Pharmacy Organizational Structure: Maximizing Health System Value

Healthcare is becoming more and more focused on value-based care. Providing high-quality, effective, and efficient care to patients relies heavily on the organizational structure of the pharmacy.

At Visante, we’ve seen firsthand the financial and clinical benefits that are achieved through the merging of multihospital health systems. Integration success boils down to structure, accountability, resource allocation, and alignment of expectations.

The Detriment of a Fragmented Pharmacy Structure

Siloed Solutions

The way pharmacy services are provided and how value is quantified varies greatly across health systems. Many health systems have historically divided their pharmacy enterprise into siloed functions—such as ambulatory, inpatient, managed care, and supply chain—that compete for resources and limit the pharmacy’s overall value.

Political Distractions

As pharmacy executives grow ambulatory services into billion-dollar enterprises, they often face internal conflict driven by competing priorities. This makes their role increasingly political, where title and organizational positioning are key to protecting current operations and advancing new initiatives.

Patient Care Under One Roof: A Unified Pharmacy Organizational Structure

Health systems are always looking for solutions that will improve operating efficiency, reduce expenses, and grow revenue. A strong, well-managed internal pharmacy program is one of those solutions. Payers and health system leaders are increasingly recognizing pharmacy as a strategic asset—one that has long been undervalued and underutilized, but holds significant potential to drive clinical and financial outcomes.

There’s great opportunity when pharmacy operations are all brought together under a unified enterprise structure. When a pharmacy executive is reporting directly to the highest level of system organizational leadership, they consistently outperform those who don’t.

Team of pharmacists smiling.

The BwB Model: Pharmacy as a High-Performing Business

The “Business within a Business” (BwB) model simply means running internal service functions in an entrepreneurial fashion (much as one would a standalone business). The BwB model gets everyone on the same page and invested in the success of the pharmacy. It promotes a culture where people work together, think creatively, operate efficiently, focus on the patients, and drive both business and quality improvements.

The Many Facets of a Successful Pharmacy Program

Building a high-performing pharmacy enterprise is varied and complex. It requires alignment in a plethora of areas, including:

Graphic of lightbulb.
  • Business development and oversight
  • Acute and ambulatory pharmacy operations
  • Medication access
  • Patient care services
  • Transitions of care
  • Retail and specialty pharmacy
  • Supply chain and logistics
  • 340B
  • Revenue cycle management
  • Skill mix optimization
  • Site of care (infusion and home infusion) strategy
  • Information technology and informatics
  • Compliance and regulatory accreditation

A Major Tool in Modern Healthcare: Telehealth

Telehealth is a foundational element of healthcare delivery. Health systems are accelerating the development of care models that fully integrate virtual capabilities to improve patient management across the continuum.

These models are designed to reduce costs, prevent avoidable readmissions, and expand access to care for patients who are geographically isolated or prefer receiving services from the comfort of home. By leveraging telehealth as a core component of care coordination, organizations can enhance patient engagement and drive operational efficiency.

Telehealth appointment.

Transforming Pharmacy into a Strategic Asset for Your Health System

Strong results rely on aligned structure with clear oversight. Organizations that recognize a comprehensive, integrated BwB approach to pharmacy produce significantly better outcomes than the traditional fragmented model. Investing in an internal pharmacy enterprise will improve patient safety and clinical outcomes, reduce total cost of care, and generate positive financial returns.

If you’re looking for help with your pharmacy organizational structure and would like to improve patient care and clinical outcomes, get in touch with Visante! Our expert team is ready to develop custom pharmacy solutions that will propel your health system forward.

 

May 20th, 2025
go back