Elevating Pharmacy Strategy & Roles in Health Systems

Having and executing a purposeful and nimble pharmacy strategy is imperative for health systems in 2025 and beyond. It’s essential for addressing the demands of high-quality care, cost containment, revenue growth, evolving patient expectations, medication access, workforce shortages, and health equity.

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?”

Smart Care is a comprehensive pharmacy strategy model that empowers health systems to improve medication management, expand access, and enhance financial performance through pharmacy leadership. Here’s how each element of the SMART CARE model strengthens pharmacy’s role as a strategic driver of health system success:

S: Safety

Medication errors harm hundreds of thousands of patients each year. Many of these situations are preventable. As experts in medication management and delivery, pharmacy teams play a critical leadership role in identifying risks, investigating root causes, and collaborating across the health system to reduce harm. Pharmacy is essential to building the culture, systems, and technology that make safe medication use a consistent standard.

M: Medication Management

Optimizing medication use is one of the most effective ways to improve patient outcomes. Pharmacy leaders are essential partners in this work; they collaborate with patients and providers to ensure medications are safe, appropriate for comorbidities, and aligned with individual health goals. Effective medication management also helps health systems reduce adverse events, improve adherence, and deliver more personalized, value-based care.

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 dedicated 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 are among the most highly regulated areas in healthcare. Dozens of federal, state, and local agencies—including the DEA, CMS, Boards of Pharmacy, HRSA, EPA, FDA, OSHA, and the CPSC—govern how medications are managed and dispensed. For health systems, maintaining pharmacy leadership with the right expertise, resources, and focus is essential to avoid patient harm, reputational risk, and financial penalties.

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

Infusion services represent one of the fastest-growing service lines, driven by a robust pharmaceutical pipeline of infused, cellular, and genetic therapies. At the same time, care is rapidly shifting into the home, including hospital-at-home, SNF-at-home, and primary care-at-home models. Leading health systems are developing ambulatory infusion strategies not only to improve patient access, but also to create sustainable revenue streams.

Pharmacy teams are also helping address one of today’s biggest barriers to access: workforce shortages. By deploying pharmacists and technicians to reduce provider workload, health systems can expand patient access, improve care coordination, and strengthen overall system capacity.

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 service 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 is evolving rapidly, driven by breakthroughs in diagnostics, treatments, and technology. With an entrepreneurial mindset, the pharmacy enterprise becomes a strategic asset, positioned to lead in value-based care, address health disparities, forge innovative partnerships, and seize emerging opportunities that have yet to be defined.

A Needed C-suite Partner: The Pharmacy Executive

Delivering on a SMART CARE pharmacy strategy in 2025 and beyond requires more than operational execution. It requires executive leadership. The scale and complexity of the modern pharmacy enterprise calls for a leader with deep subject matter expertise and strong influence within the organization’s highest levels.

Leading health systems have a dedicated chief pharmacy officer or pharmacy executive with a seat in the C-suite. Supported by a high-performing pharmacy leadership team, this executive plays a critical role in developing and executing pharmacy strategy alongside clinical, operational, and financial leaders.

The most successful pharmacy executives bring:

• Mastery of healthcare finance complexities
• Tangible ideas for new pharmacy revenue streams
• 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. 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.

Turn Strategy into Action: Questions to Get Started

Building a high-performing pharmacy enterprise starts with asking the right questions. As your organization plans for the years ahead, consider:

• Does your organization have a purposeful and adaptable pharmacy strategy aligned with system-wide goals?
• Is there a dedicated pharmacy executive with the leadership team and resources to execute that strategy effectively?
• Where are the gaps in pharmacy leadership development, succession planning, and recruitment?

Identifying these opportunities is the first step toward building a pharmacy operation that is not only clinically excellent, but financially strategic and operationally resilient.

If you’re ready to elevate your pharmacy strategy or need support developing pharmacy leadership, Visante can help. Our experts partner with health systems nationwide to deliver smart care solutions that improve patient outcomes and drive financial performance.

Connect with us to learn more.

Subject Matter Experts: Steve Rough & Phil Brummond