How 340B Covered Entities are Disrupting the PBM and Preferred Pharmacy Landscape for Community Health Plans

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The 340B drug pricing program, which allows eligible healthcare providers known as covered entities to purchase medications at a reduced price, has been an incredibly valuable tool for providing affordable healthcare to underserved populations. However, the benefits of the 340B program go beyond just reducing the cost of medications. Covered entities that also act as pharmacy benefit managers (PBMs) for health plans in their community can leverage the program to create a circular healthcare economy that benefits not just the covered entity, but the entire community.

When a covered entity acts as a PBM for health plans in their community, they are able to negotiate lower prices for pharmaceutical products on behalf of their health plan clients. These lower prices can be passed on to patients, as health plans can offer lower out-of-pocket costs for prescription drugs. Moreover, by serving as a PBM, the covered entity is able to increase its

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3 Tips for Navigating the Current 340B Environment

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Many people have been losing sleep thinking about how they should move forward in the current 340B environment. Over the last 18 months, it has felt like an external force is around every corner, pushing or pulling covered entities into new areas of discomfort.

During these turbulent times, it can help to find partners who have experience as covered entities and have weathered storms historically. As a wholly owned subsidiary of a covered entity, Hudson Headwaters 340B helps covered entities navigate the complexity of the current 340B environment and assists in developing strategies and technology solutions to minimize the discomfort and uncertainty of today.

Below are three things we suggest to improve the value and efficiency of your organization’s 340B program.

1. Automate Your ESP Data Submission

Hudson Headwaters 340B knows first-hand the challenges of reporting data to Second Site ESP. We have worked with ESP over the last several months, building

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Do it Yourself: 340B Referral Prescription Capture Made Easy

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Many covered entities are not aware of the opportunity to capture referral prescriptions. This includes ones that were initially determined to be non-eligible by your TPA but after a closer look in your EMR are deemed to be eligible. Don’t miss out on this valuable source of revenue for your 340B program by overlooking referral prescriptions. You may be overpaying inflated fees by outsourcing. However, you can easily learn to capture these prescriptions yourself—before they expire—or another round of manufacturer exclusions is announced. With the recent increase in manufacturer blocks, maximizing your 340B savings wherever possible is more important than ever.

This session will be valuable for both PharmaForce Covered Entities and non-PharmaForce Covered Entities. Join us to learn about the potential of referral prescriptions and how to capture them in-house.

We’ll show you how to use the NEW PharmaForce Referral Claims Manager Platform to:

  1. Maximize referrals and implement a compliant
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