Episode Overview

This episode of the Becker’s Healthcare Podcast features Nilesh Desai, MBA, BS, RPh, CPEL, CPPS, Chief Pharmacy Officer at Baptist Health System, in conversation with host Ella Jeffries. The discussion centers on the current headwinds facing pharmacy leaders—such as regulatory challenges, staffing shortages, and medication access—as well as the opportunities emerging for pharmacy to drive innovation, efficiency, and patient care within health systems. Desai offers strategic insights on technology adoption, prioritization, and the evolving role of pharmacy leadership.

Key Discussion Points & Insights

1. Role and Responsibilities of the Chief Pharmacy Officer

[00:29]

• Nilesh Desai oversees all pharmacy services at Baptist Health, an eight-hospital system with 12 retail pharmacies and a 100,000 sq. ft. central pharmacy.
• Key Challenge: Balancing growth and sustainability amidst financial and regulatory headwinds.
• Memorable Quote:

  “We really brought pharmacy to the forefront at Baptist with all our initiatives … But there are obviously a lot more headwinds—340B space, the Inflation Reduction Act, Medicaid reduction … and really, medication access continues to be the biggest challenge.” —Nilesh Desai [00:48]

2. Navigating 340B and Other Regulatory Pressures

[02:59]

• Desai notes the shifting 340B landscape, rising regulatory requirements, and the impact of Medicaid patient reductions.
• Baptist Health is focused on data sharing, technology leverage, and strategic partnerships to address compliance without adding to staffing burdens, due to persistent pharmacy technician and emerging pharmacist shortages.
• Quote Highlight:

  “We’ve been dealing with pharmacy technician shortage for the last 50 years … we want to judiciously use our staff. The goal is if we can leverage technology … because these requirements … are out there now.” —Nilesh Desai [03:19]

3. Strategic Prioritization of Pharmacy Initiatives

[04:27]

• Projects are regularly evaluated and prioritized based on impact: patient safety and regulatory needs top the list, followed by financial initiatives and efficiency gains.
• Employee engagement and continual reevaluation are stressed to ensure adaptability and prevent stagnation.
• Quote Highlight:

  “If you do those things first, financials always follow. But you also have to make sure you’re prioritizing or reprioritizing or adding new projects timely … so you’re not stuck in a document or a project list all the time.” —Nilesh Desai [04:48]

4. Looking Ahead: Key Projects and Focus for 2026

[05:38]

• Baptist Health is prioritizing EMR-IV pump interoperability, improvements in financial assistance, inventory management, and preparedness for continued 340B expansions.
• Data normalization, dashboard development, and AI preparation are significant initiatives for operational efficiency.
• Quote Highlight:

  “The other piece is data is—the key—where we’re normalizing a lot of our data, building a lot of dashboards out, and getting prepared for the AI... I call it the AI invasion.” —Nilesh Desai [06:27]

5. Pharmacy’s Growing Influence and Innovation Opportunities

[07:21]

• The role of pharmacy has radically evolved to become central in clinical quality, safety, revenue generation, value-based care, and specialized therapies (e.g., CAR-T, cell and gene therapy).
• Focus areas for expanded impact: specialty pharmacy, medications-to-beds initiatives, antimicrobial stewardship (especially in outpatient), and home infusion.
• Quote Highlight:

  “Pharmacy now is at the forefront... whether you talk clinical, quality, safety, and now revenue generation and all the medication access initiatives... value-based care with addition of CAR-T cell therapy... pharmacy is now really at the forefront leading a lot of those efforts.” —Nilesh Desai [07:24]

6. Demonstrating Pharmacy’s Value as a Growth Driver

[10:04]

• Pharmacy’s demonstrated effectiveness in revenue, patient and provider satisfaction, and efficiency underpins its evolving reputation as a growth engine—not just a cost center.
• The conversation within health systems has evolved, with chief pharmacy officers now playing larger strategic roles.
• Quote Highlight:

  “Chief pharmacy officers now have a larger role to play on how to grow services, how to build that infrastructure... demonstrating the results that come out of it... shows where pharmacy can make inroads and really deliver results." —Nilesh Desai [11:08]

7. Shifts Needed for the Future

[12:34]

• Pharmacy must continue to break out of traditional silos, explore innovation from other industries, and leverage technology—especially AI—cautiously and strategically.
• Addressing ongoing staffing and drug shortages, as well as pharmacy deserts, will require technology-enabled efficiencies and reallocation of resources.
• Notable Observation:

  “While we want to leverage AI to really improve our operations, become more efficient, all of that, but we also want to do it right… This is an opportunity where you can reallocate staff to do other things.” —Nilesh Desai [13:09]

8. AI Governance and Implementation at Baptist Health

[14:09]

• Baptist formed an AI infrastructure and committee to thoroughly vet new AI solutions, focusing on ROI and measurable outcomes before adoption.
• Data metrics and demonstrated benefit (quality, satisfaction, or financial gain) are prerequisites for AI integration.
• Quote Highlight:

  “Anytime we want to bring an application that provides some type of AI functionality, then we really go through the process of vetting… If we can start measuring outcomes, that's even a better benefit.” —Nilesh Desai [14:18]

Notable Quotes

• “The other piece is data is—the key—where we’re normalizing a lot of our data, building a lot of dashboards out, and getting prepared for the AI... I call it the AI invasion.” —Nilesh Desai [06:27]
• “While we want to leverage AI to really improve our operations, become more efficient, all of that, but we also want to do it right… This is an opportunity where you can reallocate staff to do other things.” —Nilesh Desai [13:09]
• “If you do those things first, financials always follow. But you also have to make sure you’re prioritizing or reprioritizing or adding new projects timely…” —Nilesh Desai [04:48]
• “Pharmacy now is at the forefront... pharmacy is now really at the forefront leading a lot of those efforts to make sure that the health systems are now up there trying to provide those streams of care, I call it.” —Nilesh Desai [07:24]

Key Timestamps for Important Segments

• 00:29 — Nilesh Desai describes his role, scope, and immediate pharmacy headwinds
• 03:10 — Addressing 340B regulations and leveraging technology to cope with staffing challenges
• 04:27 — Project and resource prioritization within the department
• 05:38 — Key upcoming initiatives: interoperability, financial assistance, inventory, and AI
• 07:21 — Opportunities for pharmacy to lead and expand: specialty, antimicrobial stewardship, home infusion
• 10:04 — Pharmacy’s growing role as a driver of growth and satisfaction within health systems
• 12:34 — Future-facing changes: breaking silos, innovation, and AI
• 14:09 — AI governance strategies at Baptist Health

Summary

In this concise yet insightful episode, Nilesh Desai provides a grounded yet visionary look at how pharmacy leadership can navigate today’s challenges—from regulatory changes and access concerns to workforce shortages—while proactively leveraging technology, data, and new care models. With an emphasis on AI and the shifting role of pharmacy within the healthcare system, Desai encourages continuous evaluation, innovation, and outcomes measurement to secure pharmacy’s place as a core pillar for health system strategy and patient care. This conversation is essential listening for leaders aiming to future-proof pharmacy operations and deepen the impact of pharmacy on health outcomes and organizational success.