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340B is a drug discount program that helps safety net facilities to stretch their resources to continue providing excellent care in their communities. These discounts are provided by drug manufacturers and are required to participate in other federal drug programs.

340B discounts are available to certain Covered Entities (CEs) defined by federal law. CEs include safety net facilities such as Health Centers, Critical Access Hospitals, Medicare and Medicaid Disproportionate Share Hospitals.

Participation in an ACO can increase 340B discounts by two to five-fold from data, programs, and processes that capture more 340B claims and make sure they are fully compliant. Data from participating in value-based payment gives the CE a much wider view into who is prescribing for their patients and where they are getting those prescriptions filled. This ability to track the prescribers results in optimized claims capture and more savings.

Careful, manual review of prescription drug and referral documentation is central to maximizing 340B income. This thorough review can ensure that providers are communicating with each other and prescriptions and specialist visits are not falling through the cracks. In our 340B pilot contracts, we spotted potential drug interactions and specialist visits that could have gone unnoticed without the benefit of that review.

Our compliant program verifies the appropriate patient care coordination, management, and documentation for every processed claim. Through our proprietary data analytics platform, Signify Health will identify potentially eligible 340B prescriptions that have been written by providers who do not practice in the covered entity locations. This rigorous process can increase 340B discounts by 100-500%. This creates a sizable financial opportunity for everyone from the smallest to the largest Covered Entity.