Med Sync Program Guide for Community Pharmacies

A medication synchronization program lines up all of a patient's chronic prescriptions to refill on the same day each month. The pharmacy short-fills some medications once to align them, calls the patient 7 to 10 days before pickup to review changes, prepares the order, and hands it over at one monthly appointment.

What med sync is

The National Community Pharmacists Association (NCPA) defines medication synchronization simply: all of a patient's prescriptions are "refilled on the same day of the month." Instead of five trips for five refills, the patient comes in once. See the med sync glossary entry for a short version.

The American Pharmacists Association Foundation calls its version the Appointment-Based Model (ABM). It describes the ABM as "a patient care service designed to improve patients' adherence to medications and build efficiencies in pharmacy operations." The model rests on a single monthly pickup with proactive outreach before it.

The key word is appointment. Med sync turns refills from something the patient has to remember into something the pharmacy schedules. The pharmacy calls ahead, catches changes, and has the order ready.

What the evidence says

The most cited study is Holdford and Inocencio, published in the Journal of the American Pharmacists Association in 2013. It compared patients in an appointment-based sync program at rural Midwestern pharmacies with matched controls, across six chronic medication classes.

Controls were also 52% to 73% more likely to stop taking their medication altogether.

Read those numbers with care. The program groups had 47 to 81 patients per drug class. It was a quasi-experimental design, meaning patients weren't randomly assigned. Patients who agree to join a sync program may already be more engaged. The result is encouraging and consistent with how pharmacists describe the model, but it isn't proof that sync alone doubles adherence.

Why it matters for your business: Medicare's Part D adherence measures use PDC (proportion of days covered), with 80% as the passing line. For how those measures work, see How to Improve PDC.

How to run a med sync program

NCPA's pharmacy manual lays out the workflow. Here it is in five steps.

On short fills and cost: federal rules require Part D plans to apply a daily cost-sharing rate when a network pharmacy dispenses less than a month's supply. In plain terms, a short fill should cost the patient a prorated copay, not a full month's copay. Check each plan's rules, since exceptions exist for some drugs.

Where programs stall

Enrollment is the easy part. The work that grows is the pre-appointment call.

Every enrolled patient needs a call every month. At 300 enrolled patients, that's 300 calls, with voicemails and callbacks on top. Each call asks the same core questions. Most answers are "no changes." The few that aren't are the reason the call exists: a new prescription from a specialist, a stopped drug, a hospital discharge.

When techs fall behind on calls, orders get prepared without the review. That's when patients arrive to find a discontinued drug in the bag, or a new one missing. Trust in the program drops, and patients drift back to filling one drug at a time.

Where AI outreach fits

The pre-appointment call is structured, repeatable, and high-volume. That makes it a good fit for an AI phone call, with a pharmacist behind it for anything clinical.

Rivvi is a HIPAA-compliant AI workspace for healthcare teams. On the Team plan it places calls and texts. For med sync, that looks like this:

• The pre-call, on schedule. Rivvi calls each enrolled patient 7 to 10 days before their sync date and asks the review questions: new medications, stopped ones, dose changes, recent hospital stays.
• In the patient's language. Calls run in Spanish and 30 more languages.
• Changes go to staff. When a patient reports a change, Rivvi creates a task with the details for the pharmacist, or warm-transfers the patient live if someone is available. Opt-outs are honored on every path.
• The list stays in one place. Staff can upload the sync roster, ask who is due this week, and see call outcomes recorded in Rivvi.

Rivvi doesn't write into your pharmacy management system. The pharmacist still reviews the order and makes the clinical calls. What changes is that the routine "no changes, see you Thursday" calls stop eating tech hours.

At Southeast Medical Group, Rivvi's refill outreach reached a 56% refill success rate versus 5 to 10% with manual outreach, and one pharmacist reached 30,000 patients versus about 200 manually (reported August 2026). That was refill outreach, not a sync program, but it's the same kind of call.

See the pharmacy workflow on Rivvi for pharmacies, or the adherence side on medication adherence.

Your first 30 days

1. Pull a list of patients with three or more maintenance medications.
2. Pick 25 to start. Choose people who visit often and who you know will pick up the phone.
3. Set anchor dates spread across the month so pickups don't all land on one day.
4. Contact prescribers for short-fill quantities where needed.
5. Run the pre-call for each patient 7 to 10 days before pickup, and log every change you catch.
6. After one cycle, look at the log. Those catches are the case for growing the program.

Once sync patients are stable, they're also easier to keep above 80% PDC. Pair this with fail-date tracking from our fail date guide for patients not yet enrolled.

Sources

• NCPA, Simplify My Meds pharmacy manual
• APhA Foundation, Pharmacy's Appointment-Based Model
• Holdford and Inocencio, JAPhA 2013, Adherence and persistence associated with an appointment-based medication synchronization program
• 42 CFR 423.153, Drug utilization management (daily cost-sharing rate)
• PQA, Measures resources (PDC)