340B Insight
340B Health
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07/20/20 • 20 min
In this episode, we speak with Sarah Dodson, the 340B Program Director at Ascension Via Christi, the largest health care provider in Kansas. Sarah talks about her work with the Community Cares Clinic, which provides comprehensive and hands-on care for vulnerable patients.
It’s also been a busy news month for 340B. In our news update segment, we discuss a drug manufacturer’s unprecedented new policy for refusing 340B pricing on one of its drugs to a covered entity that will be distributing that drug through a contract pharmacy. We also discuss new, bipartisan pro-340B legislation that has been introduced in the U.S. Senate.
A Collaborative Approach for Patients: Community Cares Clinic is one of five services offered by Ascension Via Christi that work together to address the barriers and other challenges to patient health care.
Hands-On Health Care Services: The Community Cares Clinic is a nurse practitioner house-call model that sends nurse practitioners to the homes of patients with COPD or heart failure once per month or more frequently if needed. The service also includes access to a 24/7 telephone line for patients to speak with a nurse practitioner from the program. This helps a patient’s care team understand factors affecting patients outside of the hospital setting. With more knowledge about a patient’s lifestyle and environment, health care providers can offer personalized and targeted care. These efforts in tandem with other models of care have resulted in significant reductions in avoidable hospital admissions over the past few years.
The Role of 340B in the Community Cares Clinic: The savings generated by Ascension Via Christi’s 340B participation support the Community Cares Clinic, as well as the other four model services with which it partners.
Replicating the Community Cares Clinic Model: Other hospitals looking to start programs like Community Cares should first identify key barriers for their patients such as the inability to leave their home for care. Hospitals should develop programs that address these barriers when providing services to their patients.
Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to answer on the podcast, email us at podcast@340BHealth.org.
Episode Resources:
1. 340B Health Member Alert on Eli Lilly’s Contract Pharmacy Plan
2. Bipartisan Bill Would Protect 340B Status During Emergency
340B’s Role in Supporting Rural Health Care
340B Insight
07/06/20 • 22 min
In this episode of 340B Insight we speak with Chuck Beams, executive director of pharmacy services, business development, and government relations at East Alabama Medical Center (EAMC), about how the 340B program helps EAMC serve its rural community. We also provide 340B news updates regarding the CMS Medicare Part B cuts to 340B hospitals and new 340B research.
A Diverse Patient Population: EAMC is located in Opelika, Alabama, and serves 11 counties, totaling a population of nearly half a million. Although it is located near Auburn University, it serves many underserved, rural patients who live in nearby communities.
Support Center Amid Natural Disasters: In March 2019, eastern Alabama experienced a devastating tornado that left 23 people dead. In the aftermath, EAMC held the community together with its emergency medical response and social services such as discounted medical bills.
Using 340B Savings to Serve the Underserved: EAMC is one of a dwindling number of hospitals in the area. The 340B program is a key reason why EAMC has survived. Chuck’s team has leveraged 340B savings to provide uncompensated care to uninsured and low-income patients, a meds-to-beds program to ensure patients have the medications they need at discharge, mobile health services, and access to pharmacists in the emergency department,.
The Importance of Advocating for 340B: Chuck shares the importance of advocating for the program at both the federal and state levels to ensure policymakers understand the value it brings to patients and the rural hospitals that care for them.
Check out all of our episodes on the 340B Insight podcast website. You can also stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to cover in this podcast, email us at podcast@340BHealth.org.
Episode Resources:
06/01/20 • 20 min
In this episode, we speak with Mike Bonck, Manager of Pharmaceutical Services for CHI Franciscan Health (CHIFH) in Tacoma, Washington, about the impact of COVID-19 on the US health care system. CHIFH is a system with four DSH hospitals, one rural referral center, and one critical access hospital that participate in the 340B program.
Tacoma is one of the most significantly affected regions of the U.S., having experienced a major surge of COVID-19 cases in March and April. CHIFH was one of the first hospital systems in the U.S. to face the enormous challenge of responding to COVID-19. Mike offers his perspective on the impact of the novel coronavirus on hospitals, staff, and patients. Some major takeaways include:
Planning, Communication, and Support: Hospitals overwhelmed by COVID-19 face severe equipment and drug shortages. Other major complications include scheduling surgeries and establishing new visitation policies. To address these challenges, hospitals must engage in meticulous planning, system-wide communication, and support for health care employees.
Financial Challenges: COVID-19 has severely threatened the financial health of U.S. hospitals. Federal stimulus money for hospitals through the CARES Act is helping but likely insufficient. As such, it will take a concerted effort to recover from COVID-19, from both a public health and financial health perspective.
Impact of the 340B Program: The 340B program has mitigated CHIFH’s financial challenges, helping the hospital continue to provide critical health services to low-income and underserved patients.
340B Regulatory Flexibility: Policies adopted by the Health Resources & Services Administration to provide greater flexibility to 340B hospitals have helped and should be made permanent.
Long-Term Impact of COVID-19: Innovations such as telemedicine will improve and expand health care in the long term. However, the U.S. health system faces more immediate challenges of caring for the millions of Americans who are newly unemployed and without insurance coverage.
Check out all our episodes on the 340B Insight podcast website. You can also stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to cover on our podcast, email us at podcast@340bhealth.org.
Episode Resources:
1. 340B Health COVID-19 Resource Center
2. 340B Health OPPS Resource Center
3. Sen. Ben Sasse’s press release on rural health legislation
05/18/20 • 22 min
340B Insight is a podcast hosted by 340B Health that provides its members and supporters with timely news updates and discussion around the 340B drug pricing program.
This inaugural episode includes news updates on the Centers for Medicare and Medicaid Services going ahead with a controversial survey of 340B hospitals, and lawmakers on Capitol Hill asking congressional leaders to protect 340B during the COVID-19 pandemic.
In the feature interview for this episode, the President and CEO of 340B Health, Maureen Testoni, speaks with Rear Admiral Krista M. Pedley, the Director of the Office of Pharmacy Affairs (OPA) in the Health Resources & Services Administration (HRSA). OPA administers the 340B drug pricing program, which requires drug manufacturers to provide outpatient drugs to eligible safety-net providers at reduced prices.
During the interview, Rear Admiral Pedley offers numerous insights into critical 340B issues, including:
- HRSA Provides Flexibility During the COVID-19 Pandemic: HRSA is offering certain flexibilities for covered entities to ensure that they can remain focused on patient care during the pandemic. For example, it will conduct remote 340B audits for the next several months.
- HRSA Has Limited Enforcement Powers During Audits: HRSA can only enforce 340B guidance if it discovers a clear and direct violation of the 340B statute. As such, HRSA states that it has limited capacity to broadly enforce 340B guidance.
- The New 340B Ceiling Price Website Improves Transparency: Last year, HRSA launched the new 340B ceiling price website, which has improved transparency and communications with external stakeholders in relation to price reporting and price comparisons.
- Eligible 340B Participants Must Continue to Document and Track Activities: Rear Admiral Pedley urges all 340B participants to document how they follow HRSA guidance in their policies and procedures and to keep auditable records of what makes them eligible to participate. It is also critical that 340B participants have a system in place to track every purchase of a 340B drug to an eligible patient.
- HRSA Finds Common Ground Between All Stakeholders: Rear Admiral Pedley highlights her role in listening to all sides of the 340B ecosystem to help find common ground and a sustainable path forward on reduced drug pricing.
340B Health expresses our gratitude to Rear Admiral Pedley for more than 10 years of dedication to the 340B program. Under her leadership, the 340B program continues to improve in its role as a vital health care safety net to patients in the U.S.
Check out all of our episodes on the 340B Insight podcast website. You can also stay updated on all 340B Health news and information by visiting our homepage.
Episode Resources:
340B Health COVID-19 Resource Center
340B Health OPPS Resource Center
340B Health press release on Reps. Matsui-Stewart letter
Maureen Testoni op-ed about the 340B ceiling price website
Rear Admiral Krista Pedley’s Bio
Rear Admiral Krista M. Pedley is the Director of the Office of Pharmacy Affairs (OPA) in the Healthcare System Bureau, Health Resources & Services Administration (HRSA). Her office administers the 340B drug pricing program, through which more than 700 drug manufacturers provide discounted outpatient drugs to more than 46,700 hospitals and clinics, and more than 24,500 pharmacies purchase more than $24 billion in 340B drugs annually. The 340B program spans HHS and focuses on drug pricing transparency and reducing the cost of medications for the country’s most vulnerable safety-net patient populations.
RADM Pedley began her career as a pharmacist with the United States Public Health Service in May 2000. She was assigned to the Food and Drug Administration, Office of Generic Drugs, as a Project Manager for Bioequivalence and then as Medical Affairs Coordinator reviewing topical drug protocol design. After five years, RADM Pedley transferred to HRSA and then the Office of the Secretary of Health and Human Serv...
A Guide to 340B Research
340B Insight
09/29/20 • 20 min
In this episode, we speak with Caroline Steinberg, Vice President of Research and Policy Analytics at 340B Health, about research into the 340B program. For more information about 340B Health’s research, you can review the research page on our website. Before the interview, our news segment covers the latest updates on proposed Medicare cuts to 340B hospitals and 340B Health’s Virtual Hill Day last week.
The Role of Research: Research is vital for educating policymakers about the 340B program to help ensure continuing support for the program. Research also helps demonstrate that the program is vital for safety-net institutions. For example, one study revealed that 60% of uncompensated care is provided by 340B hospitals, even though 340B hospitals are only about 40% of all hospitals. Verifiable data helps combat misinformation the policymakers hear from opponents of the program.
Research Demonstrates 340B’s Importance to Medicaid: The most recent 340B Health research study found that 75% of all hospital care provided to Medicaid patients is provided by 340B hospitals. Partly because of serving a high percentage of Medicaid patients, 340B hospitals have negative margins on average.
340B Hospital Surveys Are Key: 340B Health’s surveys of member hospitals are critical for gauging the impact of policy changes and sharing that information with policymakers. For example, as policymakers continue to discuss drug manufacturer efforts to cut back on providing discounts when drugs are dispensed at contract pharmacies, 340B Health has found that 57% of 340B savings for critical access hospitals come from community pharmacy relationships.
Outside Studies Support 340B’s Value: A recent Medicare Payment Advisory Commission report concluded there was no consistent pattern of higher or lower drug spending between 340B hospitals compared to non-340B hospitals. MedPAC also found that 340B hospitals provide more services to low-income patients, disabled Medicare beneficiaries, and younger patients and that these patient characteristics tend to be linked to higher spending on cancer treatment. Caroline says the research demonstrates that drug company price increases, especially on new drugs, drove prices higher, not the 340B program.
Meanwhile, a new study published this month in the Journal of the American Medical Association authored by an independent policy researcher found that drugs with a higher proportion of sales through the 340B program had a lower rate of price increases.
340B Hospitals Should Conduct Their Own Research: Caroline shares that 340B hospitals have opportunities to conduct their own research. To start a research project, 340B hospitals should determine how 340B savings fund specific programs and then see if they already have data available to gauge the impact of these programs. 340B Health also has launched a grant program to help hospitals conduct their own research.
Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to cover in this podcast, email us at podcast@340bhealth.org.
Episode Resources:
- Association Between the Percentage of US Drug Sales Subject to Inflation Penalties and the Extent of Drug Price Increases
- 340B Health Templates for Commenting on Proposed 2021 CMS Medicare Cuts
- 340B Health Compilation Research Brief
- MedPAC Report to Congress on 340B
- 340B Health Webinar: Update on Manufacturer Developments
Advocacy in Action
340B Insight
10/26/20 • 22 min
In this episode, we speak with Julie Clements, Director of Health and Clinical Affairs at the University of California Office of Federal Government Relations. Clements details why advocating for 340B is critical, how health care professionals can engage in advocacy, and how advocacy has changed during the COVID-19 pandemic.
The Importance of Health Care Professionals Advocating For 340B: Clements discusses how important it is for those who work with the 340B program every day, such as pharmacists and other health care professionals, to provide their first-hand experiences to policymakers on how beneficial 340B is to patients. She and her government relations colleagues partner with health care providers and other health system colleagues, such as communications professionals, to share how University of California is a good steward of the program. Health care providers advocating directly about the program to policymakers is the best way for them to understand how the 340B program works.
Educating Policymakers on 340B: Julie discusses how one of the greatest advocacy challenges is helping policymakers understand how 340B works. A couple of years ago, University of California had one of its chief pharmacists testify on Capitol Hill to educate policymakers about the program and answer their questions. The chief pharmacist discussed how safety-net hospitals rely on 340B and how they use their program savings. Julie heard positive feedback about the testimony the chief pharmacist provided and how it helped members of Congress understand 340B better.
Workarounds During COVID-19: Advocacy days also have been productive opportunities to share information to policymakers in D.C. The temporary halt to in-person events drastically altered how advocacy is done. Clements shares that one upside is the ease of setting up virtual meetings to allow for quick one-on-one conversations with members of Congress and their staff rather than long trips to and from Washington D.C. Virtual meetings also provide more opportunities for C-suite executives to participate.
Drug Manufacturers Refuse to Provide 340B Discounts: One of the biggest challenges 340B currently faces is drug manufacturers refusing or threatening to refuse 340B discounts when drugs are dispensed at community pharmacies. Julie said that the timing of the drug manufacturers’ actions is unconscionable considering the ongoing COVID-19 pandemic. The University of California is responding to these actions by continuing to demonstrate to policymakers how the health system is using 340B as Congress intended.
Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to cover in this podcast, email us at podcast@340BHealth.org.
Episode Resources
10/13/20 • 19 min
In this episode, we spoke with Dr. Jessica Tilton, the clinical coordinator for the University of Illinois Health Medication Therapy Management Clinic and a clinical assistant professor in the Department of Pharmacy Practice at the University of Illinois at Chicago College of Pharmacy. Jessica discusses the research she and her colleagues have conducted that demonstrates how the clinic is measurably improving patient health outcomes. Prior to the interview, we provide news updates on additional drug manufacturers refusing to provide 340B discounts and the Centers for Medicare and Medicaid Services reviewing comment letters regarding its proposals to make deep Medicare Part B cuts in 2021.
Improving Medication Adherence: The majority of the MTM clinic’s patients are on more than 10 medications and struggle with medication adherence. Jessica and her colleagues spend 60 minutes the first time a patient comes to the clinic evaluating the medications the patient has at home and comparing this to the medications the patient has been prescribed and indicates they are taking. Following the appointment, patients can pick up their medications all at once since the clinic is embedded within the pharmacy.
Disease State Management: Once a patient’s medication adherence challenges are addressed, the clinic’s pharmacists are working with patients on disease state management, primarily for diabetes, hypertension, and asthma. For instance, a patient with blood pressure of 200/150 can be managed weekly in the clinic until their blood pressure is under control, rather than through the emergency department.
340B Savings Create a Robust Clinic: Jessica says that 340B savings enable the Medication Therapy Management clinic to care for many more patients than it otherwise could without this financial support.
Conducting 340B Research: The Medication Therapy Management clinic partnered with the Department of Health Systems, Outcomes, and Policies to conduct its own 340B research to measure how much patients’ health outcomes were improving. The research focused on patients with diabetes and hypertension. The research found that the MTM clinic reduces A1C hemoglobin levels by an average of 0.63% and systolic blood pressure by 8.2 ml. Using modeling, the research also found the decrease in blood pressure reduced cardiovascular events by 10 and increased life years for the cohort of 200 patients by 4.5 life years. Costs to insurers were reduced by $500,000.
Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to cover in this podcast, email us at podcast@340BHealth.org.
Episode Resources:
- 340B Health Statement Regarding AstraZeneca and Sanofi Refusing to Provide 340B Discounts for Drugs Dispensed at Community Pharmacies
- 340B Health Comment Letter to CMS Regarding Proposed Medicare Part B Cuts to 340B Hospitals for 2021
- Webinar: State Policies Impacting 340B Year-In-Review
- University of Illinois Health Medication Management Clinic
- 340B Health Research
09/14/20 • 20 min
In this episode, we spoke with Nicole Shoquist, Chief Pharmacy Officer for JPS Health Network in Fort Worth, Texas. Nicole described the importance of 340B in meeting the needs of patients experiencing homelessness. Nicole describes JPS’s innovative response to care for these patients during the height of the pandemic that included telehealth and new ways to help patients receive their prescriptions. Prior to the interview, our news update segment provides an update on drug manufacturers refusing to offer 340B pricing when drugs are dispensed at community pharmacies.
340B Savings Stretch Scarce Resources: Prior to COVID-19, JPS Health Network offered primary and some specialty care for the homeless population in Fort Worth, including a mobile van, hepatitis C and HIV clinics, and nurse practitioners in shelters. Nicole emphasized the importance of 340B in making these service offerings possible.
Shelter-in-Place and the Homeless Community: When Fort Worth and Tarrant County issued stay-home orders, regional homeless shelters closed, leaving their residents without access to medical clinics or a place to receive prescriptions. The city then made its Civic Center available to several hundred residents without shelter, and JPS made health care services normally accessed at its clinics and a mobile van available at the Civic Center.
Meeting the Challenge with Innovation: In addition to expanding its care offerings to the Civic Center, JPS installed iPads and phones in private areas there so that residents could take advantage of telehealth offerings. In addition, JPS initiated prescription delivery to the Civic Center.
Maintaining 340B Compliance: JPS worked to ensure it remained complaint with 340B as it delivered care both to patients it had an existing relationship with as well as first-time patients. In some cases, prescriptions were not eligible for 340B due to program eligibility rules.
Best Practices and Silver Linings: The pandemic has led to JPS discovering new best practices for serving a community of underserved patients that can be hard to reach. JPS found that delivering patients their medications rather than asking patients to come to the pharmacy led to improved medication adherence rates and lower hemoglobin A1C and blood pressure levels. As a result, Nicole says many of these best practices are continuing even though the Civic Center shelter operations have closed.
Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to cover in this podcast, email us at podcast@340BHealth.org.
Episode Resources
- 1,100 + Hospitals Letter to Secretary Alex Azar Urges HHS to Halt Attempts to Undermine the 340B Drug Pricing Program
- 7 Groups Representing Hospitals Letter to Secretary Alex Azar Asking to Enforce 340B Rules
- Drug Manufacturer Updates for Members
- Webinar: Medicare Part B Drug Payment Cuts to 340B Hospitals
- JPS Health Network
08/03/20 • 22 min
In this episode, we spoke with Dr. Jewel Younge, Clinical Pharmacist at the University of Illinois Hospital & Health Sciences System (UI Health) and Clinical Assistant Professor at the University of Illinois Chicago College of Pharmacy. We invited Jewel on the podcast after she participated in a panel discussion on health care inequalities during the 340B Coalition Virtual Summer Conference in late July. At the start of the episode, we discussed several news updates including a new presidential executive order regarding the 340B program.
Some key takeaways from the conversation with Jewel Younge include:
Jewel’s Path to Pharmacy: Jewel took a nontraditional path to become a pharmacist. Originally the Chair of the Visual and Performing Arts Department at Olive-Harvey College, Jewel sought to expand her horizons by taking chemistry courses. After years of learning and training, she is now a practicing pharmacist and assistant professor at the University of Illinois Chicago College of Pharmacy.
COVID-19 Highlights Health Disparities in the US: Jewel shared data pointing to race and age disparities during the COVID-19 pandemic in Chicago. She notes that the Black and Latinx communities have experienced higher positivity rates and deaths, while deaths for people over the age of 60 are disproportionately high.
Busting Myths: Jewel emphasizes that communities that lack trust in health care systems are suffering from “COVID-19 myths.” For example, many are skeptical that the costs of seeking hospital care for medical conditions during the pandemic outweigh the benefits. She calls on health care professionals to improve outreach and build relationships with these communities.
340B’s Role in Addressing Health Disparities: UI Health provides more than $27 million per year in uncompensated care and has more than $19 million in 340B savings, which in turn is invested in pharmacy services, a medication assistance program, and other services that enhance patient care. Jewel said, “That's really what 340B is all about. Taking a small benefit and turning it into a massive reward for as many people as possible.”
Closing patient care gaps that perpetuate health care disparities in the U.S. will require input and action from safety-net providers. We are fortunate to have leaders such as Jewel who are leading the way toward progress.
Check out all of our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to cover in this podcast, email us at podcast@340BHealth.org.
Episode Resources:
- President Trump Signs Executive Order on 340B
- Statement on Congresswoman Doris Matsui and Congressman Chris Stewart on Bipartisan House Legislation to Protect 340B During COVID-19
- Report: The Role of Hospitals in Serving Medicaid and Low-Income Medicare Patients (and accompanying infographic)
- University of Illinois Hospital & Health Sciences System
08/17/20 • 18 min
In this episode we speak with Maureen Testoni, President and CEO for 340B Health, on new 340B policy developments in recent weeks that include a major court decision and drug manufacturer challenges to 340B contract pharmacies. Prior to the interview, we answer a member question on changes this year to the 340B hospital recertification process.
Some key takeaways from the conversation with Testoni include:
Court Decision Upholds CMS Medicare Part B Cuts: Since 2018, The Centers for Medicare & Medicaid Services (CMS) has cut payments by nearly 30% to many 340B hospitals. Testoni explains how the D.C. Circuit Court of Appeals for the District of Columbia has overturned a lower court decision and has ruled that the government has the authority to continue with the cuts. Testoni shared potential next steps in the case.
CMS Proposes Steeper Medicare Part B Cuts for 2021: Following the D.C. Circuit Court of Appeals decision to allow CMS Medicare Part B cuts to hospitals, Testoni analyzed how CMS’ proposed 2021 Medicare Outpatient Perspective Payment Systems rule could result in an even steeper cut for 340B hospitals. She explained how 340B Health plans to work with members to respond.
Recent Actions by Pharmaceutical Companies: Several drug companies are refusing or threatening to not provide 340B pricing on drugs that will be distributed at a contract pharmacy. Two of these companies are asking 340B covered entities for claims data to be shared with them. Testoni says that these actions violate the 340B statute and that requests for claims data create multiple challenges for covered entities. She also gives insight to what 340B hospitals should do when manufacturers ask for claims data or do not offer 340B pricing on medications purchased for distribution at a contract pharmacy.
Progress on Protecting 340B Hospitals During the Pandemic: For 340B hospitals whose program eligibility is determined by their DSH adjustment percentage, there is concern that changes in payor mix during the COVID-19 pandemic puts them at risk for losing program eligibility. Testoni provides updates on two new bills in Congress that have been introduced to address this problem.
Check out all of our episodes on the 340B Insight podcast website. You can also stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you’d like us to cover in this podcast, email us at podcast@340BHealth.org.
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FAQ
How many episodes does 340B Insight have?
340B Insight currently has 75 episodes available.
What topics does 340B Insight cover?
The podcast is about Health & Fitness, Pharmacy, Medicine, Podcasts and Government.
What is the most popular episode on 340B Insight?
The episode title '340B Helps Hospitals Meet Patients Where They Are' is the most popular.
What is the average episode length on 340B Insight?
The average episode length on 340B Insight is 20 minutes.
How often are episodes of 340B Insight released?
Episodes of 340B Insight are typically released every 14 days.
When was the first episode of 340B Insight?
The first episode of 340B Insight was released on May 4, 2020.
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