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

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.

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.

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]

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

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.

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.