Elevating Pharmacy Strategy & Roles in Health Systems

For 2025, having and executing a purposeful and nimble pharmacy strategy is imperative for health systems. This is crucial to meet the challenges of delivering high-quality care, cost-containment, growing revenue, evolving patient expectations, access to medications, workforce shortages, and health disparities.

C-suites at high performing organizations must have a clear set of goals and expectations for the pharmacy enterprise to deliver SMART CARE.

What is “Smart Care?”

S: Safety

Every year, thousands of people die and hundreds of thousands are harmed from medication errors. As experts in medication delivery, pharmacies should lead and collaborate on medication error identification and investigating root causes. Pharmacy is also important for implementing and maintaining the culture, processes, and technology needed to mitigate medication errors.

M: Medication Management

Optimizing medication use improves patient health outcomes. Medication Management entails pharmacists working in collaboration with the patient and other healthcare providers to ensure patients’ medications are safe given comorbidities and other medications being taken, and that they are achieving health goals in alignment with patient values.

A: Access to Medicine

Prior authorization is used by payers to manage the use of costly or potentially avoidable care. However, the negative impacts to patients and providers are significant including reduction of clinical staff time available for patient care, loss of provider autonomy, patient frustrations, and poorer outcomes from delayed or abandoned care. Organizations that have a centralized pharmacy prior authorization team consistently show improved patient, provider, and staff satisfaction, shorter prior authorization turn-around times, faster time to medication initiation, an increase in provider and clinical staff time spent on patient care activities, safer discharges, and stronger revenue cycle and overall financial performance.

R: Regulatory Compliance

Pharmacy and medication use may be one of the most highly regulated of all healthcare services. There are dozens of local, state, and national entities that create regulations such as the Drug Enforcement Agency, Centers for Medicare and Medicaid Services, Boards of Pharmacy, Health Resources and Services Administration, Environmental Protection Agency, Food and Drug Administration, Occupational Safety and Health Administration, the Consumer Products Safety Commission. Maintaining appropriate pharmacy resources, expertise, and focus is essential to prevent patient, reputational, and financial harm.

T: Technology

Pharmacy was an early adopter of healthcare technology, often the first entity in the hospital to have computer systems or automation for dispensing. Contemporary pharmacy enterprise technologies are responsible for a significant portion of limited operating and capital dollars. With workforce constraints, the ROI for technology may be higher than in years past. Strategic adoption and effective implementation and maintenance are needed to make sure returns (financial, operational, clinical) on technology investments are realized.

C: Cost Savings

The cost of pharmaceuticals is often the largest health-system non-labor expense category. Successful management of these costs requires a combination of strategies to optimize utilization, minimize waste, manage inventory, negotiate favorable contracts, and respond to shortages.

A: Access to Care

One of the largest growing service lines will be infusion services with an extensive pharmaceutical pipeline of infused medications and cellular and genetic therapies. Additionally, more services are moving into the home (hospital at home, SNF at home, primary care at home). Most leading health systems have an internal ambulatory infusion site of care strategy in development to ensure patient access and as a key revenue stream.

Workforce shortages are still a top concern of health systems. Many health systems have deployed pharmacists and pharmacy technicians to reduce physician and advanced provider workloads leading to improved access for patients.

R: Revenue

As health system margins continue to erode, a strategy based on cost reduction alone is insufficient. Successful health systems are looking at ways to increase revenues either through new services offerings like specialty/retail pharmacy, ambulatory infusion services, or maximizing existing services through improvements to medication revenue cycle management or mitigation of patient leakage.

E: Entrepreneurship

Healthcare continues to evolve at a rapid pace spurred by advances in diagnostics, treatments, and technology. When led with an entrepreneurial mindset the pharmacy enterprise can be a strategic asset to capitalize on opportunities with value-based care, healthcare disparities, partnerships, and the yet unknown.

A Needed C-suite Partner: The Pharmacy Executive

To deliver on a SMART CARE strategy in 2025, a leader capable of being an executive partner is necessary. The breadth, depth, and complexity of the pharmacy enterprise demands a unique combination of subject matter expertise and leadership abilities. The most successful organizations have a dedicated pharmacy executive with a voice in the C-suite, supported by a strong pharmacy leadership team. This team is instrumental in developing and executing the pharmacy strategy in collaboration with other clinical, operational, and financial leaders.

Pharmacy executive competencies:

• Mastery of healthcare finance complexities
• Tangible ideas for new pharmacy revenue streams
• Demonstrates values that place the organization, not pharmacy, first
• Advanced negotiation and conflict resolution skills and the ability to leverage them with external business entities
• Entrepreneurial skills and innovation beyond traditional silos of inpatient, ambulatory, and retail
• Transformational leadership to move from an organization to a system
• Creativity in how to leverage the pharmacy supply chain to create value for the organization
• The ability to attract a diversity of top talent
• Exceptional skills in nimbleness and collaboration

Unfortunately, many organizations fail to fill key pharmacy leadership positions due to an aging workforce, limited pipeline of new leaders, and insufficient succession planning and mentoring. To be successful organizations may need to find partnerships to fill these gaps.

In closing, prioritizing a health system’s pharmacy strategy and pharmacy leadership roles and abilities is key to flipping medications from a health system cost to an asset.

Questions to Get Started

• Does your organization have a purposeful and nimble pharmacy strategy?
• Do you have a pharmacy executive and supporting leadership team that can execute that strategy?
• What gaps exist in pharmacy leadership development, succession planning, and recruitment?

Looking for more information or assistance for your organization? Reach out to Visante today!

Subject Matter Experts: Steve Rough & Phil Brummond