Congress established the 340B program to help non-profit hospitals fill-in the revenue gaps inherent to their business models. What very few eligible health systems realize, even today, is that 340B can function as the central hub of a multi-point program that can profoundly impact the scale and quality of their services in the communities they support.
1. A dedicated, experienced, full-time 340B team
It goes without saying that a team capable of optimizing 340B benefits — both in terms of system revenue and patient care — is the single most-important component of a successful 340B program. In our experience, that’s a lot harder than it sounds. Which is why we’ve never seen, or served, a 340B program we couldn’t improve; in part, because of the breadth of experience that comes with the sheer number of hospitals’ 340B programs (18), and 340B pharmacies (15), we manage.
2. A specialized 340B software system
Your software platform should streamline the 340B program’s processes by minimizing unnecessary manual detail-work. It should also produce analytics you can use to constantly improve your program. For instance, ProxsysRx’s proprietary software platform — 340B PRO — can instantly produce 340B program data including:
• Real-time reports ranking revenues generated by every clinic, physician and contract pharmacy in a hospital’s 340B program — as well as by medication, and by drug manufacturer.
• Every prescription submitted to a 340B hospital’s TPAs; which 340B prescriptions the TPAs have matched, and which ones they’ve rejected.
• A template for quickly and easily re-submitting wrongly rejected 340B prescriptions.
3. A comprehensive, and compatible, 340B contract pharmacy network
As we noted in a previous article, we have never served (or seen) a 340B health system whose contract pharmacy network we couldn’t improve — both in terms of quantity and quality. The average number of good 340B contract pharmacies we’ve added to the networks of hospitals we serve is 5 to 10. 340B pharmacy fee structures can vary dramatically, even among locations within the same pharmacy chain. Which is why it is critically important that your 340B team has the resources, and the experience, necessary to identify and evaluate prospective partners in your 340B contract pharmacy network.
4. TPAs aligned with your health system’s mission
Here are a few key qualities you should expect from a TPA partner:
• The willingness to truly to understand your system’s 340B program, and help you ensure consistently-accurate data transfer from your system to theirs — while minimizing data mismatches.
• The ability to connect seamlessly with multiple technology partners and data sources, to consistently obtain accurate 340B matching data.
• A fee structure that consistently generates net-positive returns. Health systems with high-volume 340B programs, for instance, should avoid TPAs that charge fees for every pharmacy prescription-fill they assess.
5. An onsite 340B outpatient pharmacy
A well-managed retail pharmacy will generate exceptional revenue for your health system. Pharmacies owned or managed by ProxsysRx generate, on average, $750 to $1000 in net profit per bed, per month. Which means that a 200-bed hospital can generate $150,000 to $200,000 in net monthly profit from its onsite retail pharmacy.
6. A robust Meds To Beds program
Your Meds To Beds program should serve as a funnel for directing patients into your 340B program. It’s a role which has become increasingly important in overcoming manufacturer restrictions that minimize the number of contract pharmacies in your 340B network. What’s more, patients in your 340B program will enjoy superior professional care and support, post-discharge — significantly reducing the likelihood of costly readmissions, while increasing overall patient satisfaction.
7. An onsite 340B specialty pharmacy
Onsite specialty pharmacies enable 340B hospitals to offer superior care for their sickest patients, while minimizing the risk of costly, and complex, medication errors. Moreover, specialty pharmacies offer health systems the potential for generating extraordinary 340B savings — and for passing-along those savings to patients often in the greatest need of financial support. Some 340B entities generate as much as 600% in 340B specialty drug revenue as they do in retail-pharmacy prescriptions.
8. A strategic clinical and financial plan for optimizing 340B benefits
ProxsysRx’s unique approach to 340B touches every aspect of a fully-integrated program.
• We analyze your community’s areas of need, and identify opportunities for 340B to better serve those needs.
• We help your health system establish and implement sound 340B policies and procedures.
• We identify, evaluate and establish relationships with prospective contract pharmacy and TPA partners.
• We manage all aspects of your 340B retail pharmacy — from Meds To Beds to charity care for patients in need.
• We help you develop a financial “glide path” to help fund your own specialty pharmacy, then provide the leadership needed to navigate the accreditation process.
• We provide ongoing reporting on all aspects of your 340B program, as well as guidance in building-on what’s working — while addressing what isn’t working.
• We pay ourselves from the revenue and savings we generate on your behalf, so you’re never exposed to even the potential for loss.
To learn more, contact Howard Hall. C: 214.808.2700 | howard.hall@proxsysrx.com
ProxsysRx offers hospital systems proven solutions for optimizing pharmacy services’ positive impact on the continuum of care; solutions ranging from management of their 340B prescription-savings programs, Retail and Specialty Pharmacy operations, to Prescription Benefits program management, and patient financial assistance.
This post is related to:
340B Solutions, 340B Management Systems
