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Becker’s Healthcare Podcast
Expanding Infusion Services and Driving Value in Pharmacy at Cone Health
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- [00:02]
A
This is where Healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
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B
Welcome to the Becker's Pharmacy Leadership Podcast. I'm Ella Jeffries, Pharmacy Reporter with Becker's Healthcare Today I'm joined by Nick Gosta, Director of Pharmacy, Oncology and Infusion at Cone Health. In this episode, we'll be talking about key pharmacy initiatives from the past year. The priorities and headwinds leaders are navigating as they plan for 2026 and where opportunities for organizational growth are emerging. Nick, thank you so much for joining me today. To start us off, can you please introduce yourself and share a bit about your role in Cone Health pharmacy organization?
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C
Yeah, absolutely. Thanks very much for having me. First and foremost, as you mentioned, my name is Nick Gazza, Director of Pharmacy for Oncology and Infusion Services at Cone Health in Greensboro, North Carolina. Cone Health is a large IDN in central North Carolina. 5 Acute care facilities but an ever growing ambulatory enterprise. So pretty comprehensive pharmacy and general health care services for the citizens of North Carolina. We've recently aligned been about a year in our journey with integration with Risen Health which is the value based care Organization initiative supported by Kaiser and Geisinger and Cone Health. So really exciting year for their growth and looking forward for healthcare in North Carolina. At Cone Health my role I oversee oncology and infusion services. We have six cancer centers in both urban and rural areas. In our service area we have on site clinical and infusion services at all six also have oversight of our non oncology ambulatory infusion strategy. We have four non oncology infusion sites and growing and also continuing to grow and invest in centralized authorization and medication access team to help with throughput for our infusions and our outpatient pharmacy prescriptions.
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B
Great. Thank you so much for sharing that context. Now, looking back over the past year, what was the most important initiative that you led? What did you focus on and what results did you see?
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C
Yeah, absolutely. We had a lot of growth and success continuing to provide great services for patients across oncology and fusion in our patient access team. I think what I'd focus on it will be a focus at the Beckers Conference is the continued advancement of the infusion strategy for our organization, particularly in a non oncology space. It's an area that we've been providing services for a long time for patients. But really in the beginning of 2025, we identified the need to kind of get an interdisciplinary group of stakeholders together to really talk strategically and align our non oncology infusion services across the organization and look at things like standardization, patient access, customer service from both a provider and patient perspective. And really proud of the work we've done in the past year to help shepherd that strategy along. It was very much a team effort with our nursing colleagues, with our acute care colleagues, with Rev cycle and finance really all aligning and leaning into a shared goal to increase and improve services for patients. And so we've had a lot of success increasing capacity, improving customer service, decreasing turnaround times, really leveraging our technology to have standardized processes, fully centralizing authorization and med access services. And that's really allowed us to see some success with 30, 40% growth in infusion volumes, denials less than 2% and generally high patient and employee satisfaction through those. So really excited about continuing to grow those services. Infusion services are just incredibly important strategic opportunities for health systems across the country.
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B
Definitely. That's a great example. Thank you for sharing. Now, as you went and were expanding those services, what lessons did you take away from that experience? Whether it was from the successes or the challenges of that expansion?
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C
Just with a lot of things that I've learned across healthcare in general is that infusion services, just like pharmacy services, like a lot of other things, touch all aspects of the healthcare enterprise. So it's really important to get all the stakeholders at the table. You can't do it without nursing, you can't do it without transitions of care in acute care, you can't do it without physician champions. So really being able to get everyone to the table to have those conversations and really put structure and get buy in on what support and organizational structure looks like to help see those initiatives through for sure.
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B
Thank you for sharing. Now, looking ahead, what are the big priorities and headwinds you're focused on as you plan for 2026?
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C
I think 2026 is going to be a big year growth for us, really focusing on access and customer service. Now that we've kind of established, using infusion services as an example, as we established strong infrastructure and foundation for a lot of the services I oversee, really like I said, really focusing on what that next step is, how far do patients have to travel for care, how much effort it takes for providers to get patients the care that they need. How do we remain competitive in a growing area? I think those are all going to be really, really important things. Maybe a more specific example of what some things we're looking at and aligns with some of the organization's goals. How do we drive value infusion services? For instance, a great opportunity for us to continue to lean into is alternative sites of care for infusion and always bring it back to the value equation. It's really simple. Value is increasing quality and service and decreasing cost. So how do we do that in oncology? How do we do that in infusion? Looking at things like home infusion, home infusion suites, different care models that are both clinic or are going to be the most clinically and financially advantageous for our patients and for the organization, I think is going to be important. Some other areas I'd focus on, particularly in the oncology space. Novel therapy and enhanced clinical services. We've historically been a community based cancer center, but we're seeing these complex novel therapies, bispecifics, car t becoming more easily done in outpatient space, moving up in clinical guidelines. So really investing in the clinical and operational expertise that we need to help keep care local for our patients. And then lastly, and I'll be remiss not bringing it up, it's kind of buzzy, but leveraging technology and AI and processes where applicable. We've partnered with vendors to bring prior auth AI to prior auths and medication assistants are continuing to expand on that and looking to be efficient and be the best steward of our resources to care for our patients.
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B
Wow, those sound like some great priorities that are definitely going to make a really positive impact on patient care. Now, in terms of headwinds, what challenges are you foreseeing and how are those shaping your strategy right now?
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C
Yeah, absolutely. I mean, I think, you know, in the coming year, you know, we're, we're going to continue to navigate through financial headwinds and regulatory uncertainty. So we're doing what we can to implement business sustainable programs to help insulate from this uncertainty. Really building business acumen across our clinical teams as well to really understand the importance of that. One thing that we're going to be doing and focusing on is just a renewed and enhanced focus on pharmacy rev cycle, NDC and biosimilar optimization. Focus on net cost recovery. Really leaning into formulary decisions not just on the acute care, but in the ambulatory space as well, to really help us reinvest that into our patient Care services.
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B
Now, along with those priorities do come some tough decisions. What's the hardest thing that you're going to have to tackle in the coming year as a pharmacy leader?
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C
Yeah, absolutely. I think again, I think it's going to be navigating those financial headwinds and regulatory uncertainty. I think it's certainly been a challenge and a common theme over the last couple years that we are in a constantly changing environment. There's a lot of opportunity for innovation and reform in how we provide health care. And so we're in a unique spot in IDNs to lean into that but also figure out how we can still continue to provide support to our patients and high level care to our patients. And so those are. I think that's going to be really hard. And again, a lot of the things that we're doing in the last question is just continuing to try to build processes that can navigate those headwinds. Really develop financial acumen amongst our team is going to be really important as we continue to lead in an environment of uncertainty.
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B
Definitely. And within those challenges and headwinds, how are you preparing your team to embrace them or tackle them in the new year?
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C
Yeah, that's a great question. I think again, something that I always do with our teams is, you know, in the past maybe it's felt taboo. We want, you know, we want our clinical and operational teams to be thinking about what's best for the patient in front of us. But again, just building that financial acumen, being transparent around, you know, the things that we're doing and how sustainable they are moving forward and just also just leaning in the change. Change management is really is going to be incredibly important and has been and we, you know, with the COVID 19 pandemic we kind of got a crash course and comfortability with how what it is to change, you know, in a quick manner and really leveraging those skills and things we developed to help manage through a rapid environment change that we have in healthcare right now.
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B
Gotcha. Thank you for sharing that. Now, even with those challenges, there are still areas for growth. Where do you see the best opportunities for organizational growth moving forward?
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C
Absolutely. You know, for me, when you think about the organization as a whole, it's really about focusing on value based care. Again, going back to that value equation. What can we do to increase quality and increase service and decrease costs. And so all of our priorities and opportunities should really be focused on trying to drive one of those levers. Taking them down to the pharmacy department and pharmacy enterprise Pharmacy is really well positioned to intersect quality and cost across the whole enterprise of healthcare, whether that's transitions of care, infusion, specialty and community pharmacy, pharmacy's presence in population, health and primary care, procurement and rev cycle. And so I think we continue to have an opportunity to elevate pharmacies presence and expertise across the continuum to continue to drive organizational growth and again reinvest those into our patient care efforts.
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B
Definitely it's an exciting time. And what would you say excites you most about those opportunities?
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C
Yeah, that's a great question. I think it's, you know, I really love to see programs grow and being able to reinvest what we're doing to help patient care just to you know, see what we can do and navigate through some of that change and just you know, really keep, keep ourselves grounded in our, in our staff meeting, in our patient care, huddles around those patient stories and how we're making an impact on our patients. A lot of the examples I provided earlier around grow and infusion services, new complex therapies. It's just really rewarding to see the impact that the patients they had that they don't have to travel an hour and a half for their care anymore that we're able to provide state of the art care and provide new access points to patients here closer to home. So, so it's really rewarding to see the other side of that sometimes in the day to day in the minutia. We don't always celebrate that as much as we should but always like to keep it grounded in that and really excited to see the impact on the community that can have.
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B
Definitely. I couldn't agree more. You definitely need to celebrate those wins. Well Nick, this has been a great conversation. Thank you so much for sharing your perspective and insights with us. That's all for today's episode of the Becker's Pharmacy Leadership Podcast. A big thank you again to Nick Gosda for joining us to discuss pharmacy priorities, challenges and opportunities at Colton Out. Thanks for listening and we'll see you next time.