Committing to the ACO goal of increasing overall patient health means increasing patient engagement. When the majority of Americans only visit the doctor a handful of times a year, ACOs need to determine a better path to patient wellness coaching. Beth Israel Deaconess Care Organization is enacting a “Pharmacy First” program aimed to monitor plans to increase the likelihood of medication adherence; screen patients to reduce ineffective medication use; and analyze prescription habits to help providers fine-tune regimens. This Patient Engagement HIT article discusses the ways in which pharmacists are necessary for population health management and the ways in which their unique patient relationship may continue to be maximized moving forward.