Addressing Healthcare Disparities During the COVID-19 Pandemic

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 [email protected].

Episode Resources:

Some key takeaways from the conversation with Jewel Younge include:

Episode Resources:

Previous Episode

340B Helps Hospitals Meet Patients Where They Are

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 [email protected].

Episode Resources:

1. 340B Health Member Alert on Eli Lilly’s Contract Pharmacy Plan

2. Bipartisan Bill Would Protect 340B Status During Emergency

3. Ascension Via Christi Community Cares Clinic

4. 340B Coalition Virtual Summer Conference

Next Episode

Analyzing 340B News from the Courts to Pharma Manufacturer Actions

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 [email protected].

Episode Resources