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The purpose of the 340B drug pricing program remains a contested question between 340B providers and some in the pharmaceutical industry. In addition, there are questions regarding 340B’s scope including the contract pharmacy program and the definition of patient. Courts continue to wrestle with its interpretation, and the 340B community is still awaiting clearer guidance on implementation and enforcement. But while the legal battles unfold, it’s time to shift the focus from controversy to innovation. Specifically, how are covered entities (CEs) using 340B savings to stretch limited federal resources in impactful, community-centered ways?
Starting with the Mission
One belief many of us share is that every 340B CE exists to serve its community and improve its health outcomes. This mission isn’t limited to prescriptions or appointments. It’s about long-term, sustainable impact.
If we don’t view 340B through that broader lens, we risk missing its true potential.
Beyond the Pharmacy Counter
Why limit 340B’s impact to lowering prescription costs when it can do so much more?
That’s the question Conway Medical Center (CMC), a 222-bed disproportionate share hospital based in Conway, South Carolina, set out to answer. Their approach stands out as one of the most compelling uses of 340B savings to date.
The Conway Model: From Coverage to Community Health
CMC operates a high-performing retail pharmacy and a strategically designed 340B program, all in service of its mission to enhance the health of Horry County residents. In 2021, then-CFO (now CEO) Brian Argo spearheaded an internal analysis to evaluate the impact of hospital readmissions and what could be done to help patients and the hospital address this challenge.
The findings were striking:
- Of 495 readmitted claims across 11 DRGs, 274 were reimbursed at a loss—totaling $825,000.
- Uninsured readmitted patients accounted for an additional $1.5 million in losses, with little prospect for recoupment.
At that point, CMC could have used 340B savings to offset those losses and considered the matter resolved.
But they chose to do more.
A Strategic Reinvestment: Pharmacy-Led Readmission Reduction
Instead of plugging financial gaps, CMC reinvested its 340B savings into a pharmacy-driven initiative aimed at reducing hospital readmissions, particularly among high-risk and uninsured patients.
They hired a clinical pharmacist to support their Bedside Discharge Program and launched a proactive, 30-day post-discharge patient engagement strategy.
Through data analysis, the team identified key risk factors:
- Patients with more than two hospital visits per year had a 35% 30-day readmission rate.
- Those with three or more visits saw the rate climb to 47%.
- Patients with uncontrolled A1C levels faced a 19.7% readmission rate.
CMC began flagging these patients at the point of admission. The clinical pharmacist conducted in-hospital medication reconciliation, ensured patients left with access to prescribed medications, regardless of ability to pay, and maintained contact via calls and texts for 30 days post-discharge. Case management was integrated when needed.
The Results
In just six months, the impact was clear:
- Readmissions in the 3+ visit cohort dropped to 10.7% – a 77% reduction
- Readmissions for patients with uncontrolled A1C levels fell to just 1.4%, a 93% reduction.
- Patient satisfaction averaged 9.66 out of 10.
CMC didn’t just absorb the cost of readmissions, they prevented them. They used their 340B program not just to fill prescriptions, but to fundamentally improve health outcomes.
What 340B Was Designed to Do
Conway’s model is a powerful example of what’s possible when covered entities embrace the full potential of the 340B program. This is more than cost savings—it’s community transformation.
“We’ve expanded into areas of medicine we never thought we could offer. We’ve added a cancer center, a pain clinic as part of our orthopedic practice, a dermatology clinic, and a women’s center. We’re expanding our footprint, and we’re treating so many more patients than we used to. Without 340B and our Readmission Reduction program, that wouldn’t have been possible.”—Andrew Wright / Director of Pharmacy / Conway Medical Center
Final Thought
The mission of 340B isn’t only about access—it’s about impact. It’s about leveraging limited federal resources to move beyond survival and toward helping patients thrive.
Conway Medical Center offers a blueprint. And they’re not alone. Across the country, CEs are using 340B to drive meaningful change, quietly and effectively.
Howard Hall is senior vice president of Enterprise Growth at Maxor. He can be reached at hlhall@maxor.com
