340B Drug Pricing Program and hospital provision of uncompensated care

• Published in: The American journal of managed care 2021-10, Vol.27 (10), p.432-437
• Main Author: Desai, Sunita M
• Format: Article
• Language: English
• Subjects: Cost control; Hospital costs; Incentives; Indigent care; Information systems; Low income groups; Medicaid; Medicare; Participation; Pharmacy; Trends
• ISSN: 1088-0224; 1936-2692
• DOI: 10.37765/ajmc.2021.88761

Am J Manag Care. 2021;27(10):432-437. https://doi.org/10.37765/ajmc.2021.88761 _____ Takeaway Points Participation in the 340B Drug Pricing Program has not been associated with increases in hospital-reported uncompensated care provision, bringing into question whether the program is achieving its stated goal of freeing up resources that are devoted to the care of low-income populations. * Our results add to a body of work that questions the extent to which program discounts are being used by general acute care and critical access hospitals to invest in care for low-income patients. * Our findings suggest that relying on hospitals to invest surplus in care for the underserved without marginal incentives to do so or strong oversight is not a consistently effective strategy. _____ The 340B Drug Pricing Program is a federal program that entitles eligible hospitals to manufacturer discounts on purchases of drugs administered or prescribed in an outpatient setting. [...]the first 340B Coalition Winter Conference—which aims to provide 340B entities with support and information on topics including program implementation, operations, compliance, contract pharmacy relationships, and inventory management, among other practical issues—was held in 2004.6) The second period followed the 2010 Affordable Care Act (ACA), which expanded eligibility to all critical access hospitals.5,7 We estimated changes in hospital-reported uncompensated care costs associated with program participation during these 2 periods of 340B growth for general acute care hospitals and critical access hospitals. [...]we examined critical access hospitals during years 2011 to 2015; all critical access hospitals became 340B eligible under the ACA in 2010. Because reporting of uncompensated care was not mandatory during 2003 to 2009, 251 (18.7%) general acute care hospitals were excluded due to missing uncompensated care data.