Pharmacy’s Role in Enterprise Ambulatory Success
Health system executives often view pharmacy as an inpatient cost center, overlooking the potential of ambulatory services as a strategic investment. This blind spot hides major growth opportunities.
The reality is, pharmacy interacts with patients across every site of care: hospitals, clinics, retail pharmacies, specialty pharmacies, infusion suites, surgery centers, nursing homes, hospice, and the home. And as payers and patients continue to push care toward lower-acuity settings, health system pharmacy programs have a significant opportunity to holistically manage patients in all care settings. This is why trailblazing health systems embed pharmacy into the core of their strategies.
Two Pharmacy Ambulatory Growth Engines
The most significant near-term opportunities for growth lie in two enterprise strategies:
Specialty Pharmacy: Transparent Patient Care, Provider Efficiencies, & Financial Growth
Specialty medications represent more than half of the total U.S. drug market, and that share will only continue to rise in 2026 and beyond. Health systems that build or expand specialty capabilities can capture prescription revenue, strengthen continuity of care, and improve outcomes for patients with complex conditions. The marketplace is growing quickly, so organizations that have not historically had specialty pharmacy programs will still see significant value by implementing an internal program.
An internal specialty pharmacy program is a critical driver of financial and operational success:
- By handling administrative tasks and navigating complex prescription insurance, pharmacy teams free up clinical staff to focus on patient care.
- This efficiency leads to quicker patient access to prescribed medications, improving patient outcomes and convenience.
- When cost is a barrier, specialty pharmacy team members can support patient enrollment in financial assistance, copay assistance, and grant programs to lower out-of-pocket expenses.
- Pharmacy team members can also educate patients on their preferred pharmacy options and support holistic patient care through a health system’s pharmacy program(s) whenever possible.
Infusion Services: Enhance Patient Experience and Financial Growth
Expanding ambulatory infusion services inclusive of multiple internal sites of care is a fast-growing opportunity in ambulatory care for health systems. By expanding or internalizing infusion services across hospital departments, ambulatory infusion centers, pharmacy infusion suites, and even the home, health systems can reclaim care that often leaks to external providers.
When health systems implement an efficient internal referral process, busy clinic nurses and physicians can easily triage patients to the appropriate infusion setting. This allows for improving patient capture in high-margin hospital-based areas, as well as leveraging non-hospital-based infusion suites when necessary. The ultimate goal is having options available to reduce patient fragmentation by keeping all business internal to the organization, resulting in safer and higher-quality care.
Standalone competitors often win business because they simplify scheduling, prior authorizations, and patient communication (not because of superior care). Health systems can provide better, more integrated patient service, supporting more in-network infusion referrals. Organizations that simplify access for clinical teams typically see hospital-based volumes remain stable—or even grow—while capturing additional revenue in lower-cost infusion settings.
The focus shouldn’t be on protecting legacy volume. Instead, it needs to be on designing a seamless infusion ecosystem that aligns clinical triage, referral capture, and payer strategy. This allows the system to expand reach, improve efficiency, and increase revenue simultaneously.
Core Pillars of Ambulatory Growth
To achieve their ambulatory pharmacy growth potential, health systems must strengthen the core capabilities that make the medication ecosystem run effectively, efficiently, and sustainably. These capabilities are more than just ‘nice-to-have’ infrastructure. They are the enablers that determine how quickly and how far a system can grow beyond the hospital.
- Pharmacy-Based Medication Access Services accelerate the value of both specialty pharmacy and infusion services (and revenue cycle performance). Coordinated medication access services also drive improved patient and provider satisfaction and operational efficiency.
- Medication Revenue Cycle Performance Management aligns contracting, billing, and reimbursement across all care settings—inpatient, outpatient, and beyond. This ensures that every medication and infusion is captured, billed, and collected properly. It also supplements standard revenue cycle procedures to ensure proper reimbursement for administered pharmaceuticals.”A strong working relationship between pharmacy and managed care contracting is essential to having a strong pharmacy and medical benefits strategy, coupled with a strong internal employee benefit strategy for systems that have self-funded plans.
- Pharmacy Supply Chain Optimization, including centralized contracting, procurement, and logistics (often through a Consolidated Service Center), reduces variability, improves drug access, controls inventory, minimizes waste, lowers costs, and enables scalable growth in specialty pharmacy and infusion services.
- 340B Program Management maximizes savings to expand access and sustain care for underserved patients. It aligns organizational mission with financial performance, enhancing both community impact and enterprise stability.
Partnerships That Accelerate Execution
Repositioning pharmacy as a growth engine requires a strategic redesign, adding or shifting personnel, analytics, and investment from inpatient operations to focus on ambulatory strategy and execution. Many health systems’ internal pharmacy teams may have clinical expertise, but lack the enterprise-level leadership, analytics, payer strategy, and implementation bandwidth needed to scale.
The right external partner can support progress by providing:
- Credibility with boards and executives who need to see the potential value of pharmacy.
- Best practice recommendations tailored to an organization’s specific needs and marketplace strategies.
- Executional capacity to develop business cases, forecast ROI, design operating models including consolidated service centers, and manage rollout.
- A neutral enterprise lens that bridges finance, strategy, and clinical operations.
Today, speed matters, and the right partnership can be a force multiplier.
Key Takeaways: Positioning Pharmacy As Your Growth Engine in 2026 & Beyond
Healthcare is evolving rapidly, with care shifting beyond the walls of hospitals (and revenue following suit). Health systems now face a crucial decision: adapt to this shift or be left behind. Those that continue to treat pharmacy as a cost center within inpatient settings will lose patients, prescriptions, and profits to more future-forward competitors.
However, health systems that view pharmacy as a strategic asset by focusing on ambulatory care and innovation will build resilient, diversified models poised for success in 2026 and after. The era of pharmacy as a cost burden is over. The era of pharmacy as a powerful growth engine has arrived!
Contact Visante today to see how we can support your success in this new era of healthcare!
Subject Matter Experts: Dale Drizd and Joe Cesarz