Rural Reality: A Conversation with a Rural Hospital Finance Director about Adapting to 340B Challenges

headshots of Anthony Esgro, Taylor Campbell, Rochelle Manuel-Sokol

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Located in rural Peterborough, New Hampshire, Monadnock Community Hospital (MCH) is a critical access hospital that offers comprehensive inpatient and outpatient services and is celebrating its 100th anniversary. MCH joined a Signify Health Accountable Care Organization (ACO) in 2023 to align with the Centers for Medicare & Medicaid Services’ goal of having all Medicare beneficiaries in an accountable care relationship by 2030. Like many of their rural-based peers, they have transitioned from fee-for-service healthcare to value-based care using Signify’s proven population health methodologies and award-winning technology to improve patient care outcomes.

Rural-based providers face particular sets of obstacles that can make healthcare delivery challenging. Rural communities often have limited access to resources, technology, and specialists, while many of the patients in these areas experience concomitant chronic illnesses. This makes for a perfect storm of limited supply with high demand.

For more than 30 years, the 340B program has provided financial assistance to

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Provider POV: 340B is Critical. We Must Raise Our Voices.

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For over 35 years, Avita Care Solutions’ Chief Medical Officer, Dr. Christopher Hall, has devoted his career to democratizing and scaling compassionate and competent care initiatives to underserved communities—the very patients the 340B program was designed to help. In the following interview, he offers a provider’s point of view on why the drug discount program is essential to even the health equity playing field and on how clinicians play a fundamental role in securing its sustainable future.


Question: How long have you been serving marginalized patients with the help of safety net funding from the 340B drug discount program?

Dr. Hall: I’ve been working with clinical programs associated with the 340B program for just shy of 20 years. My very first interaction with 340B was as the medical co-director of a large HIV clinic in Oakland, California, which was associated with a disproportionate share hospital (DSH) and received Ryan White Care

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How to End the HIV Epidemic in One Word:  Retention

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The landscape of HIV control looks very different than it did 30 years ago.  In the early days of the epidemic, most people living with HIV didn’t know they had the virus.  Our main challenge was finding them, testing them, and getting them into care.

Fast forward to now:  The problem isn’t finding people with HIV.  Eighty-seven percent of people living with HIV already know they are positive.1  The problem is keeping these people retained in care.

Retention is key because a person can only become virally suppressed if they are regularly in care and staying adherent to the medicines prescribed by their provider.  Viral suppression, in turn, is key because:

  1. People with HIV who achieve and keep an undetectable viral load can live long and healthy lives
  2. When virally suppressed, the virus levels in the body are so low, the virus will not transmit to the HIV negative partner during
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Connect and Learn at the 340B Grantees Fall Conference 

340B Grantees Conference, October 2-4, 2023

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Powers Law Firm is proud to support an unparalleled learning opportunity for 340B grantees.  The 340B Grantees Fall Conference, hosted by Ryan White Clinics for 340B Access, the National Association of Community Health Centers, and the State and Regional Associations of Community Health Centers, prioritizes practical education for all staff levels of 340B federal grantees. Hear from leading 340B experts, collaborate with fellow professionals, and dive into the latest developments impacting 340B grantees. Several of the Powers team will be presenting at the conference.

Who Should Attend? 

All 340B grantees and partners are warmly invited. The conference is designed to

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Strengthening 340B Program Integrity to Improve Accountability and Confidence

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An update on new reporting requirements and the continuous program compliance imperative

The integrity of the 340B drug discount program is under a microscope. Two states have recently passed laws requiring 340B providers to report on how they are utilizing their savings and national legislation has passed a key committee in the U.S. House of Representatives. Covered entities must act now to demonstrate that they are good program stewards and be prepared for additional reporting requirements. 

As a bipartisan group of U.S. senators reviews responses to a congressional RFI seeking input on how to improve the 340B program, Sectyr is launching an informative webinar series designed to shed light on one of the group’s most pressing questions: How to improve the accountability of the 340B program and give policymakers and industry stakeholders greater confidence in its oversight.

On September 13, join Ted

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Five Value Pillars for 340B Program Compliance

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For 340B program directors, complying with the U.S. Health Resources & Services Administration’s (HRSA’s) requirements is top of mind, all the time. That’s partly because maintaining their employer’s 340B program directly ties to profitability and sometimes survival.  Covered entities need 340B revenue to meet the program’s purpose “to stretch scare resources as far possible, reach more eligible patients and provide more comprehensive services.” Complying with the program requires a constant focus on guidelines and regulations.

Along with protecting program benefits and monitoring changing requirements, 340B program managers also hear politicians, pharmaceutical manufacturers and the press call for more oversight by the federal government. Manufacturers are concerned about program growth.  According to HRSA, discounted purchases under the 340B Program hit $44 billion in 2021, a 16-percent uptick from 2020.  The volume may have slowed down with the recent manufacturer restrictions on use of 340B discounts in the contract pharmacy setting but

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“ChatGPT, I Need 340B Help”

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As the complexity of managing 340B programs continues to increase, there is a growing need for advanced tools and technologies to ensure compliance integrity and optimize financial stewardship. In this article, we’ll explore the scope of analytics and artificial intelligence (AI) in enhancing 340B programs. By leveraging AI capabilities, such as active decision-making and passive information generation, covered entities can unlock the potential for improved efficiency, accuracy, and cost savings.

Scope of Analytics & AI in 340B

Analytics and AI technologies offer significant opportunities to augment 340B programs and drive better outcomes. Active AI enables the automation of real-time decisions and actions within 340B software, based on pre-defined parameters set by a 340B program expert. While real people are still essential to your 340B program, active AI can be used to make the efforts of your 340B team more effective and efficient.

On the other hand, passive information AI

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