In this episode, Sheila Arquette, President & CEO of NASP, speaks with David G. Mitchell, PharmD, MBA, CSP, FCPhA, Assistant Chief Pharmacy Officer of Specialty Pharmacy & Home Delivery and Ruth Chen, PharmD, MHA, Manager of the Specialty Pharmacy Hub at UC Davis Health in Sacramento. They look at how UC Davis Health has built and scaled one of California’s most integrated health-system specialty pharmacy programs. Dr. Mitchell shares how being embedded within clinics, care teams, and the EHR enables specialty pharmacy to deliver differentiated clinical and operational value while navigating payer, policy, and access challenges in a rapidly evolving landscape. Dr. Chen discusses why a focused rare disease strategy is essential for health-system specialty pharmacies. She walks through the challenges that existed prior to implementing a centralized rare disease hub model and how those challenges shaped the development of a coordinated, pharmacy-led approach that supports patients and providers across complex therapies. Together, this conversation highlights how structure, strategy, and leadership enable innovation, workforce growth, and improved patient care.