The infusion and specialty pharmacy market is entering a period of sustained growth.
Nearly half of the $150B U.S. infusion therapy market now comes from non-acute settings, and analysts project the home infusion market to grow at a 7–8% CAGR over the next several years.
For infusion and specialty pharmacies, this growth represents opportunity, but also increased operational pressure. As claim volumes rise and therapies become more complex and expensive, the way pharmacies manage revenue cycle operations is coming under new scrutiny.
As 2026 approaches, RCM is no longer just a back-office function. It’s becoming a defining factor in whether pharmacies can scale, adapt and protect revenue in a high-stakes environment.
New research from Prochant, conducted in partnership with In90group Research, sheds light on how pharmacy leaders are navigating this shift and where challenges remain.
A High-Stakes Operating Environment
Infusion and specialty pharmacies manage some of the most complex claims in healthcare. Individual claims often represent tens of thousands of dollars and can exceed $100,000 for high-cost therapies. Achieving accuracy across coding, documentation, billing and compliance is essential, as even small errors can result in denials, delayed payments or write-offs.
At the same time, payer requirements continue to evolve, timelines are tightening and therapy innovation is accelerating. Many pharmacies are finding that legacy RCM workflows were not designed for this level of complexity or scale.
What the Research Reveals
The Pharmacy Research Report highlights a market at an inflection point.
According to the study:
- 73% of pharmacies report being less than fully satisfied with their current RCM approach, citing high denial rates, aging accounts receivable and increasing write-offs.
- 73% also report revenue losses tied to inefficient RCM processes, with downstream impacts on growth and staff retention.
- Looking ahead, 71% of pharmacies say they are considering changes to their RCM model within the next 12–24 months, signaling a widespread reassessment of how revenue cycle work gets done.
These findings suggest that dissatisfaction isn’t just about current performance; it’s about preparedness for what lies ahead.
Preparing for 2026 and Beyond
As pharmacies plan for the future, many leaders are exploring how technology can better support RCM operations. Automation, advanced analytics and AI-driven tools are increasingly being used to reduce manual effort, improve visibility into risk and enable faster, more informed decision-making.
For infusion and specialty pharmacies managing high-value claims, these capabilities are becoming essential. Reactive processes and delayed insight leave too much revenue at risk in an environment where precision and speed matter more than ever.
Looking Ahead
Operational agility, data-driven decision-making and modern RCM models will play a critical role as pharmacies navigate 2026 and beyond.
The Pharmacy Research Report provides a detailed look at the challenges pharmacies are facing today, the changes leaders are considering and the strategies being explored to future-proof RCM operations in a rapidly evolving market.
Read the full Pharmacy Research Report to explore the data, insights and implications for your organization.
