Over the years, I’ve worked closely with nearly a hundred 340B hospitals and clinics. The thing I have noticed that separates the good programs from the great ones, seems to be fairly predictable.
A lot of people think that 340B programs run on their own and this could not be further from reality.
Sure third-party software companies keep you organized, but they certainly do not check the box on maximizing your 340B opportunity.
So what is the one thing that makes a good program great?
The One Thing
Far and away the difference between a great 340B program and a meager one is how deep you are willing to dig into your data, typically your OWN data.
What do I mean by that? Well, as you may or may not know your 340B program operates on the condition that you provide awesome data to your third-party 340B administrator and pharmacies.
If you fail to do this, your 340B program is simply, inadequate.
So what do you mean by diving deep into your data? That is sort of obscure. Let me give you just one example.
One example of Diving Deep
Let’s take the simplest example we can, a Patient List. The patient list you should be sending should be SUPER INCLUSIVE. What does that mean?
Often, people who start 340B programs have no idea how to write the data extracts. So what they do is ask someone, or their EHR vendor to write the data extract for them to get the Patient List.
And what happens here is, they ask no questions. They ASSUME that the Patient List they are providing is COMPLETE. But my experience shows, this is not the case!
If for example, you are only sending 90% of eligible patients, you are foregoing 10% of eligible revenue.
It’s that simple. In a related Patient List issue, if you are working on Patient List data that depends on ICD10/Diagnosis Code matching you are GUARANTEED to be missing 340B revenue.
Diving Deep on ICD10/Diagnosis Code Data
ICD10 data matching is almost ALWAYS ineffecient in my experience. This is for a couple of reasons. First, the algorithms (systems) that match Prescription Data to ICD10 Diagnosis Codes are FAR FROM PERFECT. In fact, they are highly unreliable.
Secondly, ICD10/Diagnosis Code Data can often take a while to get into the system and thus your data feeds.
These are just two ways in which this is a likely hole in your 340B program.
Again, your complacency in accepting your 340B program and data at face value is costing you dollars each and every day.
I’ve spent the better part of the last 10 years working with 340B hospitals and pharmacies. Amazingly, the One Big Difference between a very profitable 340B program and a mediocre one, is your willingness to dig in and figure out WHAT is actually happening with your data.
I’ve written several more posts related to this topic specifically. I’d recommend you check these out. Feel free to drop me a comment below. I am happy to entertain any questions or comments!