As regulatory pressure mounts and workforce shortages persist, Louisville, Ky.-based Baptist Health System is positioning pharmacy as a safeguard for medication access and a driver of system growth.
On an episode of the “Becker’s Pharmacy Leadership Podcast,” Nilesh Desai, chief pharmacy officer at Baptist Health, discussed how the eight-hospital system is navigating 340B uncertainty, Inflation Reduction Act changes and staffing constraints — while investing in technology and data infrastructure to prepare for the future.
Among the most pressing challenges he noted are evolving 340B requirements, shifting Medicaid dynamics and medication access — particularly as community pharmacies continue to close.
“Medication access continues to be one of the biggest challenges,” Mr. Desai said. “As a lot of these pharmacies are closing and are going to close depending on how the financial viability turns out, at the end of the day we still have to figure out a way to provide patients with access to medications.”
To address those gaps, Baptist is exploring alternative models to ensure patients can access medications after emergency department visits or hospital discharges.
“We’re looking at other options where we can deploy kiosks or some type of technology,” he said. “So when they come to the ED and they need some medications, we can have those medications be available for them.”
At the same time, Mr. Desai said staffing shortages remain a major constraint, making automation and technology essential.
“One thing we don’t want to do is keep adding FTEs,” he said. “We’ve been dealing with pharmacy technician shortages for the last 15 years, and that hasn’t improved significantly. We’re also dangerously entering pharmacist shortages.”
Instead, Baptist is focused on using technology to meet growing compliance and reporting demands without expanding headcount.
“The goal is [to] leverage technology to continue to do what we need to do,” Mr. Desai said. “These requirements that are out there now — we’re exploring the right partnerships so that we can do things the right way.”
With multiple initiatives competing for attention, Mr. Desai said pharmacy leadership is constantly reassessing priorities.
“Anything that is patient safety or regulatory, those always are up there,” he said. “But even financial projects that affect the bottom line — anything that we can be efficient, anything that we can grow our services, these three always rise to the top.”
Looking to 2026, Baptist’s pharmacy team is preparing for deeper interoperability, expanded analytics and growing AI integration.
“We’re normalizing a lot of our data, building a lot of dashboards out and getting prepared for the AI,” Mr. Desai said. “I call it the AI invasion, but it’s more how do we leverage AI so that we can continually become more efficient.”
That preparation includes formal AI governance. Baptist has established systemwide AI committees, with pharmacy playing a central role in evaluating new tools.
“Anytime we want to bring an application that provides some type of AI functionality, we really go through the process of vetting it out,” Mr. Desai said. “What is the ROI? What are we trying to achieve by bringing this AI application in?”
He said measuring outcomes — whether tied to quality, employee satisfaction or financial performance — is critical before scaling AI use.
Beyond technology, Mr. Desai emphasized pharmacy’s expanding influence across specialty care, outpatient services and value-based models. Specialty pharmacy, antimicrobial stewardship and home infusion represent some of the fastest-growing areas of impact, he added.
“If you compare 10, 15 years ago to what it is today, it’s literally apples and oranges,” he said. “Pharmacy now is at the forefront.”
