A September white paper from Pioneer Institute and CancerCare compared nearly 4,000 hospitals using CMS cost report data linked to HRSA’s 340B covered-entity records to examine differences in patient assistance measures between 340B and non-340B hospitals.
Here are six things to know:
- 340B hospitals reported charity care equal to 2.16% of operating expenses, compared with 2.82% at non-340B hospitals, a statistically significant difference.
- The difference persisted for charity care specific to uninsured patients, at 1.60% versus 2.26%, and the initial obligation of uninsured patients approved for charity care, at 1.61% versus 2.27%.
- Overall unreimbursed and uncompensated care was lower among 340B hospitals, at 6.90% versus 7.18%, but the difference was not statistically significant.
- 340B hospitals reported a significantly higher share of Medicaid admission days, at 19.69% versus 17.76%. The authors argued that Medicaid volume should not be treated as a substitute for charity care.
- The analysis included 2,440 340B hospitals and 1,559 non-340B hospitals and found variation among 340B hospital categories. Disproportionate share hospitals reported the highest Medicaid volume, at 29.89% of admission days, and the highest charity care level, at 2.62%, among the 340B categories. Critical access hospitals reported 8.40% and 1.69%, respectively.
- The authors called parity with non-340B hospitals “an insufficient policy standard,” arguing that 340B hospitals receive drug discounts unavailable to nonparticipating facilities. They recommended extending accountability requirements to contract pharmacies, including capping per-dispense compensation and separating pharmacy payments from drug prices.
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