Chad Hatfield, Pharm.D., MHA, BCPS, on scaling pharmacy at UC Davis Health

Chad Hatfield, Pharm.D., MHA, BCPS, is the vice president and chief pharmacy officer at UC Davis Health, where he oversees approximately 850 employees in a pharmacy division that spans acute care, ambulatory care, home infusion, specialty and mail-order pharmacy and community retail locations. He also serves as associate dean at the UCSF School of Pharmacy.

In this video, Hatfield discusses how UC Davis Health has expanded its pharmacy enterprise, how his team is preparing for potential 340B changes and what he’s most looking forward to ahead of his first Health System Executive Summit.

In 2024, UC Davis Health opened a pharmacy shared service center, an 80,000-square-foot building that houses specialty pharmacy, a newly launched home infusion program with ambulatory infusion chairs, and pharmacy supply chain operations that serve as a central hub for clinic and infusion site distribution and drug shortage management. Hatfield said the project grew out of capacity limits he saw after joining UC Davis in 2018. The specialty pharmacy, established around 2010, was operating from an outdated location, and patient access and financial assistance teams had no room to grow within the existing footprint. The building also moved staff whose work does not require an on-campus presence, such as 340B, compliance and authorization teams, out of the hospital.

Home infusion filled a gap in the system's strategy. UC Davis Health previously had no non-hospital-based option, and as payer constraints moved certain medications to non-hospital sites of care, the system needed a way to keep those patients within UC Davis for both clinical and fiscal reasons. Hatfield described the service as a patient satisfier.

The division also embeds pharmacists across service lines. By Hatfield's estimate, well over 150 of the system's pharmacists hold board certifications. Every primary care site has pharmacists, as do specialty clinics including endocrinology, immunology, dermatology, cardiology and pulmonary, with larger clinics staffed by several. On the acute care side, critical care, emergency medicine and pediatrics each have multiple pharmacists, with staffing ratios set by patient acuity. "There's really no service that we don't actually have a pharmacist on," Hatfield said. He added that linking inpatient and ambulatory pharmacists is what helps keep patients out of the hospital.

Looking at 340B, Hatfield said his team is preparing for a potential rebate model by anticipating new data submission requirements and validating its access to that data now, while tracking litigation and HRSA policy developments. He said the system will be ready to implement by Jan. 1 if required.

Hatfield said he hopes to share practices that have worked at UC Davis and to hear from peers who can help validate initiatives his team is close to launching. "It's a communal sharing of information," he said.

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.