Todd Roberts, CFO of Cheshire Medical Center in Keene, N.H., a member of Lebanon, N.H.-based Dartmouth Health, has detailed the complexities surrounding a strategic partnership with the health system’s 340B program.
Mr. Roberts, who joined the hospital in April 2025, told Becker’s “CFO+Revenue Cycle Podcast’ that Cheshire Medical had come “very close to losing” its 340B designation in recent years, which prompted a strategic push to safeguard the hospital’s participation in the federal program.
“Really thinking strategically in how we can help ourselves down the road and not have to worry about that took a lot of effort and coordination with the system,” he said.
Cheshire Medical then entered into the partnership with Dartmouth Health to safeguard its designation around 340B. While it was implemented quickly, the financial and operational aftermath has proven more difficult to manage than anticipated.
“There was a financial tail on this project, and we’re continuing to work through that,” he said. “From a transactional reporting perspective, we knew that we would face some challenges, but did not anticipate it to take as long as it has. This issue has made data and reporting very challenging.”
With Cheshire Medical serving a rural and aging population, 340B participation can help offset the care cost for patients.
Mr. Roberts said leaning on systemwide experts has been “critical” for Cheshire Medical, particularly in combatting industrywide headwinds and regulatory changes.
“Without knowing what we might be facing, we’d be behind before anything was ever implemented,” he said. “Utilizing the appropriate resources obviously helps us get ahead and be strategic.”
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