Process Versus Outcomes Incentives for Lipid Management

Inclusion Criteria: * Individuals at high risk of a cardiac event, specifically one of the following: * Individuals with clinical ASCVD (defined as diagnosis with myocardial infarction, stroke, or peripheral vascular disease) with an LDL greater than or equal to 100 mg/dl ; * Individuals with Diabetes (between the ages of 40-75) with an LDL greater than or equal to 100 mg/dl; * Individuals without clinical ASCVD or diabetes with LDLC with an LDL greater than or equal to 100 mg/dl and estimated 10-year ASCVD risk 7.5%; * Individuals without clinical ASCVD or diabetes with LDL cholesterol 190 mg/dl * A prescription filled for a statin medication within the last 12 months (derived from pharmacy records); * Low medication adherence on self-report completed during enrollment Exclusion Criteria: * Under 18 years old * A contraindication to further statin use or have suffered statin side effects, such as myopathy * Will not or cannot give consent * A history of active or progressive liver disease * Participating in another clinical trial with related aims * Co-morbidities likely to lead to death within a short period (e.g. metastatic cancer)