Building a Specialty Pharmacy to Deliver Speed to Value & Patient Impact
Skagit Regional Health (SRH) saw specialty pharmacy as a clear opportunity to improve patient access, ease clinic workload, and drive financial performance. What they lacked was the infrastructure to make it happen. Visante partnered with SRH to build a specialty pharmacy from the ground up, designed for speed, strategy, and scale.
“They didn’t have a retail or specialty footprint, and this was truly ground-up,” described Javon Artis, Visante’s VP of Strategic Accounts. “They didn’t hand us the keys to the car—there was no car. They brought us to the garage and asked us to build the car from scratch, then get it on the road.”
The Challenge: A Specialty Opportunity Without the Blueprint
SRH previously operated retail pharmacy services but transitioned away from that model in 2018 as part of a broader organizational shift. As a result, the health system no longer maintained the specialized infrastructure, technology framework, or staffing model in place to support a specialty pharmacy program.
While leadership recognized the opportunity specialty pharmacy could represent—for patient access, provider alignment, and financial sustainability—the internal foundation to execute on that vision was no longer in place.
“With the closing of our three retail pharmacies in 2018, we lacked the expertise and infrastructure to open a specialty pharmacy,” said Keith Fongemie, Regional Director of Pharmacy at Skagit Regional Health. “We also lacked the resources to build the necessary modules in Epic to support the specialty pharmacy.”
Launching a specialty pharmacy program is fundamentally different from operating a traditional retail model. It requires payer contracting expertise, medication access support, prior authorization workflows, accreditation readiness, and optimized health system integration, all of which demand focused resources and specialized experience.
At the same time, the health system’s pharmacy leadership was managing increasing regulatory complexity, particularly in the evolving 340B environment. Internal teams were balancing day-to-day operations while attempting to stay current with industry shifts, manufacturer decisions, and compliance risk.
“We were facing staffing challenges and struggling to keep up with frequent regulatory and industry changes,” shared Danny Vera, Regional VP & Chief Operating Officer at Skagit Regional Health. “Visante brought deep subject matter expertise and helped keep us up to speed in a rapidly changing environment.”
Along with operational guidance, SRH needed a partner capable of building infrastructure while reducing risk, accelerating time to value, and aligning executive priorities.
The Solution: A Fully Integrated Expert Partnership
SRH partnered with Visante to design, build, and launch a specialty pharmacy program. This was a full infrastructure build spanning strategy, systems, staffing, and clinical integration. From day one, Visante worked side by side with SRH leadership to design and stand up the complete specialty model, including:
- Pharmacy licensing and regulatory navigation
- Vendor evaluation and contracting strategy
- Epic Willow Ambulatory build and IT infrastructure
- Workflow design aligned with accreditation standards
- Payer contracting and credentialing preparation
- Medication access and prior authorization model development
- Early provider and clinic engagement
Early clinical integration was a priority. Visante engaged providers months before go-live, strengthening medication access and prior authorization workflows to reduce administrative burden and accelerate adoption from day one.
The build required disciplined sequencing and close coordination across teams. Visante collaborated alongside SRH pharmacy and executive leadership to manage milestones, mitigate risk, and maintain alignment throughout implementation. Project governance and transparency were central to the approach, giving leadership real-time visibility into progress and potential risks.
“There was a lot of visibility in our partnership. We were able to see whether any of the project milestones were at risk or not, which was great and allowed for transparency,” said Bianca Gordan, Regional VP & Chief Nursing Officer at Skagit Regional Health.
The Results: Operational Relief, Clinical Impact, & Financial Return
The SRH specialty pharmacy launched smoothly and began delivering value earlier than expected. The program drove operational and clinical impact while establishing a scalable platform for future expansion.
“The best feedback I received was related to the fast turnaround time for prescriptions and the prior authorization team, which relieved a significant workload for our clinic staff,” said Keith.
SRH quickly saw measurable impact across clinic operations and patient experience, including:
- Average monthly volume growth of 20% since program inception
- Faster prescription turnaround times
- Dedicated prior authorization support that relieved clinic staff workload
- Strong provider adoption across service lines
- Positive patient feedback and preference for the new pharmacy model
- Expanded payer access and favorable reimbursement positioning
The program demonstrated how an accountable partnership model can accelerate outcomes while reducing operational and financial risk for the health system.
“A testament to Visante’s work is the amount of our clinics asking, ‘Can we be next?’ I think that speaks volumes,” said Bianca.
From Vision to Value: A Specialty Pharmacy Built to Perform
For Skagit Regional Health, launching a specialty pharmacy was not just about adding a new service line. It was about building a sustainable capability that supports patients, relieves clinic burden, strengthens pharmacy operations, and drives long-term performance.
By partnering with Visante, SRH gained the expertise, structure, and embedded support needed to move quickly, reduce risk, and deliver measurable results early.
“I am glad that Visante has lived up to the expectations that I had from conversations I had with other Visante clients. The onsite staff truly act as Skagit Regional Health staff members,” said Keith.
If your health system is considering specialty pharmacy, infusion, or 340B optimization—and you want speed to value without added risk—contact Visante to start the conversation.