Transforming Specialty Pharmacy: Strategic Leadership for Value-Based, Patient-Centered Care

Leslie Hurst serves as associate vice president of specialty pharmacy & PBM strategy at Baptist Health System (KY & IN). With extensive experience leading specialty pharmacy programs, she directs formulary strategy, benefit optimization and team operations, driving improved access, affordability and clinical outcomes across the health system. With a Doctor of Pharmacy from the University of Kentucky and board certification in ambulatory care, she excels in strategic planning and operational excellence. A former Walgreens specialty supervisor, she has advanced clinical practice, built high-performing teams, and enhanced medication adherence and outcomes. Hurst also champions health equity through speaking engagements (e.g., NASP) and community outreach, reinforcing her commitment to innovative, patient-centered care.

Shaping Pharmacy Strategy through Key Moments

I am committed to continuous learning and have consistently pursued opportunities that stretch my capabilities and expand my impact. A decade ago, I stepped into the evolving specialty pharmacy landscape, launching patient services in a rural market with complex access challenges. My leadership spans retail, specialty, health system, 340B, and PBM pharmacy. As I recognized the broader influence of specialty pharmacy on patient outcomes and total cost of care, I transitioned into health system pharmacy leadership—enabling end-to-end collaboration with providers to optimize medication access and adherence.

Aligning Pharmacy with Value-Based Care

Medication adherence is essential to achieving successful therapeutic outcomes. In specialty pharmacy, patients often face barriers such as high costs, complex administration requirements, and adverse effects, which can hinder adherence. Pharmacists and pharmacy technicians play a critical role in addressing these challenges by supporting patients to stay on therapy, optimizing medication use, and ultimately improving health outcomes while reducing hospitalizations and emergency department visits.

Turning Challenges into Opportunities

Cost transparency is a priority for our health plan and pharmacy benefits. As a large health system, we have insight into the total cost of care, access barriers, and the clinical and financial impact of pharmacy benefit design. In my current role, I lead our internal PBM Pharmacy & Therapeutics Committee, which guides the appropriate selection of medications and related products for our covered population. We are actively advancing generic utilization and biosimilar strategies to ensure employees and their dependents receive clinically appropriate, costeffective therapies.

Driving Innovation with Strategy

Integrating pharmacists and pharmacy care coordinators into medical groups and hospital-based clinics has accelerated pharmacy innovation across our organization. With the launch of our centralized pharmacy services center, we’ve established a scalable, efficient prescription fulfillment model while maintaining decentralized clinical medication management. This embedded, hands-on approach enhances patient support, improves provider satisfaction, and drives better medication-related outcomes. Integrated specialty pharmacy and medication fulfillment software with full EHR visibility provide a foundation for safe, efficient, and high-quality care.

Sage Advice

Proactively seek opportunities to independently build new skills and deepen expertise. Cultivate cross-organizational peer networks to enhance professional growth through collaboration. Attend strategic conferences to engage with industry stakeholders and share your team’s work to build visibility and foster partnerships for future innovation.