A Candid Look at Today’s 340B
Robin George, CPHT
Manager, Health Systems Platform Innovation
Robin George is manager of health systems platform innovation at AllianceRx Walgreens Pharmacy. Last week, he took part in a panel discussion entitled “Lessons from the Field” at the 340B Coalition Winter Conference in San Diego. The following are some key takeaways from his presentation.
The 340B Program, signed into law in 1992 as part of the Veterans Health Care Act, was designed to allow safety net providers – those who deliver healthcare services to patients regardless of their ability to pay – the ability to stretch scarce federal resources. These resources serve those in vulnerable, disproportionate communities, and allow for patients in these communities to gain access to comprehensive healthcare services.
In order to participate in the Medicaid and Medicare Part B markets, pharmaceutical companies must agree to provide outpatient pharmaceuticals to safety net healthcare providers at a discounted rate. Savings from the 340B Program help these hospitals and health systems support services for uninsured and low-income patients and those residing in rural areas.
340B Program Support for Patients
As a result of this vital program, there are countless examples of improved medication adherence, reduction in hospital readmission, and increased patient access to comprehensive health services. In a recent case study by 340B Health, 100% of disproportionate share hospitals (DSH) reported they use their 340B savings in one or more ways to serve vulnerable patients, and most reported many.
The most common uses reported were to increase access for low-income and/or rural patients (92%) and to support uncompensated and unreimbursed care (90%). Respondents of this case study also reported areas where 340B savings have supported improved outcomes. Nearly nine of 10 reported that 340B savings supported programs which improved medication adherence. Increased access and reduced readmissions were close behind. Hospitals also highlighted specific ways their organizations use their 340B savings, as well as outcomes they have worked to improve.
Strain on the System
Despite supporting a wide span of patient needs, the 340B Program faces opposition. Comments and opinions increasingly surface, questioning guidance from the Health Resources & Services Administration or how this agency enforces the rules it has issued. The recent pharmaceutical manufacturer notices restricting contract pharmacy access or requirements enforcing 340B claims data uploads have added additional layers of complexity to Covered Entities and their program management.
Collectively, these items place a tremendous amount of strain on the 340B healthcare landscape, introducing turbulence between manufacturer, provider, contract pharmacy, and payer. The patient, who remains at the center of this turbulence, is blind to the disruption within the landscape, yet faces disruption to services they may have once received.
What 340B-Covered Entities Can Do
As our country’s focus remains on the current pandemic crisis, the 340B Program and its ecosystem remain unsettled. 340B-covered entities, if not doing so already, should continue to remain apprised of any program changes and work closely with their 340B Program administrators and steering committees. Periodic reviews of the 340B Program, as it is managed by each covered entity, is pertinent to identify growth outlets, strengthen partnerships, but most importantly determine how to best serve patients and the communities that support them.
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