherence measures are triple weighted, and poor plan performance pressures your practice through value based contracts.
Every magnitude here is framed as a maximum or a possibility, not a certainty. That is the accurate and defensible reading of these programs.
The liability between you and your scores
At a chain pharmacy, if your patient's Eliquis hits a prior auth, nobody follows up.
If they skip a refill, nobody calls. If they stop taking it entirely, nobody tells you. You find out six months later at the next visit, or from a hospital discharge summary.
For an anticoagulation patient, that gap is not a paperwork problem. It is a stroke waiting to happen, and it is on your scorecard. That is not a pharmacy partner. That is a liability.
EQuIPP verified, all four measures published
Fairview is held to the same quality standards that track your patients' adherence.
EQuIPP star measures, Elevate Provider Network. Quarter 4, 2025, closed measurement year.
- Blood pressure (RASA) PDC98.2%, 215 of 219 patients5 stars
- Cholesterol PDC97.2%, 246 of 253 patients5 stars
- Statin use in diabetes96.3%, 52 of 54 patients5 stars
- Diabetes PDC95.6%, 108 of 113 patients5 stars
EQuIPP star rating 5.00. Five stars on all four measures, every year since 2022.
Fairview's EQuIPP star measure performance, issued by Elevate Provider Network for the closed 2025 measurement year: Blood pressure (RASA) PDC 98.2%, 215 of 219 patients. Cholesterol PDC 97.2%, 246 of 253. Statin use in diabetes 96.3%, 52 of 54. Diabetes PDC 95.6%, 108 of 113. EQuIPP star rating 5.00. Five stars on all four measures, every year since 2022. Our livelihood depends on patient adherence, exactly like yours. We dissect every prescription and every patient profile to make sure what you prescribe actually reaches your patient.
EQuIPP performance metrics as of Quarter 4, 2025, Medicare Part D population, benchmarked against national pharmacy averages. These measures describe prescribing and dispensing patterns. Neither is a measure of health outcomes.
You prescribe.
E prescribe to Fairview. NCPDP 2515104, NPI 1144383613.
We fill same day.
Most prescriptions filled within 24 hours, and we resolve all prior authorizations.
We monitor.
We call patients before their refills run out, typically about 5 days ahead.
We report to you.
A one page report at day ninety shows who is on track and who is not.
You reinforce.
You address adherence at the next visit, with real data instead of guesswork.
Same day fills
Every Eliquis prescription filled within 24 hours.
Prior authorization handling
We take the prior authorization workload off your staff.
Pill pack program
Synced to the patient's full medication regimen.
A one page report at day ninety
Who is compliant, who is not, every month.
Proactive refill calls
We call patients about 5 days before they run out.
Direct clinical line
Your patients call our pharmacist, not your nurses.
One short conversation
Schedule a 10 minute intro call with Dr. Mike. No commitment to start.
On the call, Dr. Mike walks through the zero risk pilot: send us 5 of your most complex anticoagulation patients for 90 days, with a one page report per patient delivered to your office at day ninety. No contract, no cost, and nothing owed in either direction.
Request your intro call
A 10 minute call with Dr. Mike, no commitment and no paperwork to start. Just tell us how to reach you and a little about your practice. The 5 patient pilot is what we walk through on the call.
Typical response: Within 1 business day
Forms for referring practices