Transcript Ted Slafsky - 340B Health

Challenges and Opportunities
Under The 340B Program
Safety Net Hospitals for Pharmaceutical Access
Ted Slafsky, Executive Director
May 10, 2010, 4:00-5:00 PM
[email protected]
202-552-5860 www.snpha.org
© 2010 Safety Net Hospitals for Pharmaceutical Access
About SNHPA

An organization of 500 public and private non-profit hospitals
and health systems throughout the U.S. that participate in the
340B Program.

When Congress was creating the 340B Program in 1992,
SNHPA took the lead role in ensuring that hospitals were
included in the program, and has been representing 340B
hospitals ever since.

SNHPA monitors and serves as an advocate on federal
legislative and regulatory issues related to drug pricing and
other pharmacy matters affecting safety-net providers.

SNHPA educates members on 340B policy developments in
Congress and in the federal agencies.
SNHPA
(202) 552-5850
2
Ted Slafsky
www.snhpa.org
Economic Challenges for
Safety Net Hospitals – More Uninsured

Continued growth of uninsured, under-insured
patient populations creates economic pressure
for nonprofit and public hospitals.
◦ 23 percent increase in uninsured patients treated
by safety net hospitals.
◦ 10 percent increase in uncompensated care costs,
averaging $2.3M increase per hospital.
◦ Large undocumented patient population excluded
from Medicaid and new insurance exchanges.
SNHPA
(202) 552-5850
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Ted Slafsky
www.snhpa.org
Economic Challenges for
Safety Net Hospitals – Closures, Mergers
Hospitals are closing or are being forced to sell to forprofits.
◦ For-profit Vanguard system announces intent to
purchase nonprofit Detroit Medical Center in March
2010.
◦ Boston Archdiocese has negotiated sale of six-hospital
Caritas Christi System to private equity firm.
◦ Jackson Health System in Florida on brink of closing
two facilities.
◦ New York’s St. Vincent’s Hospital April 30th closure
=> 3500 layoffs, emergency room services lost to
community
SNHPA
(202) 552-5850
4
Ted Slafsky
www.snhpa.org
Impact of Health Care Reform

340B expanded to rural and children’s hospitals but
no inpatient discounts.

Medicaid expansion and health exchanges, but
reimbursement likely to be inadequate.

DSH funding to be reduced but uninsured, underinsured still must be treated.

340B providers need to continue to receive discounts
on all drugs, rather than only for certain patient
populations.

Extending 340B to in-patients still #1 priority.
Safety Net Hospitals for Pharmaceutical Access
(202) 552-5850
5
Ted Slafsky
www.snhpa.org
Opportunities for Community
Pharmacies with 340B Program

New guidelines allow for expanded use of contract
pharmacies.

Currently approx. 2600 contract pharmacy
arrangements.

Majority are with community pharmacies.

New guidelines should encourage dramatic growth in
number of contract pharmacy arrangements.

340B providers willing to pay for MTM, formulary
management, and other services.
Safety Net Hospitals for Pharmaceutical Access
(202) 552-5850
6
Ted Slafsky
www.snhpa.org
Independent Pharmacies Participating &
Flourishing as Contract Pharmacies
Many great success stories already for community pharmacies.
 Eaton Apothecary, Holliston MA
 Contracts with 10 federally qualified health centers
(FQHCs), one FQHC-Look-Alike, and two hemophilia
treatment centers to provide pharmacy management
 Advantages:
1. Adds volume of business: thousands of scripts/month for
a pharmacy location
2. Niche business that chains may be less interested in.
3. Now may partner even if covered entity has contract
with chain.

eatonapothecary.com/services/partner.php
Safety Net Hospitals for Pharmaceutical Access
(202) 552-5850
7
Ted Slafsky
www.snhpa.org
Independent Pharmacies Participating &
Flourishing as Contract Pharmacies (cont’d)

Taos, NM Pharmacy & Holy Cross Hospital (47-bed
nonprofit)
◦ Robust patient safety initiative focused on diabetes care.
◦ Provides access to medications and MTM for the
uninsured and under-insured.

Goodale Pharmacy (Dover, NJ):
◦ Contracts with Zufall Health Center (FQHC).
◦ Collaborates with NJ Primary Care Association.
◦ Part of HRSA patient safety initiative.
Safety Net Hospitals for Pharmaceutical Access
(202) 552-5850
8
Ted Slafsky
www.snhpa.org
Capitalize on 340B Experience
• Rural Hospitals often don’t have
own pharmacies.
• Contract with them!
• Chains are already approaching
hospitals.
Safety Net Hospitals for Pharmaceutical Access
(202) 552-5850
9
Ted Slafsky
www.snhpa.org
Educational Opportunities

SNHPA Willing to Co-Host Webinar with NCPA
14th Annual 340B Coalition Conference
July 19-21, 2010
Omni Shoreham Hotel, Washington, DC
Special Breakout Session for Community Retail Pharmacies
www.340Bcoalition.org

Drug Discount Monitor
www.drugdiscountmonitor.com
SNHPA
(202) 552-5850
Ted Slafsky
www.snhpa.org
SNHPA Contacts
Bill von Oehsen
President and General Counsel
[email protected]
(202) 872-6770
Ted Slafsky
Executive Director
[email protected]
(202) 552-5860
Stuart Gordon
Director, Legal and Regulatory Affairs
[email protected]
(202) 552-5851
SNHPA
(202) 552-5850
Ted Slafsky
www.snhpa.org