A Strategic Look at What's Driving Pharmacy Leader Decision Making
In this session, you'll hear what leading health system pharmacy executives discussed during our Spring 2026 in-person gathering of the Pharmacy Growth Collaborative in Carlsbad, CA — and we'll share our perspective on the key themes and what they mean for industry organizations that work with them.
Below are key takeaways from our in-person collaborative with health system pharmacy leaders, offering insights on their top-of-mind issues.
Key Themes Discussed
Simultaneous regulatory change as an enterprise governance problem: Why 340B, IRA, and site-neutrality pressures arriving at once can't be managed as a pharmacy compliance task — and why eligibility risk often originates in payer-mix and service-line decisions made outside pharmacy entirely.
Workforce shortages as structural, not cyclical: How declining enrollment is pushing systems upstream into tuition-covered scholars programs, technician career ladders, and high school outreach — and why retention is shifting from a pay problem to a flexibility-and-development problem
Business acumen as the new core leadership skill: Why pharmacy asks compete with towers, elevators, and imaging equipment for capital, why pre-socializing the ask with the CFO works, and why strategic positioning matters more than the reporting line
Build-vs-partner decisions getting more deliberate: How leaders are treating partnerships as time-bound bridges — crawl, walk, run, then bring it in-house — and building only what's core to their identity and can scale
Infusion and revenue cycle as pharmacy's growth engine: Why clean site-of-care data is the prerequisite for capturing infusion volume, and how revenue-cycle maturity is earning pharmacy a permanent seat at the enterprise table
"Get us started — help us crawl, walk, and when we're in a run, [we'll] let you go."
By the numbers: One system's university scholars program produces roughly 16 new pharmacists a year with tuition covered and employment guaranteed. Another grew open-position fill from 8 to 90 through a technician training program — with zero openings at its children's hospital. Home infusion runs a 1:1 nurse-to-patient ratio versus roughly 1:4 in an ambulatory suite. One system identified tens of millions in annual infusion leakage before making its internal business case. And one revenue-cycle function took eight years to build to 30-plus FTEs — a team revenue cycle now won't finalize a new charge master without.
Why This Matters for Industry
For industry partners, these conversations carry a direct message about how pharmacy leaders now think about partnership: as a bridge, not a permanent arrangement. Leaders described partnering to move fast with an explicit plan to bring capabilities in-house later — one analytics buildout started with a third party and was rebuilt by the system's own team five to six years in. That doesn't diminish the opportunity; it defines it. Partners who help systems stand up capability quickly, transfer knowledge willingly, and frame their value in the CFO's language — margin, access, capital efficiency — are the ones getting in the room. Understanding the regulatory pressure, the structural workforce gap, and the build-vs-partner discipline taking hold is essential context for how you position your outreach and frame the value of your solutions.