Pharmacy Metrics to Integrate into the Executive Scorecard

Health systems are under growing pressure to balance quality, cost, safety, and access. Yet one of the most underleveraged drivers of performance is pharmacy. Pharmacy integration directly impacts every dimension of the balanced scorecard. This framework measures success across financial outcomes, patient experience, internal operations, and innovation.

Elevating pharmacy to an enterprise structure shifts it from a siloed department to a strategic tool for system-wide transformation. When aligned with leadership goals and supported by targeted investment, pharmacy can streamline medication workflows, reduce burdens on clinical staff, and strengthen organizational scalability and resilience.

Why Pharmacy Alignment Hasn’t Kept Pace With Care Delivery

Pharmacy involvement has traditionally focused on inpatient settings, where regulatory oversight, rising drug cost, and clinical care demand close attention. As health systems expand into outpatient, procedural, and infusion care, new opportunities are emerging to broaden pharmacy leadership and enhance support across the continuum.

Many ambulatory services were initially built without dedicated pharmacy involvement, often relying on supply chain or administrative staff to manage medication processes. Strengthening pharmacy’s presence in these areas can bring greater consistency, reduce risk, and unlock improvements in safety, access, and efficiency.

“Pharmacy becomes transformative when health systems stop viewing it as transactional and start seeing it as integral to strategy, growth, and patient care.” — Phil Brummond

As health systems expand outpatient services, fragmented medication workflows create barriers to safety, scalability, and cost control. Without pharmacy leadership in these settings, organizations face inconsistent practices that undermine performance. Pharmacy should be a clinical and operational partner and help guide how medications are chosen, delivered, and monitored regardless of setting they are administered in to support system-wide goals.

Elevating Pharmacy From Operational Silo to Scorecard Necessity

Pharmacy’s value isn’t confined to the pharmacy department. Its impact spans the full spectrum of the balanced scorecard, from financial outcomes to patient-centered care. Pharmacy contributes directly to:

• Financial stewardship through optimized drug spend and revenue capture.
• Clinical quality and safety through medication management and patient adherence.
• Operational efficiency by reducing provider burden and improving workflows.
• Access to equity through ambulatory and specialty pharmacy expansion

The Four Domains Where Enterprise Pharmacy Drives Health System Performance

1. Clinical Integration: Advancing Quality and Patient Outcomes

Pharmacy is essential to improving patient outcomes, supporting clinical quality, and reducing unnecessary utilization. By integrating pharmacists into care teams and workflows, health systems can strengthen medication safety, improve continuity of care, and reduce the burden on providers.

Pharmacy-led strategies that support clinical integration include:

• Care Team Collaboration: Embedding pharmacists in ambulatory and chronic care settings to support therapy optimization, deprescribing, and preventive care initiatives.
• Transitions of Care: Leading medication reconciliation, discharge counseling, and coordination to reduce readmissions and promote continuity.
• Refill Request Management: Centralizing refill processes to improve turnaround time and reduce administrative workload for providers.
• Evidence-Based Medication Use: Driving appropriate prescribing and adherence to clinical guidelines, reducing adverse drug events and supporting quality metrics.

2. Operational Infrastructure: Strengthening Internal Processes

Pharmacy leadership is essential to building efficient, reliable infrastructure that supports safe, high-quality care. For example:

• EMR Governance: Partnering with informatics and IT to lead medication order design and clinical decision support within the EMR.
• Medication Distribution & Inventory: Managing clinic-level medication distribution, inventory oversight, and secure storage in collaboration with nursing and administrative teams.
• Formulary & Refill Process Optimization: Streamlining workflows to improve efficiency, reduce delays, and allow all care team members to work at the top of their licenses.
• Controlled Substance Oversight: Leading diversion prevention, compliance monitoring, and alignment with regulatory requirements.

3. Access & Affordability: Expanding Reach and Equity

Pharmacy plays a critical role in improving access to medications and promoting equity across patient populations. Expanding services across ambulatory and specialty settings enhances care continuity, drives adherence, and reduces disparities—especially for underserved or high-risk groups.

• Access Services: Centralizing functions like prior authorizations, patient assistance programs, and infusion coordination to accelerate access and reduce workload for clinical staff.
• Formulary Management & Governance: Promoting consistency and affordability through oversight aligned with clinical best practices and population health goals.
• Specialty & Ambulatory Pharmacy Expansion: Extending pharmacy services into outpatient settings to support continuity of care and improve adherence across diverse communities.

4. Strategic Enablers: Driving Financial Strength and System Growth

Pharmacy is a key enabler of sustainable growth, delivering financial performance, regulatory alignment, and population health impact. Through strong leadership and data-driven strategy, pharmacy supports value-based models and long-term system resilience.

Pharmacy-led initiatives that enable strategic growth include:

• Population Health & Value-Based Care: Closing adherence gaps, optimizing therapy, and managing medication spend in risk-bearing environments.
• Regulatory Compliance: Ensuring alignment with CMS, Joint Commission, and other quality and safety standards.
• Revenue Optimization & Cost Control: Identifying new revenue streams, capturing 340B value, and managing drug utilization effectively.
• Data-Driven Decision Making: Leveraging pharmacy analytics to guide performance improvement and strategic planning.

Using Pharmacy Metrics to Strengthen Leadership Accountability

Pharmacy-related KPIs can be embedded within executive performance dashboards to provide a holistic view of system success:

• Revenue growth from ambulatory and specialty pharmacy services
• Pharmacy spend efficiency, such as drug costs relative to total operating expenses
• Provider satisfaction with pharmacy integration into clinical services
• Patient access and adherence, especially for high-risk or underserved populations
• Value from 340B programs, including reinvestment into patient-centered initiatives
• Improvements in safety, measured by reductions in medication-related adverse events
• Market share, measured by internal capture rates of high revenue specialty medications both infused and through the health system specialty pharmacy

Pharmacy Integration Happens at the Top

Pharmacy delivers its greatest value when executive leaders position it as a enterprise-wide foundational pillar of organizational excellence. Strategic commitment from the top enables innovation in medication management, entrepreneurialism in new revenue streams, strengthens regulatory compliance, and builds scalable infrastructure for long-term growth.

When pharmacy excellence is embedded into the balanced scorecard, it signals a powerful shift: medication management isn’t just a quality checkbox; it’s a system-wide strategy for driving outcomes, resilience, and enterprise value.

“Health systems achieve meaningful pharmacy integration when leadership drives it from the top. Executive alignment is what turns pharmacy from a service line into a strategic engine.” — Dave Hager

Key Takeaways: Pharmacy Is a Strategic Lever

Despite its enterprise-wide impact, pharmacy accountability remains inconsistent, particularly across ambulatory and outpatient settings where it’s needed most. Without pharmacy leadership, health systems face barriers to safety, access, and growth. Centralized, pharmacy-led services such as refills, EMR oversight, and access coordination can streamline care and ease the burden on clinical staff. But unlocking that potential requires executive support and investment in pharmacy as a core driver of performance.

To explore how your organization can better leverage pharmacy to achieve clinical, operational, and financial goals, contact Visante. We’re here to help transform pharmacy into a strategic advantage.

Subject Matter Expert: Dave Hager