340B Drug Pricing Program

So, obviously, we need to have some proper financials prepared, tax returns, year-to-dates, And part of the quality of earnings is going to also do a little bit of an add-back verification.

But with pharmacy, it's very unique because there's also, you know, what if 340B is part of your revenue? You know, there's wholesaler vendors, acquisition costs, and you might buy from multiple wholesalers.

That all kind of plays into the gross profit.

So I think pharmacists are going to have to be prepared for not only engaging proper accounting, but also perhaps be required to provide Those are the types of information that really play into what generates the gross profit.

In addition to the funding that we have for the FTEs for our organization, a lot of what we have is grant funded.

A lot of it is based upon 340B.

So there's a lot of looking and pivoting to figure out how can we go ahead and diversify? How can we go ahead and try to automate and try to work with what we have work with the amount of grants that maybe we have now, work with the economic uncertainty, but then also try to, at the same time, figure out how do we go ahead and combat that burnout? What are some things that we can do? So it's really having your hands tied, but then also trying to be very resourceful with what you have while also trying to recruit for those providers that are burning out.

And I know that Jennifer probably has the same feeling as well, that it is very tough out there in the market to really look for a lot of providers and specifically, you know, physicians.

Why aren't you using those? We have one built into our HRIS system.

and the more than we encouraged people to experiment, we heard great things.

This week alone, we are trying to plan for changes for 1-1 that might happen in eligibility to Medicare and our 340B pharmacy and things like that.

So we're doing contingency planning.

So cool.

Like I said, definitely jumping around, wanted to move over to 340B a little bit.

How does the expansion of Medicare maximum fare prices intersect with 340B contract pharmacy programs and kind of just the developments that have surrounded 340B as of late?

Yeah, 340B, I would say, is also an area where there's a lot of activity right now, particularly at the federal level.

In terms of looking at the kind of interaction between Medicare maximum fair prices and 340B, the core issue there is really deduplication.

Manufacturers are required to provide the lower of the Medicare negotiated price, that maximum fair price that we were discussing, and the 340B ceiling price.

But not both.

And what we've seen play out over the last few years is back and forth on what the how does that look like on the ground? What's the implementation approach? And we've just recently saw the federal government approve for the second time there were some legal back and forth manufacturer plans to use a.

You can't open an article or read a journal or even talk to a colleague without this topic coming up.

I think that academic health systems have historically relied on several mechanisms to help support the additional missions that we are accountable and responsible for, things like 340B, provider-based reimbursement, and other things.

Payment structures, they are all under significant scrutiny at this time.

Site neutrality is a particularly important issue because it challenges some of our underlying economics of providing complex care in our academic health systems.

Today, because there's a reason.

Because Daryl just got back from Paris, and we're going to talk about that before we start about 340B.

Paris, Texas.

Paris, Texas.

That's awesome.

Well, I tell you one thing.

When I think of Paris, I think of 340B.

Oh, yeah.