SPONSORED CONTENT

Healthcare leaders have a lot on their plates. Today’s healthcare landscape requires health care organizations to compete in attracting and retaining qualified employees, remain up to date on reimbursement changes, select and employ technologies to serve more patients in convenient ways, and adhere to quality standards to serve their communities.

With the need for pharmacy to become an integrated part of health care organizations and for leaders to be successful in achieving their objectives, organizations are turning to Maxor, a national provider of pharmacy services. Maxor’s been helping healthcare leaders tackle pharmacy challenges for more than 90 years.

Maxor partners with hospitals, health systems and grantee organizations (e.g. Community Health Centers, Ryan White Clinics, STD Clinics, FQHC and FQHC look-a-likes) to create fully customized solutions, allowing clients to realize clinical and financial benefits without the headache of running an onsite pharmacy. Not to mention, Maxor is a leading expert in 340B

SPONSORED CONTENT

Part 2 of 2: Navigating staffing shortages, unpredictable demand, and complex industry requirements

While in-house pharmacies offer a wide array of benefits both for the community health center (CHC) and their patient populations, overseeing the myriad of administrative, operational, financial, and regulatory intricacies can prove difficult to manage. In Part 1 of this series, we covered two of the biggest challenges that CHCs face while operating in-house pharmacies: managing costs and ensuring favorable contracting.

In this follow-up, we explore the pressures facing CHCs due to pervasive staffing and retention challenges, fluctuating levels of patient demand, and nuanced regulatory complexities—and how CHCs can act to boost patient demand, improve clinical outcomes, and reinforce their financial health in 2024 and beyond. This is part two of a two-part series.

Challenge 3: Staffing shortages

Attracting and retaining pharmacy talent has

SPONSORED CONTENT

Part 1 of 2: Managing costs and ensuring favorable contracting

As industry veterans know too well, having an in-house pharmacy can be greatly beneficial for both community health centers (CHCs) and their patients. Not only do they offer patient convenience and a greater level of transparency into medication adherence or prescription abandonment, but they also allow for improved engagement and educational opportunities, the potential for revenue growth, and enhancements to clinical programs that can translate directly into better health outcomes.

However, in-house pharmacies face a growing set of challenges, from managing purchasing and inventory to rising drug costs, drug shortages, unpredictable patient demand, payer contracting, staffing shortages, and regulatory complexities. And, as at least half of the average CHC patient populations is covered by Medicaid,^[1] the program’s unwinding of its continuous enrollment provision will mean an additional

SPONSORED CONTENT

If you have one or more agreements with 340B Third Party Administrator(s) (TPA) to manage your contract pharmacy arrangements, how much do you know about those contracts and associated fees?  Chances are, you don’t know the answers to all the questions that follow.  Be sure to contact your 340B TPA(s) and ask:

1. How does the TPA charge your covered entity to perform its services? Is it a flat monthly fee per contract pharmacy, a flat fee plus a percentage of savings on 340B approved claims, a percentage of savings, a captured claim fee, or per matched charge?
2. Does your TPA agreement have a minimum dollar amount threshold for administrative fees per contract pharmacy? 
3. Are you being charged for switch fees (If your covered entity is being charged for switch fees, do you know what the average switch fee cost is to compare to what you are being charged?), gateway fees, or a

SPONSORED CONTENT

When a covered entity enrolls in the 340B program it must inform the Health Resources and Services Administration (HRSA) whether it will “carve in” and acquire 340B drugs for its Medicaid fee-for-service (FFS) eligible patients, or “carve out” and purchase drugs for its FFS patients outside the 340B program.

A covered entity choosing to carve in Medicaid FFS claims must provide the HRSA Office of Pharmacy Affairs (OPA) with the Medicaid Provider Number(s) (MPNs) or National Provider Identifier(s) (NPIs) it uses to bill FFS Medicaid (in any state) for 340B drugs. This information will appear on the 340B Medicaid Exclusion File (MEF), notifying states and manufacturers that drugs purchased under that MPN or NPI are not eligible for a Medicaid rebate. Covered entities are required to ensure that the information listed on the MEF is accurate.

Published quarterly on the OPA Information System (OPAIS), the MEF is the data source HRSA uses to assist

SPONSORED CONTENT

Leaders of hospitals, health centers and other 340B provider institutions are busy and don’t have time in their demanding days to be involved in the detailed, day-to-day financial oversight of their 340B programs. Yet, they also can’t afford to leave valuable program dollars on the table, which fund vital and expanded patient services. Here’s a checklist of six key steps to help you optimize the financial health of your 340B program in 2023 and beyond. And if you have a 340B TPA (third-party administrator), this list can help you ask them the right questions.

340B Financial Checklist

1. Know the facts about your contracts and fees

• Be sure you know how you’re charged by your 340B TPA. Is it a flat fee per contract pharmacy, a flat fee and percentage of savings on 340B approved claims, or other?
• Are there minimum dollar amount thresholds you must meet?