A conversation with Chad Hatfield, Pharm.D., M.H.A., BCPS, about pharmacy expansion, clinical specialization and regulatory readiness

As health systems expand pharmacy services beyond hospital walls, they face the challenge of coordinating specialized care while preparing for regulatory change. Chad Hatfield, vice president and chief pharmacy officer at UC Davis Health and an associate dean at the UCSF School of Pharmacy, discussed how UC Davis built a shared services center to support its growing operations, embedded pharmacists across acute and ambulatory care, and is preparing for potential regulatory changes. He also described how industry conferences help pharmacy leaders share best practices and assess new ideas.

Hatfield is set to speak at the 2026 Health System Executive Summit, where he will moderate the session, ‘340B Landscape and Current Challenges to Health Systems and Specialty Pharmacy.’ The summit will take place on Oct. 16 in San Francisco.

This interview has been edited for length and clarity.

To begin, would you introduce yourself and provide an overview of your role at UC Davis as well as UCSF Pharmacy School?

I'm Chad Hatfield. I'm the vice president and chief pharmacy officer at UC Davis Health. I oversee the division of pharmacy, which includes both ambulatory care and acute care. Pharmacists are embedded in all service lines, within the four walls of the hospital, whether it's the intensive care unit, the emergency department, internal medicine, transplant, etc. We have dispensing functions within central pharmacy, our operating room pharmacies and our pharmacies in the ambulatory care space. We have home infusion, normal oncology infusion, and non-oncology infusion locations; specialty pharmacy and mail order pharmacy as well; and some brick-and-mortar locations that are sprinkled throughout the communities. In total, there are about 850 people that work within the division of pharmacy, and I oversee them from end to end, from contracting through dispensing to revenue cycle management on the back end. At UCSF, as associate dean, my focus is driving the strategy for the UCSF School of Pharmacy and bridging the gap between education and the practical side of a health system as students enter our residency programs on our training grounds.

UC Davis opened its pharmacy shared service center in 2024, which brought pharmacy services across acute care, home infusion, retail, specialty pharmacy, and other settings under one management network.
What promoted the consideration for this model, and what needs or opportunities was it designed to address?

When I entered UC Davis in 2018, 2019, we were a great organization, and we had a great service line at that time, but we were kind of busting at the seams and were ripe for expansion. Some of it was just a space issue. We needed to expand outside of the four walls of the hospital with some of our supply chain management. We had a specialty pharmacy that was already well established from 2010 or so, and that was growing, but it was in an antiquated location, and we needed to be able to work with several service lines, and so with an amalgamation of a number of service lines, we put a business case together. That building is 80,000 square feet, so it's not small. It has multiple groups in there. It has specialty home infusion, which was a newer program to us, and so we launched that service out of there with some ambulatory care suite chairs that are in the front of the building. Then we had a supply chain that moved out of the central pharmacy location area within our hospital and decided to be a hub for drug distribution and drug shortages. Then we had a number of folks who didn't need to be in the four walls of the hospital; think of your 340B teams, compliance teams, authorization teams, etc. Those individuals don't necessarily need to be on the campus, and so it was a long-term strategy to say one, we needed more space, and two, we were growing businesses in areas that we've not previously done, and so that's really the impetus of the shared services center.

UC Davis is known for its board-certified pharmaceutical care specialists. How many specialties are currently represented in your system, and how do these specialties support patient care across the system?

From a specialty standpoint, we're well above150 individuals being board certified.In terms of where we have our pharmacists positioned, we've been able to utilize our expertise in all specialties. There’sreally no specialty that we don't have pharmacists, and most of the time we have multiple pharmacists. All our primary care sites have pharmacists, as well as endocrinology, immunology, dermatology, cardiology and pulmonary.
Some of those clinics are big, and we’ll have multiple pharmacists in a particular clinic if it warrants the volume. On the acute care side, your critical care, your emergency medicine, your pediatrics, and all those service lines are represented with multiple pharmacists. We typically do apatient ratio depending onhow sick the patients are, because when we tie a pharmacist to a service line, they can home in on what the patient needs, whether it's on the acute care side or trying to get them out to the ambulatory care side. If you're on the ambulatory care side, of course, it's trying to keep them out of the hospital and at home.It's the tie between the two that keeps our patients out of the hospital as much as possible.

As you know, 340B programs continue to evolve, and there are ongoing HRSA and OPA policy changes and manufacturer restrictions.
How is your team preparing for the potential rebate program that might take effect next year?

A lot of it comes down to anticipating what those changes may be and doing some of that pre-work now. Even though we collectively say it's easy on paper, it's not as easy as it sounds. There are several things happening in the background between HERSA and others, and we continue to watch and wait there too. There's a piece of being ready by January 1st. We will be ready by January 1 if we have to be.

As you look ahead to your first Health System Executive Summit, what is it about this gathering that stood out to you, and what are you hoping to take back to UC Davis from the conversations and the connections you expect to have there?

At any conference, there is a communal sharing of information. There are a lot of things at UC Davis that we do really, really well, and if we can share some of those best practices, that's huge for us to be able to give back. There are also things that other groups are doing that we just haven't thought of, or we're getting close to pulling the trigger on, but we just need a little bit more validation. A lot of times at these meetings, colleagues and thought leaders across the industries start to validate some of the things that you're looking to implement, and it gives you the ability to get over that next hump. Globally, it'll be a great conference to network and share some of those insights as we go forward with the next year.