Becker’s Healthcare Podcast

Episode Title: Expanding Infusion Services and Driving Value in Pharmacy at Cone Health
Air Date: January 22, 2026
Host: Ella Jeffries (Pharmacy Reporter, Becker's Healthcare)
Guest: Nick Gosda (Director of Pharmacy, Oncology & Infusion Services, Cone Health)

Episode Overview

This episode spotlights the strategic expansion of infusion services at Cone Health, focusing on both oncology and non-oncology offerings. Ella Jeffries and Nick Gosda discuss the organization’s key pharmacy initiatives from the past year, lessons from rapid growth, the importance of cross-functional teamwork, and Cone Health’s approach to financial and regulatory headwinds on the horizon. The conversation explores how pharmacy leaders are driving value, leveraging technology, and preparing their teams to thrive in a changing healthcare landscape.

Key Discussion Points & Insights

1. Role & Scope at Cone Health

00:32 – 01:59

• Nick Gosda leads oncology and infusion pharmacy services for six cancer centers (urban and rural) in Greensboro, NC.
• Also oversees four non-oncology ambulatory infusion sites, a growing centralized medication access team, and partnership alignment with Risen Health, supporting value-based care alongside Kaiser and Geisinger.

2. 2025’s Key Initiative: Non-Oncology Infusion Expansion

02:35 – 04:45

• Formed an interdisciplinary stakeholder team in early 2025 to standardize and align non-oncology infusion services.
• Focuses included:
  • Standardization of processes
  • Patient and provider access
  • Enhanced customer service
• Leveraged centralized authorization and technology improvements, resulting in:
  • 30–40% growth in infusion volumes
  • Less than 2% denials
  • High patient and staff satisfaction

"We've had a lot of success increasing capacity, improving customer service, decreasing turnaround times, really leveraging our technology to have standardized processes."
— Nick Gosda (03:45)

3. Lessons from Expansion

04:45 – 05:40

• Importance of inclusive stakeholder engagement: nursing, acute care, transitions of care, physicians, finance, and revenue cycle.
• Effective change requires structure and cross-disciplinary buy-in.

"Infusion services, just like pharmacy services, touch all aspects of the healthcare enterprise. You can’t do it without nursing...you can't do it without physician champions."
— Nick Gosda (04:59)

4. Priorities & Challenges for 2026

05:48 – 08:19

• Access and Customer Service: Continuing to reduce barriers to care—distance, complexity, and provider burden.
• Driving Value: Emphasizing alternative sites (e.g., home infusions), optimizing the “value equation” (increasing quality/service while decreasing cost).
• Oncology Focus: Adapting to complex/novel therapies (CAR-T, bispecifics) in outpatient settings to keep care local.
• Technology & AI: Expanding AI in prior authorizations and med access to enhance efficiency.

"Value is increasing quality and service and decreasing cost. So how do we do that in oncology? How do we do that in infusion?"
— Nick Gosda (06:28)

5. Major Headwinds

08:19 – 09:16

• Financial and Regulatory Uncertainty: Building resilient, sustainable programs is a top priority.
• Revenue Optimization:
  • Pharmacy rev cycle
  • NDC and biosimilar optimization
  • Net cost recovery and data-driven formulary decisions (ambulatory and acute care)

6. Hardest Challenge for 2026

09:08 – 10:24

• Navigating the dual pressures of financial headwinds and regulatory ambiguity.
• Maintaining high care quality while investing in operational flexibility and financial acumen.

"We're in a unique spot in IDNs...to lean into [innovation] but also figure out how we can still continue to provide support to our patients and high level care."
— Nick Gosda (09:28)

7. Team Preparation & Change Management

10:24 – 11:15

• Promoting transparency and financial understanding among clinical teams.
• Emphasizing change management skills honed during COVID-19 for ongoing rapid adaptation.

"Change management is really is going to be incredibly important...really leveraging those skills and things we developed [during the pandemic] to help manage through a rapid environment change."
— Nick Gosda (10:54)

8. Opportunities for Growth

11:15 – 12:32

• Value-Based Care: Organizational focus is to increase quality/service and decrease costs.
• Pharmacy can drive impact in:
  • Transitions of care
  • Infusion and specialty pharmacy
  • Primary care integration
  • Procurement & revenue cycle improvements

"Pharmacy is really well positioned to intersect quality and cost across the whole enterprise of healthcare."
— Nick Gosda (11:48)

9. Motivation & Keeping Grounded

12:32 – 13:47

• Patient stories and community impact fuel excitement around organizational improvements.
• Noted the tangible benefit: patients don’t have to travel as far for high-quality care, and teams should celebrate the wins.

"It's just really rewarding to see the impact...that patients 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...closer to home."
— Nick Gosda (13:16)

Notable Quotes

• "Really being able to get everyone to the table...and really put structure and get buy in on what support and organizational structure looks like to help see those initiatives through for sure."
  — Nick Gosda (05:22)

• "One thing we'll be focusing on is just a renewed and enhanced focus on pharmacy rev cycle, NDC and biosimilar optimization."
  — Nick Gosda (08:33)

• "We want our clinical and operational teams to be thinking about what's best for the patient...but again, just building that financial acumen, being transparent...how sustainable they are moving forward."
  — Nick Gosda (10:28)

Important Timestamps

• [01:03] – Nick Gosda’s role and department overview
• [02:45] – The most important 2025 initiative: non-oncology infusion expansion
• [03:45] – Specific outcomes: growth, denials, satisfaction
• [04:59] – Lessons learned: stakeholder engagement
• [05:48] – 2026 priorities and value-driven strategy
• [08:19] – Financial and regulatory headwinds impacting strategy
• [09:16] – Hardest leadership challenges
• [10:24] – Preparing teams for rapid change
• [11:25] – Opportunities for pharmacy-driven growth
• [13:16] – Motivation: patient impact and celebrating wins

Episode Tone and Takeaway

The conversation is frank, strategic, and optimistic. Gosda underscores the importance of team collaboration and adaptability, while maintaining a clear-eyed focus on financial realities and regulatory changes. He frequently returns to the core mission of enhancing patient access and quality of care, positioning pharmacy leaders as critical drivers of value in integrated health systems.

For listeners: This episode offers actionable insights for healthcare leaders aiming to expand infusion services, future-proof their pharmacy enterprise, and drive measurable value—even amid shifting headwinds.