Opportunity 

Statin medications have been shown to prevent heart attacks and strokes and are recommended for many people with conditions like diabetes or cardiovascular disease. However, more than half of patients who meet clinical criteria for statin therapy are not currently prescribed a statin or are not taking an appropriate dose. This gap increases avoidable cardiovascular risk for patients and creates downstream burden for clinicians and the health system. 

A Penn Medicine research study showed that when statin-eligible primary care patients were referred to pharmacy, statin prescribing doubled and appropriate-dose prescribing tripled. These promising findings prompted the health system to explore an adaptation that could be sustainably implemented across primary care clinics.  

CHTI translated those research findings into the Lipid Management Program, building the workflows, staffing model, and reporting needed to implement and scale the intervention across primary care practices. 

Intervention 

The Penn Partners in Care (PPiC) Lipid Management Program uses asynchronous, pharmacist-led outreach to help eligible primary care patients start (or restart) statin therapy. Patients are identified through payor-provided lists and/or electronic health record–based reporting, then pharmacists (or, where needed, advanced practice providers) review charts to confirm eligibility and reach out to patients by phone. 

During outreach, pharmacists discuss heart disease prevention, answer questions, and address common barriers to starting statins. If a patient agrees, the pharmacist pends an appropriate statin order for the primary care clinician to co-sign, reducing the amount of work required from busy clinicians. The program also standardizes documentation (including clinical exclusions/contraindications when relevant) to improve accuracy of quality reporting and ensure outreach efforts are focused on patients who can benefit. 

Impact 

The Lipid Management Program launched a mere seven months after the research findings were first presented in 2023 – a rapid translation of scientific insight into an operational program. It has since scaled across Penn’s primary care clinic regions encompassing Philadelphia and the surrounding counties. 

The program has demonstrated measurable improvements in statin initiation. In 2025, statin orders were pended for 27 percent of the patients determined eligible for outreach. Our data suggest that the Lipid Management Program increased the portion of clinically eligible primary care patients taking statins from 25 percent to 38 percent in the largely Medicare-eligible patient population.  

In addition to advancing the health of our patients, the Lipid Management Program supports improvements in health care quality measures (e.g., HEDIS) and associated value-based contract performance, which can lead to financial benefits for the health system.