Researchers found the 340B program was associated with increased hospital-physician consolidation, through both employment and practice acquisition, and may have even induced the consolidation. The program incentivizes hospitals to consolidate with physicians who order parenteral drugs, or drugs that are infused or injected and reimbursed by Part B. This is because hospitals are paid for these drugs under 340B if they own the facility where the drugs are administered.
Using Medicare claims for three specialties associated with frequent use of parenteral drugs — hematology-oncology, ophthalmology and rheumatology — the researchers found 340B hospitals had 2.3 more hematologist-oncologists, 0.9 more ophthalmologists and 0.1 more rheumatologists than hospitals not in the program. 340B hospitals also submitted significantly more drug claims for hematology-oncology and ophthalmology patients, but not rheumatology.
Despite greater use of these services, 340B hospitals actually had lower proportions of low-income patients in hematology–oncology and ophthalmology, suggesting hospitals administered more parenteral drugs to wealthier patients. The study also showed the 340B hospitals did not have provisions in place to redirect savings from the drug program into services for low-income patients.
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