The Hidden Value of Integrated Specialty Pharmacy Partnership

Health systems build business cases for specialty pharmacy around predictable benefits: revenue retention, 340B optimization, and continuity of patient care. But the most significant impacts rarely appear in initial ROI models. These hidden advantages compound over time and are what separate high-performing programs from those that struggle to scale.

Health systems can pursue specialty pharmacy in several ways — from doing nothing formally, to DIY builds, to layering in point solutions, to partnering with an integrated provider. Each path carries different levels of operational burden, risk, and upside over time, and evaluating these models requires understanding what “hidden value” really means in practice.

Ninety-five percent of providers using integrated models agree that embedded specialty pharmacy teams save clinic staff time. This addresses a critical need, as 63% of physicians report burnout, with “too many bureaucratic tasks” as the top reason. When specialty pharmacy integrates deeply into clinical workflows, it removes administrative friction, which leads to faster time-to-therapy, measurably better adherence, and care teams that can focus on high-value clinical care instead of paperwork.

The integrated specialty pharmacy partnership model with the right partner unlocks hidden value across four critical areas: access, care coordination, data and insights, and financial performance. These advantages work together to create measurable outcomes that standalone programs struggle to replicate.

What is a Health System Integrated Specialty Pharmacy Model?

Traditional models force patients to navigate multiple touchpoints: clinic for prescribing, external pharmacy for dispensing, separate channels for prior authorization and financial assistance. An integrated specialty pharmacy model places pharmacy services directly within the health system, connecting infrastructure, staff, tools, and data to the site of care. At its core, the clinical care team collaborates across the system to ensure timely medication access, adherence, and improved outcomes. Pharmacy team members function as extensions of the care team rather than outside vendors.

Pharmacists and liaisons — whether on-site or remote — have full electronic health record (EHR) access and actively participate in care planning alongside providers. They coordinate medication access, deliver patient education, and monitor therapies in real time, creating a seamless, patient-centered approach to specialty care.

Unlike outsourced or mail‑order specialty pharmacy models, an integrated approach keeps the health system in control of its pharmacy operations, patient relationships, and brand identity. Many hospitals and health systems also choose to bring on an external integration partner to strengthen and accelerate the program. It’s important to note that not all external partners are the same. When thoughtfully selected, these partners do not replace or “take over” the health system’s pharmacy; they serve as strategic enablers. The right partner brings specialized expertise and infrastructure that would be costly and time‑consuming to build independently, including established payer and drug manufacturer relationships and track records of success; proprietary patient management technology; proven clinical workflows; and staffing models that can scale with demand.

A partnership approach addresses gaps that often emerge in DIY or point-solution models where administrative burden, payer access limitations, and fragmented workflows can stall program growth.

So what does this all mean for patients and health systems? Timely access, streamlined care coordination, expanded data visibility, and measurably better financial and clinical outcomes.

How Integrated Partnerships Improve Access

Payer network restrictions and LDD networks create persistent access barriers for specialty medications. Research shows integrated health system specialty pharmacies achieve treatment initiation six days faster than external models — a clinically meaningful difference for time-sensitive conditions like cancer and inflammatory diseases.

The access advantage of integrated partnerships stems from three reinforcing capabilities. First, a strategic partner with established and expert payer‑network relationships can help overcome barriers to payer access. Second, intentionally cultivated manufacturer connections can unlock LDD access, faster and at scale. Third, a partner equipped to build and maintain a robust data analytics infrastructure and to deploy scalable teams of data engineers and analysts can support the initial setup and ongoing optimization of payer and manufacturer access. Together, these capabilities, owned and managed by the partner, are built on years of contracting experience, proven workflows, and deep industry knowledge.

Health systems launching specialty pharmacy programs typically need several years to establish comprehensive payer networks and LDD manufacturer relationships. Identifying a partner that can navigate complex access requirements and forecast accurate timelines can significantly enhance time to value and reduce operational risk when accessing new networks. For example, one failed attempt at a new payer application can result in a health system being locked out of applying for network access for at least a year. Integrated partnerships, with their longstanding relationships and multifaceted expertise, provide accelerated or even immediate access to these networks so health systems can better retain patients and prescription volume in-house.

The Power of True Integration: SRHS Sets a New Standard in Care

Spartanburg Regional Healthcare System (SRHS) set out to enhance its specialty pharmacy by expanding services and elevating patient satisfaction. In partnership with Shields, SRHS achieved an industry-leading NPS score through an integrated, high-touch care model — delivering exceptional results amid unprecedented challenges.

Explore the full case study.

Payer Network Access

Vertical integration between payers, PBMs, and their owned specialty pharmacies has created formidable barriers for independent health system pharmacies. Even in “any willing provider” states, network restrictions frequently force patients to external pharmacies despite health systems having fully operational, accredited programs on-site.

Integrated partners bring pre-established payer and PBM relationships that significantly compress network access timelines. Their payer contracting specialists bridge the gap between the relationships health systems already have with payers and the stringent requirements of state and federal networks. This enables faster network credentialing, lower out-of-pocket costs, and continuity of care, ensuring patients can obtain medications through their trusted health system rather than being redirected elsewhere.

Access to Limited Distribution Drugs (LDD)

Manufacturers of high-cost therapies in oncology, inflammatory diseases, and rare conditions often restrict dispensing to approved specialty pharmacies. Research shows that 60% of patients report difficulty receiving their first dose of specialty therapy, with delays contributing to abandonment.

Integrated partners with established LDD relationships have the opportunity to give health systems immediate in-system dispensing paths for restricted therapies. This keeps patients within the care continuum while retaining both prescription revenue and patient satisfaction.

Shields’ Approach to Improving Specialty Pharmacy Access

Shields treats medication access as a core operational discipline. In addition to a wide range of specialized groups focused on distinct aspects of specialty pharmacy, all designed to accelerate growth, partners benefit from two dedicated access teams: Trade Relations and Payer Access. Within these teams, Shields has experts who solely focus on specific facets of their discipline, delivering unmatched expertise. At the same time, integrated pharmacists manage patient-facing workflows to ensure seamless care coordination.

Centralized payer and trade experts manage credentialing, ongoing payer support services and network-level access, and LDD manufacturer partnerships.
Clinic-embedded teams initiate prior authorizations, benefits investigations, and financial assistance at the point of prescribing using full EHR visibility.
Standardized workflows proven across 80+ health systems compress time-to-therapy and drive better adherence.
End-to-end implementation support ensures access capabilities translate into operational performance from contract signature through ongoing optimization.

How Integrated Partnerships Support Care Coordination

Care fragmentation undermines specialty medication success. Traditional models shuttle patients between clinic staff for prescribing, external pharmacies for dispensing, and separate channels for prior authorization and financial assistance. Integrated models eliminate this fragmentation by embedding pharmacy teams directly within clinical workflows.

The integrated workflow operates across three phases. Embedded pharmacy liaisons initiate prior authorizations and financial assistance at the point of prescribing. After therapies are prescribed and authorized, pharmacists counsel patients and answer patient questions in real time. After the prescription is dispensed, the same team, including clinical pharmacists and pharmacy liaisons, manages side-effect monitoring, adherence interventions, and refill coordination — all within the clinic’s existing workflow.

Patients benefit from continuity. The same pharmacy team supports them across initiation, stabilization, and maintenance phases. Providers regain time previously consumed by pharmacy logistics, insurance questions, and authorization delays, allowing them to focus on direct patient care.

Shields’ Approach to Care Coordination

Shields uses an integrated specialty pharmacy care model where embedded teams plug directly into existing operations. Each partnership begins with stakeholder alignment and workflow co-design for referrals, prescribing, prior authorizations, and follow-up.

The model delivers coordination advantages in many ways, including:

Pharmacy liaisons handle prior authorizations, benefits investigations, and refill coordination inside the clinic workflow using full EHR visibility, reducing touchbacks and freeing provider time.
Pharmacist-led clinical interventions address complex issues like toxicity management, adherence barriers, and dose adjustments throughout the patient journey, with proven impact in high-acuity settings like oncology specialty care. In 2024, Shields clinical pharmacists performed more than 67,000 clinical interventions. Providers accepted 92.7% of these interventions, ultimately resulting in improved patient outcomes.
Proactive patient engagement through phone, digital, and in-clinic touchpoints surfaces concerns early and resolves them within a coordinated, team-based care model.

Turning Data and Insights into a Performance Engine

Traditional specialty pharmacy reporting is backward-looking. Reports arrive days or weeks after events. They detail what happened in the past, but offer little insight into why or what to do about it. Integrated partnership models create a unified data foundation across pharmacy and clinical workflows, enabling real-time visibility and proactive interventions rather than reactive reporting.

When pharmacy and clinical teams operate within the same system with access to shared data, metrics like adherence, prior authorization cycle times, time-to-therapy, and abandonment risk become transparent and actionable in real time. Executive dashboards surface performance trends as they emerge, allowing leadership to identify bottlenecks, shift resources, and intervene before small problems compound.

The hidden advantage lies in network-level benchmarking. Unlike standalone programs that lack comparative data, integrated partnerships with multi-site networks can compare performance across similar clinics, patient populations, and disease states. This matters because there are few established industry benchmarks for disease-specific specialty pharmacy performance. Most health systems operate in the dark about what “good” actually looks like. Access to peer data enables systems to adopt proven practices faster and calibrate realistic performance targets based on evidence.

Shields’ Approach to Data and Insights

Shields builds real-time monitoring into partner operations through unified data platforms. TelemetryRx®, Shields’ proprietary data and workflow platform available to partners, has been proven to increase patient retention by 40–60 percent in integrated specialty care settings by replacing static monthly reports with live dashboards tracking adherence, authorization turnaround, time-to-therapy, and abandonment risk.

The approach delivers three performance advantages:

Unified data visibility across EHR and pharmacy systems gives teams clear views of where patients or workflows may be at risk. Teams can make targeted outreach or operational adjustments before issues escalate.
Network-level benchmarking across 80+ health systems highlights where sites outperform or lag on measures like proportion of days covered (PDC) or median time-to-therapy. Partners can adopt concrete best practices to close gaps.
Technology enablers including automated prior authorization workflows and text-based patient engagement reduce administrative friction. Clinical teams can focus on high-touch interventions where they add the most value.

Financial Benefits of the Integrated Model Approach

Claims analyses of patients receiving integrated specialty pharmacy care show a 13% reduction in total healthcare costs compared to national cohorts, with average annual total cost of care of approximately $84,000 for the 20 most common specialty diagnoses.

The financial impact of integrated specialty pharmacy centers in four main areas:

Earlier starts and revenue retention. Integrated teams reduce time-to-therapy and authorization delays. This helps keep specialty prescriptions and patient relationships within the health system, rather than losing them to outside pharmacies.
Lower total cost of care. Higher medication adherence and proactive pharmacist interventions reduce hospitalizations and emergency visits, directly lowering system-wide medical spend.
Strategic 340B optimization. For eligible entities, integrated on-campus specialty pharmacy models support compliant 340B enrollment. Health systems control the dispensing point and maintain rigorous oversight. This maximizes 340B savings while mitigating compliance risk.
Scalable operations. Traditional models require heavy upfront hiring and fixed staffing. Integrated partnerships scale resources with actual volume. This reduces overhead and matches costs to clinical activity.

Shields’ Approach to Helping Improve Financial Outcomes

Shields delivers measurable financial impact through an integrated approach. The model achieves an average adherence rate of 92% and an average time to therapy of under two days. Here’s how Shields helps partners achieve it:

Centralized services handle outreach, prior authorization, and financial assistance. Partners avoid the intricacies of hiring and training full internal teams while maintaining high-touch patient support.
Real-time performance monitoring identifies revenue leakage from delayed starts, therapy gaps, and missed financial assistance opportunities.
Pharmacist-led clinical interventions identify therapy issues sooner, which can help enhance care coordination, reduce hospital utilization, and drive substantial cost savings. In 2024, Shields pharmacist-led clinical interventions resulted in more than $150 million in cost savings for partners across the Shields network.
Network-level benchmarking across 80+ health systems shares best practices that improve patient care, payer performance, and financial results. All partners benefit from collective learning.

Why Shields is the Preferred Specialty Pharmacy Integrator for Health Systems

An integrated specialty pharmacy partnership is so much more than a dispensing model. Rather, it’s an approach that prioritizes care and performance model to compound value across access, care coordination, data and insights, and financial outcomes. When those pieces work together, health systems see faster time-to-therapy, less administrative burden on clinicians, clearer visibility into performance, and a measurable reduction in total cost of care.

Shields is built around that level of integration. Our team embeds into clinics, aligns with each health system’s strategy, and brings proven playbooks, analytics, and operational support that have been refined across dozens of health systems nationwide.

Beyond pharmacy operations, Shields supports education, change management, and even co-branded patient and provider materials. The result is a partnership that deepens over time: as Shields learns the nuances of each health system’s market, patient population, and clinical priorities, the model becomes increasingly tailored and optimized, driving sustained value year after year.

Ready to unlock the hidden value of integrated specialty pharmacy for your health system?

Discover how Shields helps health systems achieve breakthrough performance across access, care coordination, data insights, and financial outcomes. Contact Shields today to learn how an integrated partnership can transform your specialty pharmacy program.