Systems and methods for improving mediation adherence are provided. Various embodiments of the present invention help patients maintain their medication and other healthcare schedules and avoid costly nursing, home health care, assisted living, or nursing home alternatives whenever possible. In some embodiments, personalized recorded voice messages are used to directly contact (e.g., by telephone, VoIP, etc.) a patient when scheduled. The system can provide notifications (e.g., e-mails, text messages, automated phone calls, etc.) to a caregiver or other designated persons if the call is not acknowledged so that someone can follow up before more serious consequences arise. In addition, various reports can be generated regarding potential medication adherence and acknowledgement of the personalized voice messages. One or more rewards may be presented to the patient based on medication adherence.