Early 340B hospital participants provided more low-profit services than nonparticipants, study finds

Early participants in the 340B Drug Pricing Program spent more on uncompensated care and were more likely to provide low-profit services compared with nonparticipants, according to a study published May 21 in JAMA Internal Medicine.

The study examined how nonprofit and public hospital 340B participants differed from nonparticipants in 2015 in terms of financial stability, uncompensated care and low-profit services. Researchers at Vanderbilt University and the University of Chicago specifically took Healthcare Cost Report Information System data from more than 1,200 general acute care nonprofit and public hospitals and linked it to 660 340B hospital participants from the Health Resource and Services Administration's 2015 provider list.

The study found the 340B program has experienced significant growth. There were fewer than 200 340B hospital participants before 2004 (early participants). Participation then increased to 927 hospitals by Dec. 31, 2010, and by 2015 grew to 1,046, or nearly 42 percent of all nonprofit and public general acute care hospitals that year. Compared with later participants, early participants were generally larger and located in areas with lower income levels, according to the study.

The study also found all 340B hospital participants in 2015 were less financially stable (–2.11 percent vs. –1.74 percent) and had slightly higher compensated care burden (4.1 percent vs. 3.13 percent) than nonparticipants that year. However, researchers wrote they found all 340B hospital participants were not more likely to offer low-profit services (48.18 percent vs. 36.88 percent).

When researchers compared early participants to nonparticipants, though, they said they found early participants spent more of their funds on uncompensated care (5.94 percent vs. 3.13 percent) and were more likely than the latter to offer low-profit services (62.89 percent vs. 36.88 percent) "despite operating at a relative loss."


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