Joshua Weber, PharmD, MBA-HCM, CSP, BCMTMS, 340B ACE, Senior Director, St. Luke's Health System

Summary

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Podcast Summary: Becker’s Healthcare Podcast

Guest: Joshua Weber, PharmD, MBA-HCM, CSP, BCMTMS, 340B ACE, Senior Director, St. Luke's Health System
Host: Ella Jeffries, Becker's Healthcare
Date: January 10, 2026
Episode Focus: Recent pharmacy initiatives, leadership priorities, headwinds, and growth opportunities in U.S. health systems—spotlight on St. Luke’s Health System

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Episode Overview

This episode features Joshua Weber, Senior Director at St. Luke’s Health System, who shares insights into recent pharmacy innovations, organizational priorities for 2026, challenges ("headwinds") shaping pharmacy strategy, and forward-looking opportunities. The conversation outlines how St. Luke’s is building a patient-first model, innovating with technology, and preparing both staff and operations for the rapidly evolving healthcare landscape.

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Key Discussion Points & Insights

1. Introduction to St. Luke’s Health System and Joshua Weber’s Role

[00:29]

• St. Luke’s: Idaho-based, non-profit, community-owned health system serving southern and central Idaho, eastern Oregon, and northern Nevada.
• Weber oversees ambulatory med access, retail, and specialty pharmacy.
  • 25,000 patient lives supported, >850,000 ambulatory prescriptions annually, on track for 1 million/year.
• Emphasis on patient-centered care: “Patients today want easier access, fewer handoffs, faster answers, transparency around cost, and really confidence that someone is advocating for them.” (Joshua Weber, [00:53])
• Vision: Become the community’s most trusted partner in health—pharmacy as a key pathway.

2. Critical Pharmacy Initiatives (Last Year)

[02:01]

• Investments for a "future ready, patient first" pharmacy model:
  • Paperless workflows systemwide: multilingual/video education, reduced verification delays, sustainability (projected to save 2 million papers from landfill).
  • Lean Six Sigma workflow redesign: Bottleneck elimination, improved delivery, especially for chronic/complex care.
  • Central Service Center fill engine (automation): Phase one will improve prescription turnaround, set stage for further automation.
  • AI-enabled prior authorization (PA) and appeals: PA times cut from 15-20 minutes to under 5, leading to faster therapy starts and fewer delays.
  • Expanded access: Secured payer and limited distribution drug networks for 5 new specialty/rare disease medications, 5,000 more patient lives covered.
  • Centralized benefit investigation in EHR: Proactive patient guidance to St. Luke’s pharmacies for better continuity, affordability, and outcomes.
• Josh’s core philosophy: “When access is delayed, outcomes and trust suffer.” ([03:55])

3. 2026 Priorities and Headwinds

[04:33]

• Central Service Center Central Fill Pharmacy Launch:

  • Integrated, robotically assisted environment for specialty, home delivery, and central fill. “Integration and centralization matters because patients don’t experience care at silos, they experience it as one journey.” ([04:54])

• Workforce retention and growth: Commitment to engaged, supported employees as drivers of patient care excellence.

• Advancing Value-based/Population Health Models: Aligning with shared risk or pay-for-performance models; imperative to adapt proactively.

• Strategy framework: “The Five P’s”:

  • People (employees), Patients (experience & outcomes), Providers, Partners (payers, manufacturers, vendors, legislators), and the P&L (financial outcomes as a result, not drivers).

• Headwinds:

  • Regulatory uncertainty (esp. 340B), increasing direct-to-patient disruption, shrinking reimbursement, Medicaid/Medicare enrollment decline.

  “There’s lots of regulatory uncertainty in the 340B space. Every single day, it seems like something’s changing there...” ([05:28])

4. Strategy Adaptation Amid Headwinds

[06:52]

• Focus on maximizing patient access sustainably, being “smart” in response to external challenges.

• Flexibility in capital investment and financial planning for resilience.

• Pharmacy as a “strategic enabler” and organizational driver of smart revenue growth.

  “We can’t really control what happens legislatively... but we can control how we respond. And so we’re trying to do things smart...” ([06:55])

5. Hardest Challenge for Coming Year

[08:10]

• Balancing accelerated growth and unyielding commitment to quality and excellence.

• “Growth creates opportunity... but it also introduces risk if you move too fast.” ([08:19])

• Maintaining trust, safety, and outcomes as measures of success, not speed.

  “Patients don’t really measure us by how fast we grow. They really measure us by how well we show up when they need us most.” ([08:34])

6. Team Preparation and Leadership Approach

[09:01]

• Active listening to frontline and system leaders to understand pain points and priorities.
• Building trust and purpose with staff—definition and daily living of organizational values.
• Empowering employees to align with the vision: “Once you unlock that kind of value prop, really the results comes by themselves.” ([09:55])

7. Best Opportunities for Growth

[10:25]

• Building a nimble, adaptable culture—critical for rapid innovation and resilience.

  • “Good teams win when they have a great culture…” ([10:35])

• Deepening community-based trust—patients desire local, accountable, coordinated care.

• Combination of agility, trust, and a commitment to defined excellence creates meaningful, sustainable growth.

  “When you combine an agile and people focused culture with deep community trust and a commitment to define an excellence, you really create growth that’s sustainable, meaningful and genuinely patient centered.” ([11:22])

8. What Excites Josh Weber About the Future

[11:49]

• Finds challenge motivating: “To me, that’s the most exciting time. Right. Those that truly want to lead... are inspired when things get tough, how do you kind of rise to the occasion and win?” ([11:55])
• Surrounded by great teams enables continual pursuit of excellence in patient care and healthcare overall.

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Notable Quotes & Memorable Moments

• On St. Luke’s Mission:
  “Our vision is to be the community’s most trusted partner in health and pharmacy is one of the most tangible ways we earn that trust every single day.”
  — Joshua Weber [01:41]

• On Adapting to Change:
  “We can’t really control what happens legislatively... but we can control how we respond.”
  — Joshua Weber [06:55]

• On Leadership:
  “Once you build that trust, you lay that foundation, you really encourage your employees and your front lines to really lean in on that vision, to become the most trusted partner in health.”
  — Joshua Weber [09:36]

• On Growth and Excellence:
  “Patients don’t really measure us by how fast we grow. They really measure us by how well we show up when they need us most.”
  — Joshua Weber [08:34]

• On Opportunity:
  “When you combine an agile and people focused culture with deep community trust... you really create growth that’s sustainable, meaningful and genuinely patient centered.”
  — Joshua Weber [11:22]

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Timestamps for Key Segments

• [00:29] – Introduction to Josh Weber & St. Luke’s Health System
• [02:01] – Major Pharmacy Initiatives Completed
• [04:33] – 2026 Priorities and Headwinds
• [06:52] – Adapting Strategy in Response to Headwinds
• [08:10] – Hardest Challenge for Coming Year
• [09:01] – Preparing the Pharmacy Team
• [10:25] – Opportunities for Growth
• [11:49] – What Excites Weber About the Future

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Summary Takeaways

• Patient centricity is central to all transformations and operational adjustments at St. Luke’s.
• Technology and workflow innovation (paperless, AI, automation) have yielded faster, more efficient patient care delivery.
• Culture, adaptability, and community trust are the greatest organizational differentiators and opportunities in the evolving healthcare space.
• Resilience and smart strategy are vital amid ongoing regulatory and financial uncertainties.
• Leadership at St. Luke’s is committed to listening, empowering staff, and balancing growth with unwavering standards of care.

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This episode is essential for healthcare leaders seeking real-world, actionable strategies for delivering patient-centered pharmacy care, navigating industry headwinds, and fostering sustainable organizational growth.

Transcript

[A]

Welcome to the Beckers Pharmacy Leadership Podcast. I'm Ella Jeffries, pharmacy reporter with Becker's Healthcare. Today I'm joined by Josh Weber, senior director at St. Luke's Health System. In this episode, we'll be talking about recent pharmacy initiatives. The priorities and headwinds leaders are navigating as we look toward 2026 and where opportunities for growth are emerging across health systems. Josh, thank you so much for joining me today. To start us off, can you introduce yourself and share a bit about your role at St. Luke's Health System?

[B]

Yeah, absolutely. Thanks Ella. First of all, thank you for the opportunity. My name is Josh. As Ella mentioned, I currently oversee ambulatory med access, retail and specialty pharmacy services here at St. Luke's Health System. St. Luke's is the only Idaho based, non for profit, community owned and community led health system. Our mission is simple but really deeply meaningful to improve the health of people in the communities we serve across southern and central Idaho, eastern Oregon and northern Nevada. From a pharmacy perspective, we support more than 25,000 patient lives and dispense over 850,000ambulatory prescriptions each year. And I will add, we're on track for 1 million this year and really excited for that goal across specialty, home delivery and retail settings. What really defines us though is how patient centered our care is. Patients today want easier access, fewer handoffs, faster answers, transparency around cost, and really confidence that someone is advocating for them. Everything we're building here at St. Luke's both clinically and operationally, is designed to meet patients where they are and remove friction from their from their care journey. Our vision is to be the community's most trusted partner in health and pharmacy is one of the most tangible ways we earn that trust every single day.

[A]

That's great context. Thank you so much for sharing that, Josh. Now thinking back over the past year, what's the most important initiative that you've led? What did you focus on and what results did you see from that?

[B]

Yeah, great question. So the most important work we led this past year was really making intentional investments. Now to build a future ready patient first pharmacy operated model. We fully implemented first paperless workflows across all pharmacy sites. Which sounds simple but for patients it really means better multilingual and video based education where applicable and really removes the rate limited steps in the verification process. Waiting on that printer, always one of our favorites. We are now on track to save more than 2 million patients from entering landfills and also helping with our sustainability efforts. We redesigned our pharmacy delivery workflows using Lean Six Sigma principles really eliminated bottlenecks and maximizing throughput to patients so they receive their medications faster and more reliable, especially those managing chronic or complex conditions. We also are about to launch phase one of our central service center fill engine, which really is going to lay the foundation for a much larger phase two automation investment. This really provides the dispensing system IT components for later investment and improves prescription turnaround times for our patients. On the access side, we implemented AI enabled prior authorizations and appeals. Workflows across more than 300 clinics cut in times per PA from 15 to 20 minutes down to under 5 minutes for patients. That translates directly into faster therapy starts and fewer frustrating delays. We also expanded access by securing limited distribution drug and payer networks for five additional specialty and rare disease medications and added a large regional payer network bringing care access to an additional 5,000 patient lives. Finally, we advanced advanced centralized benefits investigations directly within our EHR, using tools that really proactively guide patients into St. Luke's pharmacies where we believe that improves continuity of care, affordability, patient outcomes and the overall patient experience. You know, all of these are important investments as the organizations that really win in the future are the ones that align people, technology and operations around one central truth. When access is delayed, outcomes and trust suffer.

[A]

For sure. Those are great examples. Thank you so much for sharing. Now, looking ahead, what are the big priorities and headwinds you're focused on as you plan for 2026?

[B]

Yeah, no shortage of headwinds, but first, our priorities. You know our biggest priority here in 2026 is going to be launch in PH of our central services center Central Fill Pharmacy which really brings specialty home delivery and true central fill operations together into a single, highly coordinated, conveyor based and robotically assisted production environment. This integration and centralization matters because patients don't experience care at silos, they experience it as one journey. We're also heavily focused on workforce retention and career growth efforts. As excellence for patients starts with engaged supported employees who see a Future. Here at St. Luke's another major priority is advancing value based and population health care models and close partnership with our health plan and clinical partners. Really as payers continue to move towards shared risk and or pay for performance reimbursement models, we really need to be able to proactively adapt and to be able to win accordingly. You know, I really often frame our strategy and priorities around what I call the five P's. It starts with our people, our employees, our patients, their experience and outcomes, our providers who are really making care easier to deliver every single day. Our partners, folks like payers, pharmaceutical manufacturers, vendors, and even state legislators. And when you really get those right, the P and L improves as an as a result, not as the primary driver on the headwinds front. They're really real and they're constantly shifting. You know, there's. There's lots of regulatory uncertainty in the 340B space. Every single day, it seems like something's changing there. Increasing direct to patient disruption, shrink in reimbursement, and then decline in patient enrollment, especially in Medicaid and Medicare populations, are all pressures we're actively navigating, but really affect our ability to financially model and have financial resiliency in these changing times. We feel the key is staying focused on patients and the signal, even when the environment gets full of noise.

[A]

For sure. And how would you say that those headwinds are shaping your strategy right now?

[B]

Yeah. So again, getting back to how, in times where there's financial uncertainty, how do we maximize our patient access and do that in a smart and sustainable way? So we can't really control what happens legislatively other than advocacy, but we can control how we respond. And so we're trying to do things smart. And that really means how do we cut back on labor investment that's needed to still accelerate growth, but also doing it in a way that really maximizes patient access? And so one thing it changes is we have a couple different models of how we look at capital investment and financial plan in each year. And it really kind of helps us be resilient in the face of change. And so pharmacy is a strategic enabler and really an organizational driver of smart revenue growth. And that's really been the key to our success here at St. Luke's as we're definitely positioned well to really drive organizational success, despite all the change in headwinds that we see in the news and in some of the bills that are passed.

[A]

Definitely. And, you know, along with those priorities do come some tough decisions. What's the hardest thing that you'll have to tackle in the coming year as a pharmacy leader?

[B]

Yeah, great question. The hardest challenge is really balancing accelerated growth that we just talked about with our unwavering commitment to quality and excellence. You know, growth creates opportunity. And when we say growth, we really want to, you know, be the pharmacy of choice for every patient, every One of those 25,000 patient lives in Idaho. But it also introduces risk if you move too fast. You know, our responsibility is to innovate boldly without ever compromising on key principles such as safety Outcomes or trust. Patients don't really measure us by how fast we grow. They really measure us by how well we show up when they need us most. And keeping that balance front and center is both the challenge and really what I see is the privilege of leadership.

[A]

Definitely. And how are you preparing your team to tackle this challenge?

[B]

Yeah, that's a great question. So, you know, getting back to how we focus on our people first, you know, one thing you have to do is you have to actively listen. And so one of the first things I did as a new leader here at St. Luke's is really just had different sessions with our frontline leaders, our system level leaders and our frontline teams to really understand, you know, what are the pain points, what are the things they want us to act on first and what are some of their priorities. And so that really kind of creates that trust with your employees. And when you do that, you know, it really kind of helps you first define, you know, what our purpose is. And then from there, how are we going to do what we need to do to achieve that purpose? I'm a big believer in to really drive excellence, you have to define how you get there and then you have to live by that every single day. And so once you build that trust, you lay that foundation, you really encourage your employees and your front lines to really lean in on that vision, to become the most trusted partner in health. And how did the individual contribute to that? Once you unlock that kind of value prop, really the results comes by themselves.

[A]

That was some great leadership advice. Thank you for sharing. Now, even with those challenges, there are still areas for growth. Where do you see the best opportunities for organizational growth moving forward?

[B]

Yeah, the greatest opportunity for sure starts with culture. Really building an organization that's nimble, adaptable and able to quickly pivot as fast as healthcare is changing. I'm a big sports fan as well. And really when you see good teams win is when they have a great culture. And we're trying to do that here at St. Luke's with our employees, but also across our whole health system. How do we really become nimble and adaptable? And that's going to be key. Healthcare today rewards teams that can learn quickly, really test thoughtfully, test and invest, and then adjust without losing sight of our purpose. From there, community based trust remains our strongest differentiator. Patients really want local care that feels personal, that's coordinated and accountable and not transactional. And so if we're able to kind of focus on those efforts, I really think that's going to be a key kind of opportunity for growth. What it comes down to is when you combine an agile and people focused culture with deep community trust and a commitment to define an excellence, you really create growth that's sustainable, meaningful and genuinely patient centered. And that's our focus here at St. Luke's in our pharmacy and across our entire organization.

[A]

Definitely that's a great focus. And what would you say excites you most about those opportunities?

[B]

Yeah, a lot of times that's a great question. You know, we have so many headwinds, so many barriers to care. To me, that's the most exciting time. Right. Those that truly want to lead and I really think that as a privilege really are inspired when things get tough, how do you kind of rise to the occasion and win? And so I think when you have great teams, when you have great leaders like we do here at St. Luke's it's really fun to kind of see challenges as more as opportunities. We're all facing the same challenges and I think when you surround yourself with great people, you kind of unlock that ability to keep on one end, to keep doing the right thing for our patients and to continue to define what excellence means not only in pharmacy, but in healthcare as a whole, for sure.

[A]

Well, Joshua, this has been a great conversation. Thank you 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 Josh Weber for joining us to discuss pharmacy leadership priorities and opportunities at St. Luke's Health System. Thanks for listening and we'll see you next time.