Insights Unveiled at Asembia’s AXS25 Underscore Need for Revenue Cycle Innovation in Specialty Pharmacy
SAN DIEGO–(BUSINESS WIRE)–#digitalpathology—XiFin, Inc., a leader in revenue cycle management (RCM) and billing solutions enhanced with embedded artificial intelligence (AI), shared findings from its inaugural Specialty Pharmacy survey at Asembia’s AXS25 specialty pharmacy summit. The survey1 finds an industry poised to step into a more significant role in addressing patient care needs, with a focus on managing chronic conditions that require increasingly complex medication regimens.
“As the population continues to age and the burden of chronic conditions grows, the demand for specialty pharmacy services is rising rapidly, and pharmacists are poised to do even more for their patients,” said David Pope, Chief Pharmacy Officer at XiFin. “However, XiFin’s 2025 Specialty Pharmacy Transformation Outlook survey indicates that while pharmacy professionals are confident in their ability to meet these needs, they acknowledge continued technology and staffing challenges and that there is opportunity for improvement as many are still in the early stages of developing the RCM infrastructure to support long-term, sustainable growth.”
XiFin’s 2025 Specialty Pharmacy Transformation Outlook research report provides a cross-sectional view of the current specialty pharmacy landscape, including the timing and scope of service expansion, as well as key challenges, opportunities, and barriers that organizations are navigating.
As thousands of pharmacy leaders converged at AXS25, many conversations echoed key survey findings — the impact of staffing shortages, the opportunity raised by AI, and continued industry growth. Notably absent from the sessions was an exploration of the shift towards the medical benefit billing pathway, future-ready technologies, and new strategies needed to maximize reimbursement.
Specialty Pharmacy Research Finds Positive Outlook
- Industry Optimism: A large majority of respondents expressed confidence in the future of specialty pharmacy, driven by expectations that pharmacists will play a larger role in addressing physician shortages and managing chronic conditions that require complex medication regimens.
- Pharmacist Role Expansion: More than three-quarters of respondents (77%) identified the expanding role of pharmacists in bridging physician care gaps as the leading growth opportunity, with two-thirds (68%) emphasizing the growing role of pharmacies as holistic health and wellness hubs.
- Revenue Growth: Thirty-eight (38%) of respondents who have expanded both clinical services and specialty pharmacy offerings reported a moderate or significant increase in revenue.
Specialty Pharmacy Continues to Expand
- Recent Expansion: Specialty pharmacy services continue to grow, with significant adoption and expected growth in immunosuppressives, inflammatory, and oncology-related therapies.
- Near-term Expansion: Within the next one to three years, pharmacy professionals expect the specialty medication market to see significant growth, noting patient needs in hepatitis C, sleep disorders, infertility, and immune deficiency treatments.
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Evolving Patient Care Services: Specialty pharmacies are broadening their offerings:
- 53% plan to offer specialty diagnostic testing
- 62% plan to support chronic care management in the next three years
- 52% will offer health and wellness consultations
Specialty Pharmacy Working to Address Gaps, Navigate Market Uncertainties
- RCM Improvements Needed: Respondents identified the need for next-generation RCM capabilities to improve medical billing and increase collection rates. This comes as 39% of pharmacies are experiencing a shift from pharmacy benefit to medical benefit billing.
- Patient Estimates Top Reimbursement Issues: Respondents ranked challenges with providing patients with an upfront out-of-pocket expense estimate for clinical services as their top issue, surpassing the lack of a comprehensive view into reimbursement status.
- Persistent Industry Challenges: Ongoing concerns, including drug shortages, reimbursement complexities, and workforce issues—ranging from stress and burnout to low morale and time constraints—remain top concerns across the industry.
“Respondents identified specific improvements needed to increase collection rates. In combination, they point to existing technology limitations and limited awareness of the types of technologies available, including rules/logic-based automation aligned with payor policy, AI, and analytics,” shared Sandra Greefkes, Vice President, Product and Partner Marketing at XiFin. “Pharmacy organizations that harness the medical benefit billing pathway, incorporate purpose-built technology solutions like XiFin’s, and tap into partners with payor expertise will be better positioned to enhance patient access and capitalize on additional revenue opportunities,” she added.
Access the survey at xifin.com/specialty-report
About XiFin
XiFin is a healthcare information technology company that empowers organizations to navigate an increasingly complex and evolving healthcare landscape. Leveraging AI-enabled technologies and services, the XiFin Empower platform delivers enhanced operational efficiency, increased productivity, and workflow automation. Our comprehensive set of solutions—spanning revenue cycle management, clinical workflow enablement, laboratory information systems, and patient engagement—provides healthcare organizations with the tools they need to achieve financial strength, optimize operations, and implement industry-leading strategies. XiFin Empower solutions deliver THE POWER TO DO GOOD® so that healthcare organizations can do more good for more patients. Visit www.XiFin.com, follow XiFin on LinkedIn, or subscribe to the XiFin blog to learn more.
1 The 2025 Specialty Pharmacy Transformation Outlook survey was conducted in October and November 2024 using an enterprise-grade online platform targeting U.S.-based pharmacy professionals.
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