challenges and opportunities under the 340b program safety net hospitals for pharmaceutical access...
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Challenges and Challenges and Opportunities Opportunities Under The 340B ProgramUnder The 340B Program
Safety Net Hospitals for Pharmaceutical AccessTed Slafsky, Executive Director
May 10, 2010, 4:00-5:00 PM
[email protected] www.snpha.org
© 2010 Safety Net Hospitals for Pharmaceutical Access
About SNHPAAbout SNHPA An organization of 500 public and private non-profit
hospitals and health systems throughout the U.S. that participate in the 340B Program.
When Congress was creating the 340B Program in 1992, SNHPA took the lead role in ensuring that hospitals were included in the program, and has been representing 340B hospitals ever since.
SNHPA monitors and serves as an advocate on federal legislative and regulatory issues related to drug pricing and other pharmacy matters affecting safety-net providers.
SNHPA educates members on 340B policy developments in Congress and in the federal agencies.
2SNHPA Ted Slafsky(202) 552-5850 www.snhpa.org
Continued growth of uninsured, under-insured patient populations creates economic pressure for nonprofit and public hospitals.
◦ 23 percent increase in uninsured patients treated by safety net hospitals.
◦ 10 percent increase in uncompensated care costs, averaging $2.3M increase per hospital.
◦ Large undocumented patient population excluded from Medicaid and new insurance exchanges.
Economic Challenges for Economic Challenges for Safety Net Hospitals – More Safety Net Hospitals – More UninsuredUninsured
3SNHPA Ted Slafsky(202) 552-5850 www.snhpa.org
Hospitals are closing or are being forced to sell to for-profits.◦ For-profit Vanguard system announces
intent to purchase nonprofit Detroit Medical Center in March 2010.
◦ Boston Archdiocese has negotiated sale of six-hospital Caritas Christi System to private equity firm.
◦ Jackson Health System in Florida on brink of closing two facilities.
◦ New York’s St. Vincent’s Hospital April 30th closure => 3500 layoffs, emergency room services lost to community
Economic Challenges for Economic Challenges for Safety Net Hospitals – Closures, Safety Net Hospitals – Closures, MergersMergers
4SNHPA Ted Slafsky(202) 552-5850 www.snhpa.org
Impact of Health Care ReformImpact of Health Care Reform
340B expanded to rural and children’s hospitals but no inpatient discounts.
Medicaid expansion and health exchanges, but reimbursement likely to be inadequate.
DSH funding to be reduced but uninsured, under-insured still must be treated.
340B providers need to continue to receive discounts on all drugs, rather than only for certain patient populations.
Extending 340B to in-patients still #1 priority.
Safety Net Hospitals for Pharmaceutical Access Ted Slafsky(202) 552-5850 www.snhpa.org5
Opportunities for Community Opportunities for Community Pharmacies with 340B Pharmacies with 340B ProgramProgramNew guidelines allow for expanded use of
contract pharmacies.Currently approx. 2600 contract pharmacy
arrangements.Majority are with community pharmacies.New guidelines should encourage dramatic
growth in number of contract pharmacy arrangements.
340B providers willing to pay for MTM, formulary management, and other services.
Safety Net Hospitals for Pharmaceutical Access Ted Slafsky(202) 552-5850 www.snhpa.org
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Independent Pharmacies Independent Pharmacies Participating & Flourishing as Participating & Flourishing as Contract PharmaciesContract PharmaciesMany great success stories already for community
pharmacies. Eaton Apothecary, Holliston MA Contracts with 10 federally qualified health centers
(FQHCs), one FQHC-Look-Alike, and two hemophilia treatment centers to provide pharmacy management
Advantages:1. Adds volume of business: thousands of
scripts/month for a pharmacy location2. Niche business that chains may be less
interested in.3. Now may partner even if covered entity has
contract with chain. eatonapothecary.com/services/partner.php
Safety Net Hospitals for Pharmaceutical Access Ted Slafsky(202) 552-5850 www.snhpa.org
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Independent Pharmacies Participating & Independent Pharmacies Participating & Flourishing as Contract Pharmacies Flourishing as Contract Pharmacies (cont’d)(cont’d)
Taos, NM Pharmacy & Holy Cross Hospital (47-bed nonprofit)◦ Robust patient safety initiative focused on
diabetes care.◦ Provides access to medications and MTM for
the uninsured and under-insured.
Goodale Pharmacy (Dover, NJ):◦ Contracts with Zufall Health Center (FQHC). ◦ Collaborates with NJ Primary Care Association.◦ Part of HRSA patient safety initiative.
Safety Net Hospitals for Pharmaceutical Access Ted Slafsky(202) 552-5850 www.snhpa.org
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Capitalize on 340B Capitalize on 340B ExperienceExperience
•Rural Hospitals often don’t have own pharmacies.
•Contract with them!
•Chains are already approaching hospitals.
Safety Net Hospitals for Pharmaceutical Access Ted Slafsky(202) 552-5850 www.snhpa.org
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Educational Opportunities
SNHPA Willing to Co-Host Webinar with NCPA
14th Annual 340B Coalition ConferenceJuly 19-21, 2010
Omni Shoreham Hotel, Washington, DCSpecial Breakout Session for Community Retail
Pharmacies
www.340Bcoalition.org
Drug Discount Monitorwww.drugdiscountmonitor.com
SNHPA Ted Slafsky(202) 552-5850 www.snhpa.org
SNHPA ContactsBill von Oehsen
President and General Counsel [email protected]
(202) 872-6770
Ted SlafskyExecutive Director
[email protected](202) 552-5860
Stuart GordonDirector, Legal and Regulatory Affairs
[email protected](202) 552-5851
SNHPA Ted Slafsky(202) 552-5850 www.snhpa.org