Shields Health Solutions (Shields), the leading specialty pharmacy operating partner to over one-third of health systems nationwide, announced today the evolution of its integrated care model. The enhanced model introduces a new layer of AI and informed automation to its industry-leading clinical expertise to improve patient outcomes and care coordination, simplify operational complexity, and help deliver a more connected specialty care experience.
As specialty medications represent more than half of U.S. drug spending, patients face increasingly complex treatment journeys that require greater coordination, access, and clinical intervention. Shields serves as a single accountable partner for end-to-end specialty pharmacy and patient support. Through its pharmacist-led care model, Shields consistently delivers measurable clinical, financial, and operating results for health systems. In 2025, Shields clinical pharmacists engaged with more than 130,000 patients, providing always-on clinical care, and produced differentiated clinical outcomes that have outperformed industry benchmarks for more than a decade.
Health systems are facing growing financial, regulatory, and workforce pressures, with many turning to technology to address these headwinds. However, many technology-only solutions increase fragmentation, create disconnected workflows, and require health systems to coordinate across multiple vendors with competing priorities. Unlike point solutions focused on disparate workflows, Shields delivers connected performance by integrating clinical expertise, advanced technology, and embedded support teams.
“Health systems deserve a partner that connects the people, technology, and insights required to improve performance across the specialty care continuum,” said Michael Ham, Chief Executive Officer of Shields Health Solutions. “That’s what we’ve built at Shields. By combining purpose-built technology with embedded clinical expertise, we help health systems identify opportunities, act with conviction faster, and deliver better experiences and outcomes for patients. As one accountable partner, we drive results and growth across every stage of the specialty care continuum.”
“We needed a partner who could help us grow our specialty pharmacy program while keeping patients at the center of everything we do,” said Jim Coleman, CEO of Erlanger. “This partnership will help Erlanger expand access to essential medications and clinical support for thousands of patients throughout the greater Chattanooga area. Together, we’ve built a program designed to improve access, strengthen care coordination, and support better outcomes. We’re excited to continue partnering with Shields as they advance a care model designed to meet the evolving needs of both patients and health systems.”
Connected Performance Across the Specialty Care Continuum
Shields’ teams and capabilities deliver connected performance across the specialty care journey for health systems to:
- Accelerate Program Expansion – As specialty care extends to more sites of care, health systems face greater challenges in maintaining continuity, coordinating treatment, and driving program growth. By unifying specialty patient support across care settings and coverage types, health systems can deliver a more seamless patient experience. RxTriage®, Shields’ new specialty care coordination and optimization solution, extends the same high-quality patient and provider experience regardless of where therapy is administered. RxTriage enables health systems to maximize the clinical and financial value of their specialty care programs by retaining specialty patient volume, expanding services regardless of coverage type (pharmacy or medical benefit), reducing time to therapy, and improving care coordination across all sites of care.
- Optimize Patient Experience – Navigating care for complex or chronic conditions is time consuming and overwhelming for patients. Through end-to-end, AI-enabled workflow automation, powered by Foundation Health, and a connected communication suite, Shields supports patients across the entire specialty medication journey—trusted experts supporting patients when they need it most. By streamlining prior authorizations and enabling timely engagement through refill reminders and adherence check-ins, Shields helps health systems get patients on therapy faster, while empowering pharmacists and liaisons to focus on high-touch care.
- Enhance Intelligent Clinical Intervention – Shields transforms fragmented, manual pharmacy workflows into a connected, AI-enabled experience that helps health systems scale clinical services while maintaining high-quality care. Through predictive insights, real-time quality monitoring, automated documentation, and coordinated care workflows, Shields’ clinical intelligence reduces administrative burden and improves operational performance across the patient journey. The result is more time for pharmacists to focus on patient care, contributing to an approximate 35% increase in time spent with high-risk patients while supporting better outcomes, patient safety, and quality at scale.
- Simplify Operational Complexity – High-touch patient care is proven to improve outcomes, but resource and administrative demands often make it difficult for health systems to scale efficiently. Complex program management and changing 340B requirements compound operational challenges. Through 340B IQ™, Shields’ proprietary 340B program management solution, health systems gain the compliance oversight, real-time operational support, and actionable reporting needed to reduce administrative burden and enable teams to focus more on patients.
“Innovation at Houston Methodist is focused on identifying and implementing solutions that address real challenges for patients and clinicians,” said Daniel Metzen, PharmD., Senior Director of Pharmacy at Houston Methodist. “By bringing together technology, clinical expertise and operational alignment, this model has helped improve coordination across the patient journey and support more timely access to therapy, contributing to better care and experiences for both patients and providers.”
Shields’ 15 years of experience informs technology that empowers care teams to turn automation and intelligence into action. The impact of automation should go well beyond cost reduction or workforce efficiency. Shields believes more time should be spent caring for patients, and value to health systems should be measured by superior patient outcomes and financial performance to support their mission.
The Shields model has helped achieve:
- Time-to-therapy in less than 48 hours, compared with 7 to 10-day industry average
- 91% of patients reported improvement in well-being since initiating therapy and 93% medication adherence rate (PDC), compared to the industry average of 80%
- A 200% increase in prior authorization throughput
- 13% reduction in total cost of care, including 35% fewer physician and ED visits
- $2 billion in financial assistance secured for patients in 2025; $9 billion since 2019
- Improved Shields’ team’s efficiency by 43%, leading to $200M of cost avoidance for Shields health system partners
“Health systems are being asked to do more with less, and while many see the opportunity to innovate in specialty pharmacy, they often face challenges managing multiple vendors at once,” said Jake Gaffey, President of Shields Health Solutions. “We’re bringing together people, technology, and insights into a single operating model – from referral to refill and beyond – for a more connected, accountable approach to specialty care. As our health system partners have come to expect from us, the Shields team will continue driving innovation and value for them across the full specialty continuum.”
For more information about Shields Health Solutions capabilities, visit its website.
About Shields Health Solutions
Shields Health Solutions (Shields), the specialty pharmacy operating partner for health systems, is working with nearly 80 of the nation’s leading health systems to deliver an integrated, connected experience that results in quality outcomes at scale. By combining proprietary technology with 3,000+ clinical and operational experts, plus relationships across 90% of commercial payers and access to 90% of limited distribution drugs, Shields helps health systems expand access, improve clinical outcomes, and scale specialty pharmacy growth at enterprise scale. Follow Shields on LinkedIn or visit the website for more.
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