At Baptist Health System, specialty pharmacy is more than a service — it’s a strategic lever for improving patient care, reducing administrative burden and managing costs. Leading this effort is Leslie Hurst, PharmD, BCACP, Associate Vice President of Specialty Pharmacy and Pharmacy Benefit Management (PBM) Strategy, who has helped scale the system’s specialty pharmacy operations from a limited presence in a few clinics to a robust network embedded across the enterprise.

Building from the Clinic Out

“When I joined in late 2020,” Hurst said, “we had limited specialty pharmacy services in a couple of our cancer centers and one neurology clinic.” That quickly changed. Today, Baptist has embedded pharmacists and technicians in 40 clinics across 12 specialty disease state programs, with around 10,000 patients enrolled in their specialty pharmacy programs. They have also achieved URAC (Utilization Review Accreditation Commission) and Accreditation Commission for Health Care (ACHC) specialty pharmacy accreditation.

Key to that growth: co-location and seamless integration with the system’s electronic health record (EHR). “All our programs are housed in the same software as our EHR,” she noted. “It’s been really efficient and positive to have pharmacy embedded in our own facilities.”

Why Baptist Built Its Own Specialty Pharmacy

Baptist’s decision to provide its own specialty pharmacy was driven by a few key insights. “We saw the value in having medication experts directly embedded in care teams,” Hurst explained. “It offloaded the administrative burdens for medical assistants and other staff.”

Delivering better care for patients was also a profound motivator. “It allowed us to improve turnaround times, help patients navigate prescriptions and affordability challenges, and support clinical outcomes — including making an impact on their disease states.”

Patient Impact: From A1C Control to Oncology Access

Some of the most compelling proof points have come directly from patients. Hurst recalled patients with diabetes whose A1C blood sugar levels dropped from 12 or 15 (very high) to below 6 (normal is 5.7 or lower) thanks to pharmacist-led interventions.

The program has also provided affordability assistance and secured significant cost savings for program-enrolled patients. One recent example was an oncology patient who had started reducing their oral chemotherapy dose due to cost. “We were able to step in, navigate grants and affordability programs, and help that patient resume their full prescribed therapy,” she said. “We provide this level of financial support for all program-enrolled patients with affordability barriers.”

Challenges Facing the Field

Like many health system specialty pharmacies, Baptist faces persistent barriers around payer network access and evolving reimbursement models. Maintaining strong partnerships with providers such as larger PBMs and seeking more sustainable procurement strategies is a constant focus. “Margins are shrinking,” Hurst acknowledged. “We have to stay proactive.”

Centralizing Fulfillment, Maintaining Clinical Decentralization

In 2024, Baptist took another leap forward with the launch of a centralized pharmacy services center. This move consolidated fulfillment for greater efficiency, speed and cost control — while preserving the decentralized, clinic-based model for clinical care. “We’re proud that we’ve maintained our patient-focused approach while improving operations at scale,” Hurst said.

The Value of HOSP Collaboration

For Baptist, membership in HOSP provides a vital forum for strategy sharing and advocacy. “We’re all facing similar issues — from payer access to regulatory uncertainty,” Hurst said. “HOSP helps bring experts together to share best practices and push for the changes we need.”

She also emphasized the potential for health system owned specialty pharmacies to close equity gaps. “We all serve patients with varying levels of health literacy and access. When we collaborate, we can support one another and patients in ways that go beyond our individual systems.”

Staying Vigilant in a Shifting Landscape

With the future of 340B and other key programs in flux, Hurst stressed the need for readiness. “There are a lot of unknowns. We have to stay ahead of regulatory changes so our patients aren’t the ones who lose.”

Baptist Health System’s specialty pharmacy journey reflects what’s possible when clinical strategy and operational execution are tightly aligned — and when the pharmacy team is embedded not just in the clinic, but in the mission.

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