Becker’s asked pharmacy executives from hospitals and health systems across the U.S. to share the most underappreciated trends in healthcare today.
The 22 executives featured in this article are all speaking at the Becker’s Healthcare Spring Chief Pharmacy Officer Summit, from April 15 – 16, 2026 at the Hyatt Regency Chicago.
To learn more about this event, click here.
If you would like to join as a speaker or a reviewer, contact Mariah Muhammad at mmuhammad@beckershealthcare.com or agendateam@beckershealthcare.com.
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As part of an ongoing series, Becker’s is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Question: What are the underappreciated trends in healthcare today that deserve more attention?
Muhammad Xhemali, PharmD. Director of Pharmacy at Family Health Center of Worcester (Mass.): Pharmacy is the earliest and most frequent touchpoint in the patient journey, yet it is rarely used as a systemwide signal. Refill gaps, therapeutic duplication, and benefit barriers are actionable within pharmacy workflows if leaders wire them to care management. Automating routine billing reconciliations and eligibility checks frees pharmacy teams from low-value work, creating bandwidth to expand direct patient services. Pairing this with AI that flags risk earlier and streamlines decision support turns pharmacy into the operating platform for risk detection and access, positioning organizations to succeed in value-based care.
Erica Marchese, PharmD. Clinical Pharmacy Program Director of City of Hope (Duarte, Calif.): A key underappreciated trend is the insufficient focus on workforce well-being. While burnout is widely acknowledged, concrete action remains limited. Ongoing issues, including documentation burden, staffing shortages, regulatory complexity, and moral distress, are directly impacting patient care. Health systems must move beyond asking staff to simply cope and instead prioritize redesigning work to improve patient safety, financial sustainability, and the adoption of innovation.
Bickkie Solomon, PharmD. Director of Pharmacy, and Director of Residency Program Director PGY-2 HSPAL at HCA Florida North Florida Hospital; Assistant Professor of Pharmacy at West Coast University (Irvine, Calif.): The underappreciation of AI in pharmacy often stems from a widespread fear that it will replace pharmacy personnel, rather than support them. This misconception overlooks the transformative potential of AI when applied thoughtfully. Combining AI for Operational Efficiency with Ambient Clinical Intelligence creates a powerful framework for USP <797>/<800> compliance. AI can optimize staffing, supply chain, and scheduling, while ACI ensures real-time documentation of compounding activities, environmental monitoring, and personnel behaviors. Together, they reduce manual errors, enhance audit readiness, and support continuous quality improvement. Crucially, AI augments pharmacy teams — it automates routine tasks so professionals can focus on high-value clinical and regulatory work, strengthening system resilience without compromising safety or standards.
Charlene Hope, PharmD. Chief Pharmacy Quality and Safety Officer of University of Chicago Medicine: One of the most underappreciated trends in healthcare is recognizing quality as a core business strategy, not just a regulatory requirement. Too often, safety and quality are viewed as compliance checkboxes rather than drivers of financial performance. In reality, preventable harm and poor outcomes carry enormous costs. Organizations that treat quality as a strategic asset — not an expense — unlock better patient outcomes, stronger margins, and lasting competitive advantage.
Matthew Rim, PharmD. Chief Pharmacy Officer of Ambulatory Services at Northwestern Medicine (Chicago): One of the most underappreciated trends in healthcare is the quiet shift of high-acuity, high-cost, high-touch care into ambulatory spaces without a development or redesign of pharmacy delivery model. We often talk about home infusion, specialty pharmacy, or cell and gene therapies in isolation, but the deeper trend is the blurring of lines between hospital-level care and community/ambulatory-level delivery. This shift is accelerating, yet it is happening unevenly, and it demands a rethink of how we staff, finance, and measure success in pharmacy.
Matthew Eberts, PharmD, MBA. Senior Director of Hospital Clinical Operations at Lancaster General Hospital (Pa.): There are a number of forces at play as we move into 2026 that are going to significantly increase the financial strain on health systems. Regarding revenue, decreases in Medicaid enrollment as well as the end of subsidies for individuals purchasing insurance on the health exchange will result in more uninsured patients. We are also seeing decreases in reimbursement due to Medicare expanded site-neutral payment, and payment reductions for certain outpatient services. At the same time, we have pressures on the expense side including the increasing cost of labor, supplies, equipment and technology. Critically, we will see 340B savings put at risk in 2026 due to decreased entity DSH days (due to decreased Medicaid patients), the 340B rebate pilot replacing upfront savings, and continued restrictions on contract pharmacies. The ability for healthcare systems to maintain a viable margin is going to only get harder.
Joshua Weber, PharmD. Senior Director of St. Luke’s Health System (Boise, Idaho): Trend 1:
Healthcare’s future is shifting from hospitals to high-efficiency hubs and the rise of centralized service centers integrating ancillary support services (e.g., centralized prior authorization, benefits verification) with automated dispensing and fulfillment under one roof. AI-driven solutions are also crucial to unlock access, improve margins, and reduce burnout.
Trend 2:
Care and costs are shifting rapidly out of hospitals and into outpatient services like pharmacy, ambulatory infusion suites, and home health which are projected to outpace hospital EBITDA growth as patients and payers prioritize lower-cost sites of care. Health systems that blend these care-model shifts with digital tools such as advanced data analytics, agentic AI, and omnichannel call centers will be well-positioned to thrive and capture additional revenue pools.
Trend 3:
Finally, specialty and rare disease pharmacies (including cell and gene therapy) are quietly becoming a growth engine and the future of biopharma investment, with hospital-owned programs projected to exceed 10% EBITDA CAGR through 2028. This is fueled by new therapies, site-of-care shifts, and evolving 340B dynamics and will support the more than 400 million people worldwide living with one of 7,000 rare diseases still waiting for an FDA approved treatment as there are currently <7%.
William Lee. Senior Director of Pharmacy System Innovations at Carilion Clinic (Roanoke, Va.): Remote Patient Monitoring (RPM):
- Appreciation Status: RPM is widely recognized in policy and reimbursement frameworks, but actual front-line adoption and evidence-based application are still limited, particularly in at-home care and among diverse patient populations.
- Underappreciated Synthesis: While RPM has experienced explosive growth, its utilization is concentrated, inconsistent, and under optimized, particularly outside clinical offices. From a strategic and clinical impact standpoint, remote patient monitoring can be considered an underappreciated trend, as its full potential for improving access, chronic disease management, and cost efficiency has not yet been fully realized across the healthcare system. The underappreciation stems not from lack of awareness, but from low penetration, inconsistent application, and incomplete integration with evidence-based care. Scaling RPM effectively will require better oversight, integrated workflows, and targeted implementation in high-need populations.
Hospital-at-home (HaH):
- Appreciation Status: Hospital-at-home (HaH) programs deliver hospital-level acute care within patients’ homes, combining telehealth, remote patient monitoring, and in-person visits from clinicians. Despite clear benefits, these models remain underutilized, and adoption has been slower than their clinical and economic promise suggests.
- Underappreciated Synthesis: Hospital-at-home is an underappreciated evolution of modern healthcare, offering simultaneous clinical, economic, and patient-centered benefits. Its slow adoption stems less from a lack of awareness and more from policy uncertainty, logistical and technological hurdles, and ingrained hospital-centric healthcare culture.
Medication Guidance and Preventive Health:
- Appreciation Status: Pharmacists now extend beyond dispensing to actively manage medication therapy and preventive services. Although, the professional identity of pharmacists is still largely tethered to medication distribution. This creates a perception gap among patients, other health professionals, and health systems, obscuring pharmacists’ broader preventive and population health contributions.
- Underappreciated Synthesis: The underappreciation of pharmacists in community and population health is multi-factorial, stemming from historical professional identity, systemic policy limitations, educational gaps, public perception, and insufficient dissemination of impact evidence. Strategic recognition, policy integration, reimbursement reform, and educational expansion are essential to fully leverage pharmacists’ unique accessibility, pharmacotherapy expertise, and public health contributions.
Wearable Devices for Continuous Clinical Monitoring:
- Appreciation Status: Wearables are evolving from fitness trackers to medical instruments reporting heart rhythms, glucose, or sleep patterns in real time. Despite rapid technological advancements and clear clinical potential, wearable devices in healthcare remain an underappreciated trend due to a complex interplay of technical, systemic, and sociocultural factors. Clinicians underuse this data for intervention planning, partly due to concerns about accuracy and integration with electronic health records.
- Underappreciated Synthesis: Wearable devices remain underappreciated in healthcare due to evidence gaps, integration challenges, regulatory barriers, unequal adoption, and cultural perceptions. However, their potential for transforming preventive care, chronic disease management, and patient empowerment is considerable. Strategic focus on clinical validation, interoperability, equitable access, and integration into value-based care models is essential to move wearables from a niche trend to a mainstream healthcare tool.
Patient Experience and Engagement as Clinical Determinants:
- Appreciation Status: Enhanced digital patient interfaces, real-time updates, and personalized communication improve adherence and outcomes. Yet many institutions focus merely on operational efficiency, underestimating patient experience as a driver of measurable clinical results.
- Underappreciated Synthesis: Despite the mounting evidence that patient experience and engagement (PX/PE) are pivotal to clinical outcomes, operational efficiency, and cost containment, these factors remain underrecognized as core clinical determinants. Patient experience and engagement are clinically potent determinants influencing adherence, chronic disease management, preventative care uptake, communication quality, and overall health system efficiency. Yet, entrenched biomedical paradigms, fragmented responsibilities, measurement challenges, digital inequities, incentive misalignment, and cultural inertia collectively contribute to their underappreciation.
Conclusion:
These trends illustrate the subtle yet transformative forces shaping modern healthcare. While high-profile areas like AI in diagnostics or telemedicine expansion receive substantial attention, these underappreciated trends hold considerable promise to improve outcomes, efficiency, and patient-centered care if strategically adopted and scaled. Providers and stakeholders who recognize and invest in these domains today may define the next wave of impactful change in healthcare.
Stephanie Goldman, PharmD. Vice President of Pharmacy at Tower Health (West Reading, Pa.): One underappreciated trend that deserves far more attention is the increasingly strategic role of pharmacists in value-based care and the ambulatory care setting. Pharmacists are uniquely positioned to improve clinical outcomes, reduce total cost of care, and drive medication adherence — especially in populations managing chronic conditions or complex regimens. Yet their potential is still under-leveraged in most healthcare systems. Another area with transformative potential is improving access to specialty care through collaborative practice agreements. By establishing formalized partnerships between pharmacists and providers — particularly in underserved or high-demand therapeutic areas — we can extend the reach of care teams, close care gaps, and accelerate time to treatment. This is especially powerful in areas like cardiology, and endocrinology, where wait times can delay care and worsen outcomes. Both trends highlight how a more integrated, pharmacy-enabled model of care can address systemic challenges while aligning with value-based goals.
Jorge J. Garcia. Assistant Vice President of System Oncology, Infusion and Investigational Drug Pharmacy Services at Baptist Health South Florida (Coral Gables, Fla.): Vast opportunities continue to emerge within specialty infusion, yet infrastructure and process development remain unmet needs for most provider organizations. The current landscape of therapies, coupled with a rapidly expanding pipeline, create a unique moment of opportunity to expand patient access, deliver cutting-edge treatments, and diversify both service offerings and revenue streams. Over the past five years, I have largely dedicated my career to validating specialty infusion models across therapeutic areas and distinct markets; one thing is clear, a tailored practice design and a strategy that is sensitive to the local market, is pivotal for service line success.
Barbara Higgins, PharmD. Director of Pharmacy at Michigan Medicine (Ann Arbor): Healthcare is just starting to appreciate the impacts of cyber-attacks and the need to prepare. For decades we have been preparing for chemical, biological and infectious disease disasters. The COVID-19 pandemic illustrated that we were underprepared for something for which we had spent years preparing. Just one of the issues related to cyberattacks is that the preparation includes reverting back decades of technological advances to paper, pens and hardcover reference books to protect ourselves from data breaches of patient information and malware designed to shut down our infrastructures. Our technology, at even a basic level, is very assistive and many healthcare workers have never worked without it. For example, we may have to remind prescribers how to write inpatient orders or outpatient prescriptions since there will be no prompts for including all of the necessary information.
Michael Stepanovic, PharmD. Assistant Professor, UNC Eshelman School of Pharmacy (Chapel Hill, N.C.): From the pharmacy lens, one underappreciated trend is how payer vertical integration continues to squeeze health system margins while pharmacy leaders are simultaneously tasked with creating sustainable operations that still deliver ROI. This is driving renewed focus on supply chain innovation, such as leveraging 503B outsourcing, robotics and shared services models; not just to cut costs but to improve safety and scalability. These same shared service infrastructures are becoming essential enablers of hospital-at-home programs, where pharmacy logistics such as cold-chain delivery, courier contracts, and remote medication management often determine success. Beyond that, shared services can streamline formulary management, centralize prior authorization teams, and create systemwide approaches to shortage mitigation that individual sites could never achieve alone. Health systems that view pharmacy not only as a cost center but as a strategic driver of integration, resilience, and new care models will be best positioned to thrive in the years ahead.
Nick Gazda, PharmD. Director of Pharmacy Oncology and Infusion at Cone Health (Greensboro, N.C.): While technology and AI remain at the forefront of conversations in healthcare, it is important to focus on what this enables for our clinicians. There will continue to be an evolution towards personalized medicine as well as complex cellular and gene therapies. Systems must focus on improving and optimizing access of these services to patients in a cost effective and business sustainable fashion. This includes investment in their pharmacy services and infusion strategies.
David Coriale, PharmD. Director of Pharmacy at Finger Lakes Health (Geneva, N.Y.): I believe there are many unappreciated trends in healthcare.
The main concern is the for profit American healthcare insurance industry. The trend continues to maximize profits for the shareholders and develop niche medications. Our healthcare system is based on quality treatment of acute care or trauma but fails to move towards preventing and treating chronic conditions. The oncology and specialty, while needed, fails to serve the majority of the population.
In addition, the failure of the federal government to recognize pharmacists as providers severely limits the ability for revenue generation which can be invested directly into the community.
Dmitry Walker, PharmD. Director of Pharmacy, Oncology and Investigational Drug Services at WVU Medicine (Morgantown, W.Va.): One of the most underappreciated trends in healthcare today is that access to the most beneficial and safest medications for patients is becoming more complex, expensive, and challenging to coordinate for both patients and clinicians. This is happening despite health-systems, independent practitioners, and our society as a whole investing more resources than ever towards providing the best treatment access to patients in the United States. A truly successful medication access model requires proactive, continuous, and seamless interdisciplinary collaboration between all stakeholders who play a part in the patient’s treatment journey. Healthsystem pharmacy service lines have an opportunity to make a huge positive impact on this work within their organizations.
Katherine DeSanctis, PharmD. Pharmacy Director of Home Hospital at Mass General Brigham Healthcare at Home (Somerville, Mass.): The way we deliver care is evolving to better reach patients where they are. From mobile community care programs to hospital-at-home service lines, health systems are revolutionizing access to safe and timely care. These innovative models introduce new approaches to clinical operations and medication use processes. We have a solid foundation of medication safety studies and standards from traditional settings. Now, we have a unique opportunity to adapt these standards to innovative care environments and develop new ones as necessary.
Yahya Ahmed, PharmD. Pharmacy Director Associate of UK HealthCare (Lexington, Ky.): Healthcare systems face mounting financial pressures, necessitating innovative strategies to optimize resources and improve care delivery. One promising approach is the expansion of pharmacist-led ambulatory clinics. Traditionally focused on anticoagulation and transplant management, these services have now broadened to encompass areas such as urinary tract infections, weight management, and population health. Evidence consistently demonstrates that pharmacists in these roles enhance patient outcomes while alleviating the workload of other healthcare providers.
To fully realize the potential of this model, efforts must be directed toward achieving payment parity at state and national levels. Recognition by health insurance providers is essential to sustain and further expand pharmacist driven care as a cost effective, patient-centered solution with potential to create new revenue streams for health systems.
Edith Okolo, PharmD. Director of Pharmacy at Cedar Crest Hospital (Belton, Texas): Home-based healthcare has always existed but was never taken advantage of until during COVID. Homecare has been a growing industry for years. People are more comfortable seeing providers from the comfort of their homes, with increasing chronic conditions, insurance costs and rising cost of healthcare generally, demand for home health is surging. There is a need to create a network of healthcare providers and allies who can manage patients’ care directly from the patient’s home and virtually.
The need to utilize telehealth and AI becomes inevitable as they have come to stay and will facilitate the management of patients in the comfort of their homes. The healthcare industry is ever changing, requiring the development of forecasting systems to enable organizations to make necessary adjustments to accommodate the trends just as we have outpatient, ambulatory care. Organizations evolving with changing times and trends remain relevant and are financially stable.
Increase in Health Information and knowledge have led a lot of patients to self-prescription, self-medication and treatment. There is a need to develop a system that manages this societal ill. Provides should be easily accessible to patients. More people are self-medicating now than ever. People’s first response to any ailment is to google the issue and use home remedies and herbals before turning to healthcare. Which has led to a delayed diagnosis and untimely treatment of serious diseases. There is the tendency of lack of objectivity, goal of treatment, professional judgment or opinion
Gene therapy is all about precision medicine, which enables the matching of patients to medications they most benefit from. This eliminates failure of therapy and optimizes therapy and cost. It identifies genetic variations linked to disease and drug responses. Targeted therapy can be utilized in our various clinics and hospitals to predict patient response, relationship between gene, disease and drugs.
Brian Dotter, PharmD. Senior Director of Pharmacy at St Luke’s Boise Medical Center (Boise, Idaho): One of the underappreciated trends in healthcare is pharmacy’s involvement in the revenue cycle. Hospital pharmacies must be recognized not merely as cost centers, but as critical contributors to financial operations. Their role in billing, reimbursement, and chargemaster accuracy ensures proper and timely medication reimbursement. This stewardship becomes even more vital as hospitals expand into complex service lines like infusion and specialty pharmacy, where billing intricacies can significantly impact margins.
John Pastor, PharmD. President of Fairview Pharmacy Services (Minneapolis): Reclaiming the mission: Differentiators that matter
- Every competitor says they care about patients. But when your business model flows profits back to shareholders instead of communities, the mission breaks down.
- In a market where lock-in contracts are the norm, the differentiator is not just price, it’s transparency. Health systems deserve full visibility into utilization, spend, and opportunities. The systems that insist on keeping their data and building internal competency, with outside partners playing a supporting — not owning — role, will be the ones best positioned long-term.
- Many health systems don’t realize how much leverage they have to run their own pharmacy and PBM models. The prevailing industry narrative suggests you must hand over your data, your contracts, and your economics to national players. But there’s a growing recognition that systems can and should retain control. The trend worth watching: “do-it-yourself with the right partner” versus “outsourcing everything.”
Danielle Sestito, PharmD, MBA. Assistant Vice President of Pharmacy Services at Northwell Health (New Hyde Park, N.Y.): Growth of Specialty Pharmacy and Complex Therapies
The upsurge of cell and gene therapies is reshaping pharmaceutical distribution. These treatments bring major supply chain challenges, especially with ultra-cold storage and transport. Their personalized, patient-specific nature requires exact handling and seamless coordination across providers, manufacturers, and specialty pharmacies. This is creating a whole new model for how medications move through the channel. Future success will depend on how well we adapt our systems to meet these new demands.
Tim Affeldt, PharmD. Vice President of Specialty/Infusion Operations at Fairview Pharmacy Solutions (Minneapolis): The movement of care out of hospital departments to the home is a trend that is underappreciated.
