Becker's Hospital Review

18 PHARMACY Pharmacy leaders adopt a new language for the C-suite By Paige Twenter e role of health system pharmacy executives has changed, as has the communication style required to sustain it. Pharmacy leaders at New Hyde Park, N.Y.-based Northwell Health, UChicago Medicine and Morgantown, W.Va.-based WVU Medicine told Becker's how they translate pharmacy operations to the rest of the C-suite, including presentations to boards and fielding texts from CEOs about Mark Cuban. Know your audience Onisis Stefas, PharmD, CEO of VIVO Health — a specialty pharmacy enterprise wholly owned and operated by Northwell Health — starts from a simple premise: C-suite leaders are in back-to-back-to-back meetings, and pharmacy has a narrow window to communicate priorities. e window shrinks further if you walk in with the wrong frame. A chief financial officer needs a margin conversation, a chief medical officer needs a quality and outcomes perspective, and a COO needs the operational aspect. Delivering a one-size-fits-all explanation is a mistake, Dr. Stefas said. "Use plain English and have the confidence and competence in C-suite discussions," he said. "Raise your hand instead of waiting to get invited to the conversation." He also flagged something many pharmacy leaders skip: end every meeting with a clear ask. Define what support is needed. Explain what the organization gets in return. Give the executive enough to weigh the request against everything else competing for their attention. "It's not the pharmacy problem we're looking to solve," Dr. Stefas said. "It's the organizational problem we're looking to solve." When he needed to explain how the Inflation Reduction Act's CMS- negotiated drug pricing would affect Medicare Part D reimbursement, Dr. Stefas did not start with the mechanics. He began the conversation with cash flow and pulled in industry data on expected rebate delays to establish this was a national issue, not a VIVO Health problem. Come with a solution and show up before the crisis Denise Scarpelli, PharmD, chief pharmacy officer at UChicago Medicine, has built that principle into organizational structure. Pharmacy has a dedicated page in the system's annual operating plan. Dr. Scarpelli attends high-level organizational meetings consistently, not just when a problem surfaces. Additionally, quarterly town halls connect front-line pharmacy staff to systemwide priorities so the team understands how their work ties to the organization's strategy, not just the department's. Her go-to communication formula is to state the issue, quantify the organizational impact and present the mitigation plan. For example, when regulatory changes to the federal 340B program prompted a board-level briefing, Dr. Scarpelli distilled the program, which was created in 1992, into a single slide organized around four factors: patient, provider, place and prescription. e simplicity gave the board a frame sturdy enough to hold as the regulatory environment shis. "ere's a lot of other stuff I le out, just because it's very complicated," she said. e briefing was "really for them to understand what a [disproportionate share hospital] was, what the covered entity is, and what falls under it." When something isn't landing, Dr. Stefas said he pulls the conversation back to something the room already understands, such as device contracting or procurement rebates, and rebuilds the frame from there. Credit the team, not the department Todd Karpinski, PharmD, chief pharmacy officer at WVU Medicine, oversees pharmacy operations across a 25-hospital system that will have 32 hospitals by the end of 2026. In health system pharmacy departments, he said new services such as specialty and home infusion generate revenue streams that did not exist 15 years ago. But when that revenue comes in, Dr. Karpinski does not claim it as a pharmacy win. "It's not pharmacy's dollar," he said. "If we didn't have great specialty physicians writing for specialty medications, we would not have the opportunity to fill that medication, treat that patient and make some dollars on that." Claiming the revenue as a pharmacy win risks the turf dynamics that quietly cut a department off from the rest of the enterprise. At the system level, Dr. Karpinski holds a seat at a monthly CEO council meeting, runs quarterly updates with local leadership across WVU Medicine and fields questions from local CEOs about national pharmacy news. "I can get a text or email from any local CEO [that says], 'Hey Todd, you see this thing about Mark Cuban?' And I'm like, 'Yep, we are engaged with Cost Plus [Mark Cuban's pharmaceutical company]. We're using it in our retail pharmacies,'" he said. Building the next generation Both Dr. Karpinski and Dr. Stefas named the same underlying gap: the distance between pharmacy's clinical training and the executive fluency the role now demands. At WVU Medicine, an administrative pharmacy residency is designed to close that gap. "I'm excited to see their optimism in the profession and the excitement to grow," Dr. Karpinski said of the system's combined Master's of Healthcare Administration and pharmacy residency program. "We have so many areas that we can expand what pharmacists are doing." e gap, Dr. Stefas said, may be less about expertise than confidence. "Too oen, when it comes to the C-suite, we don't step forward with the confidence and conviction that our expertise deserves," Dr. Stefas said. "Come to leadership with a solution, not just a problem, and present it with conviction." n

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