340B Insight

As specialty drugs play an increasingly important role in patient care, 340B hospitals need to be planning for how to obtain these high-cost medications when they come online and how best to support their patients once they start using these treatments. Tina Do is associate director of clinical strategy and business development at Yale New Haven Health. She discusses the ways her health system has achieved success in connecting patients with some of the most complex and costly specialty drugs and what other hospitals can learn from those examples. Why Specialty Drugs Are Key for 340B HospitalsDo says specialty drugs are becoming more important to the 340B world for much the same reason they are becoming more important in the health care system. More than 70% of drugs in development are specialty drugs, including numerous therapies that are considered ultra-specialty drugs. That makes it imperative for 340B hospitals to be considering the projected costs of these drugs and the often-substantial amount of patient support that is necessary for people who need these complex therapies.Hospitals Must Anticipate Upcoming Drug TherapiesDo argues that hospitals need to be monitoring medications coming down the pharmaceutical pipeline because of all the strategic conversations that need to happen within and outside of a pharmacy. Hospitals might need to acquire certain equipment or technology to support these therapies and make plans for the financial impact of new treatments on both the health system and the patients.What Hospitals Need to Figure Out Ahead of TimeBefore new treatments come online, Do says health systems need to ask numerous questions about accessing and administering them. Is a specialty medication going to be a limited distribution drug? Will the medication be part of payer contracts? How many patients and prescribers are affiliated with a particular health service and might be interested in receiving or prescribing the medication? How can the hospital help patients stay on this complex therapy and access financial assistance when necessary? Figuring out the answers to these questions well ahead of time will go a long way in setting up the hospital and its patients for success.

The popular belief that pharmacy technicians are solely focused on dispensing drugs is a common misconception, especially when these techs are working for 340B hospitals. We speak about the increasingly important role pharmacy techs are playing in the 340B world with Dartmouth Health Senior 340B Analyst Kayla Ciampi. Getting Into the 340B WorldAfter having limited experiences with 340B earlier in her career, Ciampi said things became “340B on steroids” once she moved to Dartmouth Health. Now much of her day-to-day responsibilities revolve around 340B purchasing and compliance issues, involving significant amount of time working with Excel, third-party administrators, and 340B claims auditing. She said what keeps her coming back are the challenges she tackles and the satisfaction she gets from finding solutions after hours of research.The Changing 340B Roles of Pharmacy TechsCiampi says pharmacy techs are working hard figuring out when to purchase drugs on 340B accounts, ordering for contract pharmacies, and keeping track of increasing drugmakers restrictions. Techs are doing much of the analytical work behind the scenes to make sure 340B claims are eligible, making them a key part of the compliance infrastructure at hospitals.Advice for Other TechsAs the 340B world picks up speed, Ciampi said being a pharmacy tech in that field can feel like being on a fast-moving freight train and trying to see what’s happening outside. Because of how rapidly that landscape is changing, she says attention to detail, a willingness to adapt, and a desire to learn are the keys to 340B success for techs.Resources340B Health Urges CMS To Abandon Proposed Medicare Cuts to 340B Hospitals

A key dimension to navigating 340B involves data, because the way hospitals and their pharmacies crunch numbers can be key to avoiding compliance issues and finding new opportunities to improve savings and patient access to care. Saint Francis Health System’s 340B Program Manager Ted Houston tells us how his health system is getting the most value out of all the data.Compliance and Savings OpportunitiesHouston says his health system has put in a lot of work with its enterprise and data analytics team to align what the electronic health record system is exporting to what drug companies are demanding in order to improve compliance. But he said improving reports also led to additional savings for his system, as some claims were miscategorized within third-party administrator systems. Data Consolidation, Better WorkflowsHouston said health systems can improve their data monitoring by reducing individual data sources — for example, by using a standardized data extract from a third-party administrator and using tools to scan for certain types of claims. Saint Francis found success with improving oncology medication workflows, finding tens of thousands of dollars’ worth of eligible savings on certain oncology medicines.Investing in Better Data Quality, Not VolumeTo improve data collection, Houston said self-education — both about different analytical resources and what use cases would have the biggest impact — is critical to optimizing data. Those tools may cost money, but it is important to concisely communicate the value proposition for compliance or savings when investing in new tools to improve how hospitals gather and process data.Resources:Episode 140: What Illinois 340B Advocates Did To Succeed on 340B ProtectionsIllinois Governor Signs 340B Contract Pharmacy Protections as Drugmakers File Lawsuits

Mid-August to mid-September marks the time every year when hospitals need to recertify for 340B. Failure to recertify in time could cost a hospital its ability to participate in 340B. 340B Health Associate Director of Policy and Compliance Rebecca Swartz joins us to walk listeners through the process.Why recertification is “exceptionally important”Swartz says annual recertification is not just important, it’s also one of the central tenets of 340B compliance. All hospital types except critical access hospitals need to make sure they’re meeting the minimum disproportionate share percentage threshold. Hospitals also need to affirm that they are nonprofit facilities and that all their registered parent and child sites continue to have reimbursable outpatient costs and charges on their Medicare cost reports.The cost of losing eligibility is highFailure to recertify 340B eligibility in a timely manner can lock hospitals out of their access to 340B pricing for a year or more. That could deprive a hospital of crucial resources to provide the care and support its patients need.Tips for a smooth recertificationSwartz says a key to making the process go smoothly is to start early and make sure hospital officials have the necessary worksheets and other documentation before the recertification process begins. Authorized officials (AOs) and primary contacts (PCs) should be on the lookout for returned tasks from the Health Resources & Services Administration (HRSA) and other messages to ensure their recertification process is complete. Taking screenshots of each step of the process also can help identify and fix discrepancies that might arise.ResourcesHospital Recertification Begins Aug. 10, Prepare Now!340B Health Registration and Recertification Resource Page340B Health Webinars

With hospitals facing increasing drug company restrictions on access to 340B savings and other challenges, some might be considering opening their own retail pharmacies to serve their patients. We speak with Sherstin Willyerd, director of pharmacy operations at Montgomery County Memorial Hospital in Iowa, to learn about how her hospital went this route and what others want to consider before doing the same. Buying Existing Pharmacies Can Be a Solution Willyerd said her hospital was able to purchase two independent pharmacies whose owners were retiring, providing an existing dispensing infrastructure and patient base from which to start. While the hospital still has some contract pharmacy partnerships, the in-house locations can serve patients and generate 340B savings that are less prone to drugmaker restrictions.A Retail Pharmacy Can Give Better Insight into Patient StrugglesOperating a retail pharmacy allowed Willyerd’s hospital to see more clearly which patients were struggling with prescription drug costs and medication adherence and to provide more assistance to them. She noted that capturing more 340B savings makes it easier to pass along more discounts to patients who otherwise would not be able to afford their drugs.An Independent Insurance Plan Means Even More AssistanceMontgomery County Memorial Hospital also partnered with a pharmacy benefit manager (PBM) to create a primary and secondary prescription drug insurance plan that it offers to certain patients with low incomes and hospital employees. Willyerd noted that this plan can mean hundreds of dollars in savings per month for uninsured patients and those whose coverage comes with high cost sharing.Resources:HRSA Releases 340B Purchase Data for 2025