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The healthcare system is undergoing a major transformation, with a growing emphasis on value-based care and outcomes-based payment models. These shifts aim to improve patient outcomes and reduce costs, fundamentally challenging traditional fee-for-service approaches. Against this backdrop, the 340B program is a vital lifeline that underserved communities must adopt to remain relevant and impactful. While some critics question its compatibility with value-based care, the 340B program has the potential to serve as a critical driver of equitable, patient-centered healthcare.
Understanding the Challenge
Value-based care rewards healthcare providers that improve patient outcomes while reducing unnecessary costs. This new framework is built on efficiency, quality, and accountability. 340B provides discounts on certain outpatient drugs to eligible entities, allowing them to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.
Critics argue that 340B incentivizes the purchase of high-cost medications and aligns more closely with volume-driven systems than with value-based care. However, these criticisms often ignore 340B’s real impact. The program has consistently enabled safety-net providers to expand care, address health disparities, and improve access to life-saving medications. In fact, focusing on high-risk, underserved populations can directly align with value-based care priorities. The challenge now is ensuring that 340B stakeholders take deliberate steps to integrate the program into this evolving healthcare environment.
How 340B Can Align with Value-Based Care
To secure its future, the 340B program must evolve alongside the healthcare system. Covered entities, pharmacies, and policymakers can take several key actions to demonstrate the program’s value in a value-based care framework.
1. Investing in Community Health Initiatives
Using 340B savings to fund population health programs is one clear way the program can support value-based care. These funds can be used to support chronic disease management, preventive care, and addressing social determinants of health, such as housing, nutrition, and transportation. These initiatives can help reduce long-term costs and improve health care outcomes and align with value-based core objectives.
2. Building Outcomes-Based Partnerships
Specialty pharmacies and covered entities should explore outcomes-based contracts with manufacturers and payers. These agreements tie reimbursement to measurable health improvements, such as medication adherence, reduced hospitalizations, or better disease management. Demonstrating success through such partnerships can strengthen the case for 340B in a value-driven system.
3. Improving Transparency and Accountability
To counter criticisms of the 340B program and align with value-based goals, covered entities should prioritize robust data collection and reporting of how 340B savings are reinvested into the care of patients. Tracking metrics like patient outcomes, medication adherence, and savings reinvestment shows how 340B savings support cost-effective, high-quality care. This transparency is vital for building trust with policymakers and the public.
4. Integrating into Collaborative Care Models
Embedding 340B services within patient-centered medical homes or accountable care organizations can enhance coordination and efficiency. Specialty pharmacies in particular can help manage complex medication regimens, reducing complications and supporting better overall care. This approach aligns the program with broader value-based care efforts to deliver seamless, high-quality care.
Looking Ahead
By enabling providers to deliver more comprehensive care to underserved populations, 340B can support covered entities in addressing disparities that often drive poor outcomes and higher costs. With targeted investments and strategic partnerships, covered entities can adapt to the changing healthcare landscape while staying true to its mission of improving access to care through expanded 340B participation.
Conclusion
As value-based care continues to reshape healthcare, the 340B program faces an important crossroads. Its success will depend on its ability to demonstrate alignment with new priorities while continuing to support vulnerable populations. By focusing on transparency, outcomes, and community health, the program can evolve to meet the challenges of value-based care and remain a vital force for equity and access in the years ahead.
William Riley is VP Commercial Analytics at Maxor. He can be reached at wariley@maxor.com.
