A proposal in the Senate aims to create savings for health providers while a new report details how to maximize the program’s pharmacy benefits.
The 340B Drug Pricing Program represents ample healthcare and business opportunities to some, while others see it as a federal program in need of significant reforms to address outstanding cost concerns.
The program, which provides Medicare payments for outpatient drugs to hospitals serving high volumes of low-income patients, has garnered both praise and controversy in recent months. The program is viewed as crucial for rural hospitals attending to high Medicare populations, but also as a lightning rod for perceived governmental mismanagement.
Sage Growth Partners, a healthcare business consultant agency based in Baltimore, released a report Thursday titled, “Realizing the Full Power of 340B Pharmacy Benefits.” The report includes three distinct 340B models health systems can implement: do-it-yourself, contract pharmacy, or global managed services.
Dan D’Orazio, CEO of Sage Growth Partners, said while contract pharmacy models have been the most popular approach, businesses have to assess their own expectations and needs when getting involved with the 340B program.
“This report takes a look at how you decide to manage or operate one of these entities and whether you go it alone, find a commercial partner like a pharmacy or find a managed partner to help you do that,” D’Orazio told HealthLeaders Media. “There are different models to do that and I think they have different ramifications for profitability, patient care, coordination of care, and medication adherence.”
D’Orazio said recent reports have indicated the 340B program is “a little out of control” but said the public should not be scared, adding the program represents a “real opportunity” for health systems dealing with financial pressures. He also said the program’s rules are clear, though hospitals may need to engage with managed partners for experience and assistance with any lingering complexities.
Ire, attention center on 340B
Despite the enthusiasm to maximize 340B benefits, the program has sustained pointed criticism in recent months.
A recent Pacific Research Institute study found numerous cases of abuse and profiteering, ultimately urging Congress to reform the program. A report from the Department of Health and Human Services’ Office of Inspector General last month highlighted $4.4 billion in federal funds misspent on health care programs last year, including 340B.
Those interested in implementing the strategies detailed in the Sage Growth Partners’ report will have to account for legislative corrections, which could be on the way.
Sen. Bill Cassidy, R-La., introduced the HELP Act on Tuesday, which would create a moratorium on registering “new non-rural section 340B hospitals and associated sites.” In a press release, Cassidy stated his support for 340B while highlighting the need for improvement after documented instances of wasteful spending.
“But too often the program’s discounts are used to pad hospitals’ bottom lines instead of helping disadvantaged patients afford their treatments,” Cassidy said. “This bill will increase transparency and accountability and help ensure these discounts reach patients.”
The group 340B Health, which represents hospitals and health systems, issued a statement responding to Cassidy’s legislative proposal.
“We agree the 340B program is an important resource for hospitals and their patients, and support having a thoughtful conversation about transparency in the 340B program,” the statement read. “However, we are concerned by the proposals included in the HELP Act.
“If enacted, these changes would limit the ability of 340B hospitals to fulfill their mission to care for all Americans regardless of their ability to pay. The legislation would make changes to the rules on which hospitals can participate in 340B, which could reduce the number of hospitals that could qualify for the drug discounts. It would also impose significant new reporting requirements that would not shed any light on what hospitals do with their 340B savings to help patients.”
So far, the bill has not even advanced to a committee vote.