Podcasts about 340b

Based on AHLA's annual Health Law Connections article, this special ten-part series brings together thought leaders from across the health law field to discuss the top ten issues of 2026. In the sixth episode, Mary R. Kohler, Founder & Principal, Kohler Health Law PC, speaks with Kristie C. Gurley, Partner, Covington & Burling LLP, about the targeted reform and broad shifts that U.S. drug pricing is currently undergoing. They discuss issues related to Inflation Reduction Act implementation, litigation, the Trump Administration's approach to drug pricing, pharmacy benefit managers, and 340B. From AHLA's Life Sciences Practice Group.Watch this episode: https://www.youtube.com/watch?v=dIdgAUQA7toRead AHLA's Top Ten 2026 article: https://www.americanhealthlaw.org/content-library/connections-magazine/article/a879dda5-35f9-46fb-ad45-1b0799343d74/Health-Law-Forecast-2026Access all episodes in AHLA's Top Ten 2026 podcast series: https://www.americanhealthlaw.org/education-events/speaking-of-health-law-podcasts/top-ten-issues-in-health-law-podcast-seriesLearn more about AHLA's Life Sciences Practice Group: https://www.americanhealthlaw.org/practice-groups/practice-groups/life-sciencesEssential Legal Updates, Now in Audio AHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Comprehensive members. Get all your health law news from the major media outlets on this podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast. Stay At the Forefront of Health Legal Education Learn more about AHLA and the educational resources available to the health law community at https://www.americanhealthlaw.org/.

Infusion services make up a roughly $150 billion market in the U.S., and underpin the financial stability of major service lines, especially oncology. Historically, health systems have enjoyed strong volumes, favorable reimbursement, and access to 340B discounts that keep their infusion business profitable. But rising competition, payer and employer driven site of care shifts, and looming policy changes are putting pressure on what many leaders have relied on as a stable, margin accretive business. In this episode, host Abby Burns sits down with Advisory Board expert Chloe Bakst to break down what's actually happening in the infusion market — and why every health system leader should be paying closer attention. Together, they explore how new competitors are capturing leakage you may not even see, how payers and employers are steering patients away from hospital outpatient departments, and how upcoming 340B reforms and Medicare drug price negotiations could reshape the economics of infusion over the next three years. Chloe also shares the strategies forward thinking systems are using to protect their infusion business and prepare for rapidly emerging headwinds. We're here to help: Webinar | The top trends in today's infusion market Tool | Market Scenario Planner Ready-to-Use Resource | Policy Scenario Impact Calculator Expert Insight | The 3 trends reshaping the specialty drug pipeline today Podcast | 270: Service line snapshot: What every health leader needs to know Webinar | Join Optum Advisory experts at this upcoming webinar to learn how optimizing patient access unlocks the value of digital innovations and drives long-term sustainability. Expert Insight | How data-driven risk reduction protects patients and providers A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.Some of the biggest recent policy developments for 340B hospitals are when states enact legislation to protect access to 340B pricing through contract pharmacies. Olivia Little, 340B director at Johnson County Hospital in Tecumseh, Neb., was closely involved with a coalition of providers that was able to get such a bill passed through the state's legislature and signed into law by the governor. But she describes why getting the law enacted wasn't the end of the story.A Wide Range of ResponsesLittle says once her state's contract pharmacy protection law went into effect, she began receiving notices about 340B pricing being restored from some drug companies. But not all drugmakers restored previous pricing levels right away in Nebraska — some took months, and some have not yet done so despite the law going into effect nearly a year ago. The wide range of ways in which companies responded to the new law created difficult choices for hospitals between risking a potential compliance issue or leaving some 340B savings on the table. Having a Game PlanLittle says her advice to other health systems in states with new contract pharmacy protections would be to have a plan in place for what happens when the law goes into effect. Implementing these protections can raise questions about issue such as backdating, inventory, and retesting claims for 340B status. The complex tracking of multiple drugmaker policies in response to the Nebraska law resulted in her needing to closely document communications with drug companies and their vendors.The Need To Be PersistentLittle also stressed that getting pharmacy protections to pass through her state legislature and get to the governor's desk took years of effort, advocacy, and redrafting to ensure success. Between media appearances and advocating in the statehouse and on social media, Little says this success ultimately came down to the core message: 340B is good for patients, hospitals, and communities.Resources:HRSA Gives Short Window for Stakeholder Input on Reviving 340B Rebate Model

On this episode of Legislative Review:  Legislation concerning discounted drug access under the 340B Program.  Plus a bill that would create a board to address childcare labor standards.

In this episode, AJ Rivosecchi & Lauren Forni with Bluesight, discuss pharmacy purchasing & supply in the new 340B paradigm.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into a series of breakthroughs and strategic maneuvers that are reshaping the landscape of this dynamic industry.Roche is making waves with its antibody Gazyva, initially recognized for cancer treatment. The company has successfully ventured into autoimmune diseases, targeting kidney conditions. Recent phase 3 trials have reinforced Gazyva's efficacy in treating immune-mediated kidney diseases, building on its prior approval for lupus nephritis. This marks a potential paradigm shift from oncology to autoimmune therapy applications, offering a promising new avenue for treating complex kidney disorders. Such advancements underscore the power of immune modulation in addressing severe health conditions.Turning to oncology, Eli Lilly is expanding the use of its cancer drug, Retevmo. Originally approved for specific lung and thyroid cancers with rare biomarkers, Lilly is now exploring its use in the adjuvant setting for non-small cell lung cancer. This effort reflects a broader trend in oncology: companies are increasingly looking to extend the application of targeted therapies beyond their initial indications. This expansion could significantly enhance treatment options and improve patient outcomes.In ophthalmology, Ocular Therapeutix is preparing for an FDA filing following positive phase 3 results for its wet age-related macular degeneration treatment. Their candidate, AXPAXLI, showed superior efficacy compared to Regeneron's Eylea in head-to-head trials. Despite investor skepticism, Ocular remains confident in its product's potential to impact retinal disease management positively. The competitive landscape in ophthalmology is fierce, and innovative treatments with substantial clinical benefits over existing therapies can redefine standards of care.Eli Lilly is also strategically stockpiling Orforglipron, its oral GLP-1 candidate, in anticipation of FDA approval for obesity treatment. This proactive measure aims to prevent supply chain issues seen during previous GLP-1 launches. It reflects an industry-wide focus on ensuring product availability at launch to meet growing market demand effectively.On the regulatory front, there are significant shifts as well. The Trump administration's renewed pilot of 340B rebates aims to optimize drug pricing frameworks. Novartis has secured a long-term supply agreement with Niowave for Actinium-225 (Ac-225), crucial for developing targeted cancer therapies. This highlights the sustained demand for radiopharmaceutical isotopes as part of precision medicine initiatives.Biopharma funding is expected to recover steadily by 2026, albeit with a cautious approach favoring de-risked assets over broader platform technologies. Venture capitalists prefer predictable returns amidst an evolving market landscape.Now, let's turn to Japan, where Innovacell is planning a $92 million IPO on the Tokyo Stock Exchange. This move signals a renewed interest in biotech within the region after a long drought in IPOs. Financial strategies like these are vital for advancing cell therapies that hold promise for treating conditions once deemed challenging.Gilead Sciences has acquired synthetic lethal therapy from Genhouse Bio through a $1.5 billion deal, further underscoring the growing interest in synthetic lethality as a novel cancer treatment approach. This strategy focuses on targeting tumors while sparing normal cells, offering more effective therapies with fewer side effects.In mental health innovations, Compass Pathways has reported positive results from its pivotal trial using psilocybin for treatment-resistant depression. The success of this phase 3 trial highlights the potential role of psychedelics in psychiatric care and could revolutionize mental health treatments by providing new options Support the show

In this episode of Treating Together, host Pallav Mehta, MD, medical oncologist and director of Integrative Oncology at Cooper University Health Care and medical director of Reimagine Care, is joined by Debra Patt, MD, PhD, MBA, oncologist and executive vice president at Texas Oncology. Patt also serves as the president of the Community Oncology Alliance (COA). Their discussion focuses on the rapid transformation of community oncology and the growing pressures shaping its future. Themes and Key Discussion PointsThe episode focuses on the central role of community oncology in preserving local, quality care. Highlights include: The Evolution of Community Oncology: Drs Mehta and Patt explore how community oncology has changed over the past 2 decades from largely independent practices to consolidated health systems and clinically integrated networks. Financial forces, including the 340B program and broader reimbursement reform, have significantly influenced consolidation trends. Policy as a Driving Force: Dr Patt explores how legislation such as the Inflation Reduction Act (IRA) and evolving Centers for Medicare & Medicaid Services (CMS) reimbursement models may impact drug payment, cash flow, and practice viability.  The Explosion of Targeted and Advanced Therapies: Oncology has entered an era of unprecedented therapeutic expansion. With this progress comes more complexity: longer treatment durations, higher toxicity management demands, and logistical hurdles of administration. Digital Transformation and AI Integration: With the accelerating role of digital tools and artificial intelligence (AI) in practice, practices face both opportunity and implementation challenges. Workforce and Rural Access Challenges: The conversation addresses mounting physician and nursing shortages, burnout, and the sustainability of rural cancer care, requiring a reimagining of policy, workflow efficiency, and staffing models. Find a full transcript of the podcast: https://www.targetedonc.com/view/community-oncology-at-a-crossroads-navigating-policy-progress-and-practice

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we're diving into a range of stories that highlight the dynamic and often challenging landscape of these industries, as they navigate through scientific breakthroughs, strategic collaborations, regulatory hurdles, and market trends.Starting with corporate restructuring, Roche's Genentech has announced significant layoffs, totaling 489 positions in the previous year. This move is part of broader restructuring efforts seen across large pharmaceutical companies like Bayer and Bristol Myers Squibb. The layoffs illustrate the tightening financial and scientific constraints that are influencing pipeline decisions and capital allocation. Companies are facing increasing pressures to maintain credibility while also dealing with economic challenges that impact their strategic directions.On the regulatory front, the U.S. Department of Health and Human Services (HHS) encountered legal setbacks concerning its 340B rebate model pilot program. Following a lawsuit from the American Hospital Association, HHS withdrew notices and application approvals for this initiative. This development indicates a need for more comprehensive public feedback before any future attempts at similar programs are made, highlighting how complex regulatory landscapes can become.Turning to clinical trials, Fierce Biotech identified several significant failures in 2025, underscoring the inherent risks involved in drug development. These setbacks emphasize the importance of robust trial designs and execution strategies to mitigate risks. Meanwhile, Fresenius Kabi and Phlow Corporation have announced a strategic alliance to produce epinephrine injection API in the U.S., aiming to strengthen supply chain resilience—a crucial lesson learned from vulnerabilities exposed during the COVID-19 pandemic.Eli Lilly has made waves with its $2.4 billion acquisition of Orna Therapeutics, marking its entry into the in vivo CAR-T space. This acquisition underscores a growing interest in advanced cell therapies with transformative potential for cancer treatment. Additionally, Lilly has expanded its collaboration with Innovent Biologics through a $350 million upfront payment and milestone payments totaling $8.8 billion, focusing on oncology and immunology. This reflects a shift towards deeper integration in drug development efforts beyond traditional licensing models.Takeda Pharmaceuticals' $1.7 billion AI-driven drug discovery agreement with Iambic Therapeutics highlights the increasing adoption of artificial intelligence to accelerate drug discovery processes. AI's potential to enhance precision medicine approaches is becoming more pronounced as companies seek innovative methods to improve target identification and lead optimization.In market dynamics, Hims & Hers withdrew from launching a generic version of Novo Nordisk's weight loss pill due to regulatory pressures from the FDA. This incident underscores the complex interplay between innovation and compliance that companies must navigate when bringing new therapeutics to market. Additionally, legal actions have been initiated by Novo Nordisk against Hims & Hers over patent infringement claims related to semaglutide—a case highlighting ongoing challenges in patent protection within rapidly evolving drug compounding arenas.Eli Lilly also leveraged the global stage of the Winter Olympics for a campaign drawing parallels between scientific progress and athletic achievement. Such campaigns align with industry efforts to enhance public perception and trust amid ongoing challenges.Overall, while the pharmaceutical and biotech industries face significant challenges—from regulatory hurdles to clinical trial setbacks—there are substantial opportunities for growth driven by technological advancements and strategic collaborations. NaSupport the show

In this episode, Sam McCrimmon, J.D., Vice President of Development at Regional One Health, joins the podcast to discuss the growing role of philanthropy in safety net hospitals, from supporting patient access to funding major capital projects. He also shares insights on 340B, AI, federal funding shifts, and Regional One's vision for a new hospital and future academic medical center.

340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.For the third year in a row, we consulted 340B Health's experts on our staff to answer our listeners' most pressing 340B questions. As 2026 gets underway, we answer your questions about the CMS drug acquisition cost survey, what states are doing on 340B this year, and more. Some of the topics we cover:CMS Drug Acquisition Cost Survey Not MandatoryEarlier this year, the Center for Medicare & Medicaid Services (CMS) launched a new survey focusing on hospitals' outpatient drug acquisition costs, which could lead to Medicare Part B payment cuts for 340B drugs. Some hospitals recently saw materials suggesting they are required to complete the survey. Amanda Nagrotsky, vice president of legal and policy for 340B Health, notes that a CMS rule states there are no penalties under the Medicare statute for hospitals that choose not to respond. 340B Health and other groups sent a joint letter asking for the language to be corrected, citing the confusion it has caused.State Legislatures Are Becoming Major Battlegrounds for 2026Just over one month into 2026, statehouses are already shaping up to be one of the biggest venues to debate various aspects of the 340B. Two broad categories of bills are emerging: legislation protecting access to 340B pricing — including protections for contract pharmacy arrangements — and state-level reporting mandates. 340B Health Senior Vice President of Government Relations Tom O'Donnell says the proposed reporting mandates mirror other states' recently enacted requirements, and he argues they can be misleading, burdensome, or modeled on frameworks promoted by large drug companies.Medicare Announces More Drug Price Caps for 2028Medicare is phasing in maximum fair pricing – or MFP – for high-spending drugs over several years. CMS recently announced the next group of 15 drugs that will be subject to these types of price caps in 2028, adding to the 2026 and 2027 drug lists. Starting in 2028, these price caps will apply to both Medicare Part D and Part B drugs, including those purchased through Medicare Advantage. 340B Health Senior Manager of Pharmacy Services Gilda Yeboah says this means hospitals will see reduced 340B savings on certain drugs as Medicare prices move closer to existing 340B ceiling prices. Yeboah says the issue is complex and evolving, and 340B Health is working to share concerns about MFP implementation with federal agencies.Resources340B Health and Allies Urge CMS Contractor To Correct Statement Suggesting Hospitals Must Respond to OPPS Drug Cost SurveyStates Introduce New 340B Legislation in 2026 SessionsMaine Federal Court Rejects Drug Company Challenge to State 340B Contract Pharmacy LawMedicare Expands List of Drugs Subject to Price Caps, Decreased 340B Savings Starting in 2028Manufacturer Notices to Covered EntitiesHRSA Releases 340B Purchase Data for 2024FY 2025 Manufacturer Audit Results

The 340B Program is a lifesaver for our Kansas community. 

The 340B Program is a lifesaver for our Kansas community.

In this episode, Tiffany Love, Associate Vice President of Nursing at Greater Lawrence Family Health Center, discusses tackling the primary care shortage through triage innovation, telehealth expansion, and nursing leadership. She also shares how federally qualified health centers are preparing for potential Medicaid and 340B changes while continuing to serve vulnerable communities.

In this episode, Tiffany Love, Associate Vice President of Nursing at Greater Lawrence Family Health Center, discusses tackling the primary care shortage through triage innovation, telehealth expansion, and nursing leadership. She also shares how federally qualified health centers are preparing for potential Medicaid and 340B changes while continuing to serve vulnerable communities.

Send us a textSchedule an Rx AssessmentWith Medicare's Maximum Fair Price (MFP) rebates officially underway and the 340B rebate mechanism on hold, pharmacy owners are left navigating one of the grayest areas the industry has seen in years.In this episode, Scotty Sykes, CPA, CFP®, Bonnie Bond, CPA, MBA, and Austin Murray sit down with Julie Crozier, CEO at  @secure340b to unpack how MDPNP is colliding with 340B and what pharmacies should be paying attention to right now.We cover:How MDPNP and MFP rebates are flowing todayThe duplicate discount problem no one is reconcilingBeacon's role and why future reconciliation risk mattersDispensing fee pressure, CE relationships, and contract implicationsPractical considerations if TPAs or covered entities push for carve-outsAnd more!More About Our Guest:As CEO of Secure340B, Julie is responsible for formulating and executing strategic plans and technology to deliver critical and timely intel to 340B stakeholders. Julie has over 25 years of pharmacy experience including co-founding, growing and leading a pharmacy software company, Macro Helix, which was acquired by McKesson Corp (NYSE: MCK) in 2012. Julie also has experience in retail pharmacy, long-term care, state Medicaid programs and healthcare revenue cycle. She holds a Bachelor's in Pharmacy and a Master's in Pharmacy Administration from The University of Texas at Austin.Julie serves on the board at Crossroads Community Services, a food pantry, and lives in Dallas, Texas with her husband and 2 daughters.Stay connected with Julie and Secure340B: Julie Crozier LinkedInSecure340B WebsiteSecure340B FacebookSecure340B LinkedInSecure340B InstagramStay connected with us: FacebookYouTube LinkedInInstagramMore resources on this topic: Podcast - Driving Independent Pharmacy Profitability in 2026Podcast – The Startup Compounding Pharmacy PlaybookPodcast – Inside the Fight for Compounding: Advocacy, Growth, and Regulation

In this episode, Greg and Rob are joined again by healthcare attorney Emily Cook. They discuss a recent HRSA Information Collection Request (ICR) that describes some changes being made to the 340B enrollment, registration and recertification processes. They also discuss recent industry observations around hospital disproportionate share percentage calculations and impact on 340B Program eligibility. Going to 340B Coalition Winter Conference in San Diego? Come see the SpendMend team at booth #418!

Health Affairs' Rob Lott interviews Sayeh Nikpay of the University of Minnesota about her recent paper exploring how The Medicaid Drug Rebate Program and the 340B Program interact in ways that can unintentionally increase costs, the adoption of cost-saving strategies to mitigate these interactions, and how policymakers can act to balance Medicaid savings with revenue impacts on 340B-participating safety-net providers.Order the January 2026 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast

In this episode, Rob and Greg are joined by guest Andy Ruskin, healthcare attorney and government payer expert from K&L Gates. They'll be discussing the 2026 CMS OPPS Final Rule, focusing on the provision related to the ODACS, or Outpatient Drug Acquisition Cost Survey. They'll review the statutory landscape surrounding the survey, recap past attempts by CMS to lower 340B hospital reimbursement, and discuss considerations for hospitals as they contemplate how to respond this time around. In the intro, the guys review updates to manufacturer 340B policies. Specifically, they discuss a new policy from one manufacturer that conditions 340B pricing access for in-house pharmacies on claim submission requirements. 

340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.January was set to be the first month of a new 340B rebate pilot program, marking a seismic shift in how the drug discount program functions. But a flurry of court activity just before and after the new year put a sudden pause on the rebate program and left the future of the rebate pilot in question. Amanda Nagrotsky, vice president of legal and policy with 340B Health, joins the show to fill us in on the latest.HRSA Pauses Rebate Implementation After Court RulingIn late December, a federal court in Maine issued a ruling that temporarily blocks the Health Resources & Services Administration (HRSA) from moving forward with the 340B rebate pilot. HRSA then announced it was pausing the pilot and instructed drug companies to continue providing 340B pricing through the traditional upfront discount model. Nagrotsky says the judge found that hospitals had demonstrated a high likelihood of irreversible harm if rebates went forward.Government Appeals, Then ReconsidersImmediately after the ruling, HRSA unsuccessfully argued to the Maine court and an appeals court that the agency still should be able to implement the 340B rebate pilot program while it appealed the initial ruling. After the courts denied that request, the government agreed to voluntarily dismiss its appeal and said it would reconsider its rebate program approvals. Nagrotsky stresses that it is unclear what this means. It could mean the government might overhaul or scrap the rebate program, or it might issue revised approval notices to better explain the rebates' purpose and address concerns of potential harm to 340B hospitals.Medicare Maximum Fair Price Provisions Still Take EffectDespite the legal questions surrounding the 340B rebate pilot program, new Medicare maximum fair price (MFP) provisions did take effect at the beginning of January for the drugs that would have been subject to the rebates. Nagrotsky says that while 340B still can be used for these drugs, covered entities are not entitled to MFP refunds from drug companies in those scenarios. She recommends hospitals closely track expected MFP rebates to identify any missing refunds for claims that did not use 340B drugs.ResourcesDismissal of Appeal Sets Stage for HRSA Reconsideration of 340B Rebates

In this episode, Roya Tran, PharmD, MS, 340B ACE, Associate Chief Pharmacy Officer for Pharmacy Finance and Supply Chain at Duke Health, joins the podcast to discuss her experience with the 340B program and how it supports access to care. She shares perspectives on expanding the ambulatory pharmacy space, identifying growth opportunities, and improving access to pharmaceutical care through strategic finance and supply chain alignment.

 In Episode 123 of DC EKG, Joe Grogan sits down with Jackson Hammond (Senior Policy Analyst, Paragon Health Institute) to unpack what the latest CMS National Health Expenditure (NHE) data says about where U.S. health care is headed. They break down the June 2025 NHE release, compare it to Jackson's earlier “Paragon Prognosis” analysis, and explain what changed, what didn't, and what it means for affordability, Medicare, Medicaid, and long-run fiscal pressure. They also connect the spending outlook to Jackson's paper, “How to Reform the CMS Innovation Center with a Choice and Competition Approach,” and debate whether CMMI is bending the cost curve or just adding bureaucracy without accountability. Jackson argues we should aim for health care so affordable you barely need insurance. Chapters / Timestamps  00:00 – Intro + welcome  00:55 – Jackson's background: how he got into health policy  03:39 – Focus areas: Medicare, hospitals, drug pricing, PBMs, 340B  05:14 – What the NHE report is showing  06:14 – $5.2T → $5.6T → $8.6T: why the trajectory matters  08:00 – Why health spending isn't really “optional”  10:11 – Where the money is going: payer mix + per-enrollee costs  12:23 – Medicaid costs, provider taxes, and state financing tactics  15:58 – Medicare spending pressure and fiscal risk  21:06 – Misconception: “coverage = care”  26:18 – Why provider payments keep rising (post-COVID demand + consolidation)  33:01 – Rural care, consolidation, and the REH / hub-and-spoke model  40:08 – Drug pricing: retrospective vs prospective MFN  49:20 – 2026 outlook + closing thanks In This Conversation  • NHE 2025: what the June 2025 data confirms about spending growth and the federal share.  • Rising prices, flat health: why prices climb while outcomes lag.  • Medicare and Medicaid: why they remain major budget drivers.  • Coverage vs access: why an insurance card doesn't guarantee care or better health.  • Hospitals and consolidation: what's driving higher payments and fewer choices.  • Rural vs urban: why patients bypass local hospitals and what a better model could look like.  • Drug pricing: what MFN approaches might mean for costs and innovation.  • 2026: what Jackson expects next and what reform could realistically look like. Key Takeaways  • NHE data points to continued, unsustainable spending growth.  • Medicare and Medicaid drive long-term budget pressure.  • Consolidation and payment incentives shape prices as much as utilization.  • CMMI reform hinges on accountability, choice, and competition.  • Smarter drug pricing policy should lower costs without undermining innovation. About Our Guest  Jackson Hammond is a Senior Policy Analyst at the Paragon Health Institute focused on health spending, CMS policy, and reforms centered on choice, competition, and patient-centered care. He authors Paragon's “Paragon Prognosis” analyses and wrote “How to Reform the CMS Innovation Center with a Choice and Competition Approach.”

Podcast TitleDC EKG with Joe Grogan: A Healthcare Policy Podcast Episode124 Episode TitleRyan Long on the ACA Subsidy Fight, Phantom Enrollees, and Reforming 340B Episode DescriptionJoe Grogan is joined by Ryan Long of Paragon Health Institute and the University of Southern California to break down two fights shaping health policy right now: a California wealth tax pitch framed as a health care fix, and the battle over extending enhanced Affordable Care Act subsidies. They unpack how enhanced subsidies changed who qualifies, why zero-premium plans opened the door to broker-driven enrollment and fraud, and why the medical loss ratio creates perverse incentives that can push premiums higher. They also explain how silver loading and cost-sharing reduction policy distort the exchange market, and what reforms could lower costs without writing a blank check. The episode closes with Ryan's latest work on the 340B program, including why drug arbitrage rewards hospitals with a stronger commercial mix and can fuel consolidation, and why direct, targeted assistance could better support hospitals that truly serve low-income and rural patients. Chapters and Timestamps00:01 Intro00:23 Welcome, and what is on the agenda01:25 California wealth tax and structural deficits11:20 Enhanced ACA subsidies and the shutdown fight16:54 Income caps, zero premium plans, and phantom enrollees21:50 Fraud, Medicaid exposure, and public trust30:39 Medical loss ratio incentives and ACA market fixes38:41 340B: how arbitrage works and why it drives consolidation44:51 What reform could look like47:20 Closing SEO KeywordsAffordable Care Act, ACA subsidies, enhanced subsidies, premium tax credits, exchange plans, zero premium plans, phantom enrollees, medical loss ratio, cost sharing reduction, silver loading, Medicaid fraud, Minnesota fraud, California wealth tax, 340B program, drug arbitrage, hospital consolidation, site neutral payments, commercial mix, Medicare Trust Fund About Our GuestRyan Long is a health policy expert with experience on Capitol Hill, including years in the Speaker's office and on the House Energy and Commerce Committee. He is affiliated with Paragon Health Institute and the University of Southern California. CreditsSponsor: Survivors for SolutionsExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Julie Riga, Stay on Course Studios, https://www.stayoncourse.studio

The Centers for Medicare and Medicaid Services has finalized the 2026 Outpatient Perspective Payment System (OPPS) rule, with most policies taking effect on January 1, 2026. Jenna Stern, Vice President of Regulatory Affairs and Public Policy at Vizient, joins host Carolyn Liptak, Pharmacy Executive Director in Vizient's Center for Pharmacy Practice Excellence, to discuss key updates to payment policies, payment rates, and quality provisions affecting Medicare beneficiaries receiving care in hospital outpatient departments and ambulatory surgical centers.   Guest speaker:    Jenna Stern Vice President of Regulatory Affairs and Public Policy Vizient Host:   Carolyn Liptak, MBA, RPh  Pharmacy Executive Director Vizient  Verified Rx Host   Show Notes: 00:05 — Introduction Announcer welcomes listeners to VerifiedRx. Host Carolyn Liptak, Pharmacy Executive Director at Vizient, introduces the episode focus: the 2026 CMS Outpatient Prospective Payment System (OPPS) Final Rule. Guest: Jenna Stern, VP of Regulatory Affairs and Public Policy at Vizient.   01:12 — Overview of the OPPS Final Rule OPPS sets Medicare payment for most hospital outpatient services. Published annually (typically November), effective January 1. Covers payment rates, policies, quality programs, and compliance requirements. Note: CMS delayed enforcement of hospital price transparency requirements until April 1, 2026.   01:34 — Key Takeaways From the 2026 Final Rule Jenna's high-level insights: Hospitals will continue facing financial pressure in 2026. Modest payment rate increase combined with reimbursement-reducing policies. Expansion of site-neutral payment policies will be particularly impactful. Rule reflects emerging administration priorities shaping future policy.   02:21 — OPPS Payment Rate Update for 2026 CMS finalized a 2.6% OPPS schedule increase factor for hospitals meeting quality reporting requirements.   02:40 — What the 2.6% Increase means Based on: 3% market basket update –0.7% productivity adjustment Results in a modest net increase. Slightly better than the proposed 2.4% increase, though still viewed as inadequate. CMS estimates $8 billion increase in total OPPS payments compared to 2025.   03:37 — 340B Remedy Offset: Background From 2018–2022, CMS paid for 340B drugs at ASP –22.5%. Prior Supreme Court decision from 2022 found that CMS lacked authority to vary rates as finalized in prior rulemaking (e.g., without using drug acquisition cost surveys to inform policy).   04:13 — 340B Remedy Offset in the 2026 Final Rule CMS considered increasing the remedy offset from 0.5% to 2%. Stakeholders strongly opposed the increase due to hospital financial strain.   05:10 — Final Outcome CMS retained the 0.5% offset for 2026. CMS signaled that larger offsets may be proposed for 2027. This marks the first year the remedy offset takes effect,   06:00 — Site-Neutral Payment Policy: What It Is Concept: same service = same payment, regardless of site of care. Hospital concern: policy reduces hospital reimbursement without accounting for site of care differences, patient acuity, overhead, or service complexity.   06:15 — Site-Neutral Expansion in the 2026 Rule CMS expanded site-neutral payment to include drug administration services at excepted off-campus provider-based departments.   07:08 — Financial Impact Reimbursement aligns with Physician Fee Schedule rates. CMS estimates $290 million reduction in outpatient spending for 2026. $220 million of savings accrue directly to Medicare. Not implemented in a budget-neutral manner.   08:14 — Non-Opioid Pain Management Payments Temporary additional payments began January 1, 2025. Authorized under the NO PAIN Act (Consolidated Appropriations Act of 2023).   08:28 — What's New for 2026 CMS finalized the renewal of: 5 drugs 13 medical devices eligible for separate payment in HOPD and ASC settings. Per statue, payments available through December 31, 2027.   09:32 — Process Improvements CMS will allow more frequent consideration of new qualifying products (not limited to annual updates). Quality criteria unchanged; timing flexibility added. CMS released guidance on how stakeholders can engage for inclusion.   10:58 — OPPS Drug Acquisition Cost Survey CMS finalized plans to survey hospitals on acquisition costs for separately payable OPPS drugs.   11:21 — Why CMS Is Advancing the Survey Addresses Supreme Court requirements from prior 340B litigation. Aligns with White House Executive Order on lowering drug prices. Positions CMS to use survey data for 2027 rulemaking.   12:47 — OPPS Packaging Thresholds for 2026 Drugs and biologics: Threshold remains at $140. Diagnostic radiopharmaceuticals: Increased to $655 (from $630). Products below thresholds retain Status Indicator “N” (packaged payment).   13:26 — Why Billing Packaged Drugs Still Matters Even though not separately payable, hospitals must bill for packaged drugs. Billing data feeds cost reports used to calculate future bundled payments. Failure to bill can result in inaccurately low reimbursement.   14:14 — Elimination of the Inpatient-Only (IPO) List CMS finalized a three-year transition to eliminate the IPO list by January 1, 2029.   14:32 — Why This Change Is Significant IPO list historically ensured certain services were provided inpatient only. CMS emphasizes provider judgment in determining site of care. Raises concerns about: Patient safety Payer coverage changes Pressure to move services outpatient   16:28 — ASC Covered Procedure List Expansion CMS expanded the ASC Covered Procedure List. Enables more Medicare covered services to be performed in the ASC settings.   16:48 — Price Transparency: Still a Priority No major overhaul, but continued refinement. CMS exploring new uses of price transparency data beyond patient comparison.   17:46 — Most Critical Policies to Watch Jenna highlights: Modest OPPS payment increase Site-neutral payment expansion 340B remedy offset Drug acquisition cost survey Broader regulatory activity beyond OPPS   18:43 — Available Vizient Resources OPPS Final Rule Summary Government Relations & Public Policy Summaries  Advocacy   19:20 — Closing Carolyn thanks Jenna for her insights. Reminder to subscribe, like, and share feedback. VerifiedRx is produced by the Vizient Center for Pharmacy Practice Excellence.   Links | Resources:  Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots: Click Here CMS fact sheet on the Final Rule: Click Here Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey: Click Here Vizient Office of Public Policy and Government Relations final rule summary:  Click Here Final List of Qualifying Products for Separate Payment for non-opioid pain medications: (Table 136, pgs. 1138-1140)   VerifiedRx Listener Feedback Survey: We would love to hear from you - Please click here   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed    

In this episode, Greg and Rob share some initial reactions around the recent judicial activity affecting HRSA's 340B rebate model. They'll discuss thoughts on the federal court ruling that halted the rebate model from going into effect, and also debate what the fallout could be for manufacturers and covered entities given the lack of a regulated deduplication process for MFP and 340B prices. They'll also discuss some of the preliminary steps hospitals might need to take in response to the CMS OPPS Drug Acquisition Cost Survey. Email us at 340BUnscripted@spendmend.com if you have questions or topics for us to cover!

In this episode of The Counterweight, Doug Rogers and Russell Neiman Stover discuss the latest developments in health tech, focusing on AI applications like ChatGPT and Doctronic. They explore the implications of AI in healthcare, including prescription capabilities, regulatory challenges, and the growing consumerism in healthcare. The conversation also touches on insights from the upcoming JPMorgan Healthcare Conference and the future of AI in patient care.TakeawaysDoctronic is the first AI company approved to write prescriptions.AI tools like ChatGPT are changing patient interactions with healthcare.The healthcare landscape is shifting towards consumerism.Regulatory challenges remain a significant barrier for AI in healthcare.The JPMorgan Healthcare Conference will highlight financial performance and challenges for health systems.24 million Americans are affected by the lapse of ACA subsidies.340B programs are crucial for health systems' financial stability.AI can help alleviate labor shortages in healthcare.The future of healthcare will involve more AI-driven solutions.Consumer access to healthcare information is increasing.

In this episode, Joshua Weber, PharmD, MBA-HCM, CSP, BCMTMS, 340B ACE, Senior Director, St. Luke's Health System, highlights the organization's future-ready pharmacy transformation, including paperless workflows, AI-enabled prior authorizations, EHR-integrated benefits investigations, and expanded specialty drug access for 5,000 more patients.

In this episode, Thomas Carey, PharmD, Senior Director, Pharmacy Services, UW Northern Illinois, shares how the organization elevated its Med to Bed discharge program using multidisciplinary coordination, driving a nearly 30% reduction in 30-day readmissions. He also discusses agility in 340B compliance, leveraging learners, and the future of pharmacy growth through technology, automation, and workforce investment.

To kick off the new year, Heather, Lauren, and Matthew offer a high-level overview of what's shaping the healthcare and life sciences industries in 2026. From cybersecurity threats and physician employment risks to the growing role of AI, Lauren and Matthew share insights from recent conversations with hospital general counsel and industry leaders. They also look ahead to key policy issues like HIPAA updates, 340B changes, PBM regulation, and private equity oversight in healthcare. Tune in now for takeaways and predictions to help you navigate the year ahead!

Rural Health News is a weekly segment of Rural Health Today, a podcast by Hillsdale Hospital. News sources for this episode: Ella Jeffries, “CMS approves rural health awards for all 50 states,” December 29, 2025, https://www.beckershospitalreview.com/financial/cms-awards-50b-to-states-for-rural-health-transformation/, Becker's Hospital Review. CMS.gov, “CMS Announces Establishment of the Office of Rural Health Transformation,” December 29, 2025, https://www.cms.gov/newsroom/press-releases/cms-announces-establishment-office-rural-health-transformation/ Erica Cerutti, “ED boarding in 2025: 4 notes,” December 29, 2025, https://www.beckershospitalreview.com/care-coordination/ed-boarding-in-2025-4-notes/, Becker's Hospital Review. Kara Gavin, “Wait times for emergency hospitalization keep getting higher,” August 4, 2025, https://www.michiganmedicine.org/health-lab/wait-times-emergency-hospitalization-keep-getting-higher, Michigan Medicine. Ella Jeffries, “Judge blocks 340B rebate pilot program,” December 29, 2025, https://www.beckershospitalreview.com/pharmacy/judge-blocks-340b-rebate-pilot-program/, Becker's Hospital Review. Elizabeth S. Eaton, “'Threadbare administrative record': Federal judge stops 340B rebate pilot,” December 30, 2025, https://firstwordpharma.com/story/7022857, FirstWord Pharma. Rural Health Today is a production of Hillsdale Hospital in Hillsdale, Michigan and a member of the Health Podcast Network. Our host is JJ Hodshire, our producer is Kyrsten Newlon, and our audio engineer is Kenji Ulmer. Special thanks to our special guests for sharing their expertise on the show, and also to the Hillsdale Hospital marketing team. If you want to submit a question for us to answer on the podcast or learn more about Rural Health Today, visit ruralhealthtoday.com.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into a series of significant events that are shaping the landscape of this dynamic industry. The ever-evolving arena of drug approvals, regulatory challenges, and strategic shifts continues to captivate stakeholders across the globe.Sanofi's recent acquisition of Dynavax for $2.2 billion illustrates a prevailing trend within the sector—mergers and acquisitions aimed at expanding vaccine portfolios in response to global health priorities. This strategic move provides Sanofi with access to Heplisav-B, a hepatitis B vaccine, thereby reinforcing the importance of broadening vaccine offerings amid ongoing global health concerns.The U.S. Food and Drug Administration (FDA) has been active in granting approvals for new therapies, reflecting ongoing efforts to address a wide range of medical needs. Agios Pharmaceuticals has received approval for Aqvesme, a treatment designed specifically for anemia in patients with either alpha- or beta-thalassemia. Meanwhile, Vanda Pharmaceuticals has secured approval for Nereus, a novel motion sickness treatment. These approvals highlight the FDA's dedication to advancing treatments for both common and rare medical conditions.A noteworthy milestone was achieved by Omeros Corporation as it secured FDA approval for Yartemlea—its first U.S. approval in 31 years. This drug is a novel treatment for hematopoietic stem cell transplant-associated thrombotic microangiopathy, underscoring the industry's focus on developing therapies for niche yet critical medical conditions.Verastem Oncology has opted to halt its phase 1/2 trial of a KRAS G12C inhibitor targeting non-small cell lung cancer due to increasing competition from next-generation inhibitors. This decision reflects the competitive and rapidly evolving landscape of oncology therapeutics where companies must adapt their strategies based on interim data and market dynamics.Foresee Pharmaceuticals has reported promising phase 3 results for Camcevi in treating central precocious puberty (CPP), a rare hormonal disorder. This demonstrates the potential for repurposing established drugs to address unmet needs in pediatric endocrinology.Inflarx is actively exploring partnerships to revitalize its C5a antibody vilobelimab which was initially developed for pyoderma gangrenosum but faced setbacks after a terminated phase 3 trial. The company's persistence in seeking new pathways forward exemplifies the challenges and resilience required in drug development, especially for rare diseases.Regulatory hurdles remain a significant challenge as illustrated by Outlook Therapeutics' ophthalmic bevacizumab facing another FDA rejection. Such outcomes emphasize the stringent regulatory environment that companies must navigate to bring innovative therapies to market.A federal judge's temporary pause on the 340B rebate pilot underscores ongoing legal and regulatory debates impacting healthcare policy and industry operations. The contentious rollout of this pilot reflects broader tensions between administrative actions and healthcare stakeholders.As we look forward, industry analysts anticipate that the surge in mergers and acquisitions observed in late 2025 will persist into 2026. Companies are driven by growth aspirations through strategic acquisitions aimed at expanding their pipelines and market reach.Despite positive advancements, some companies face setbacks. Johnson & Johnson's discontinuation of its $1.2 billion eczema therapy due to unsatisfactory clinical results highlights the inherent risks and unpredictability of drug development. Similarly, Genmab's withdrawal of a cancer drug from development underscores these challenges within oncology research.In contrast, Neuralink's plans to ramp up production of its brain-computer interface devices highliSupport the show

Pharmacy buyers play a critical role in keeping hospitals running—and their partnership with a GPO can make all the difference. In this episode of Verified Rx, Jackie Stokes sits down with Theresa Brown and Michelle Crump, two powerhouse pharmacy buyers and members of Vizient's Pharmacy Technician Committee, to talk about the tools, programs, and peer networks that help them thrive in their roles. From leveraging pharmacy analytics to navigating shortages, maximizing NovaPlus value, and strengthening buyer-to-buyer collaboration, this episode is packed with insights to help pharmacy teams work smarter, save money, and support better patient care.   Guest speakers:  Theresa Brown National Pharmacy Purchasing Specialist Prospect Medical Holdings   Michelle Crump, ASBA, CPhT National Certified Pharmacy Technician Buyer Pharmacy Host: Jackie Stokes Program Services Manager Center for Pharmacy Practice Excellence (CPPE) Vizient   Show Notes: [00:48] — Guest Introductions Theresa National pharmacy purchasing specialist Background: inventory control, home infusion startup, pharmacy technician educator [01:14] — Michelle Nationally certified pharmacy technician since 2016 Pharmacy buyer at a small independent county critical access hospital Transitioned from accounting into pharmacy purchasing   [01:26] — The Role of Vizient in Supporting Pharmacy Buyers Theresa: Biggest benefit: relationship with pharmacy executive & sourcing team Uses Pharmacy Analytics (formerly VSAP) to evaluate spend and inventory control across 63 facilities   [02:16] — How Pharmacy Analytics Supports Buyers Theresa: Data mining on spend increases/decreases Tracks product returns Identifies sharing opportunities to prevent waste [02:59] — Michelle's Experience Analytics helps mitigate waste Collaboration with other buyers has been essential — especially for someone new to the buyer role Learns navigation of Vizient systems and how to work with the local GPO Peer support helps demystify a “diverse and complex” buyer role   [04:02] — Value of the Vizient Pharmacy Technician Committee Provides national peer networking Helps buyers learn from subject matter experts Even highly experienced buyers (35+ years) learn from every call   [04:41] — Vizient Programs: NovaPlus, NES, Forum Calls, Hot Info Bimonthly Forum Calls Provide regulatory updates Help expand buyer knowledge in real time Hot Info Weekly Updates Keeps users informed on inventory, shortages, spend impacts [05:31] — Michelle on Program Impact Calls and shared expertise were critical when she was new NovaPlus program especially valuable in critical access settings   [06:32] — Deep Dive: How the NovaPlus Program Works Michelle explains: NovaPlus (Y-label) aligns with manufacturer-labeled products (M-label) Quarterly rebates provide significant savings Critical access hospitals benefit via 340B optimizer software that extracts outpatient utilization to qualify for discounted M-label purchasing Can result in “significant savings” depending on contract structure   [08:38] — What If NovaPlus Pricing Isn't the Best Price? Michelle: Buyer's responsibility to identify price discrepancies Communicates with Vizient representative to reassess contracting needs Often resolved through rebates or future price adjustments [09:30] — Theresa: Price challenges taken seriously Many result in price reductions visible in Hot Info the next week Demonstrates importance of strong GPO relationships   [10:07] — Understanding NES: NovaPlus Enhanced Supply Theresa: Her hospitals are exploring NES participation Requires 90% compliance (higher than standard 80%) Benefits include prioritized product access during shortages Critical when national backorders exceed 200+ items Ensures better patient care continuity   [11:34] — Supply Assurance & Mitigation Strategies Michelle: During the North Carolina hurricane, Vizient's mitigation strategy was “imperative” Vizient engaged Baxter directly to resolve critical fluid shortages Small hospitals especially reliant on support in crisis situations [12:36] — Theresa: Shortage team provides substitution guidance and clinical appropriateness information Vizient recommendations support discussions with local clinical teams Crucial during COVID start date — her first day in national role   [13:23] — Continuing Education (CE) Programs Theresa: Vizient CE programs help maintain technician licensure Webinars are interactive, engaging, and more informative than generic CE resources   [14:07] — Networking and Pharmacy Aggregation Groups (PAGs) Theresa: PAGs offer cost savings and peer collaboration Ability to share information and bring value back to her own network [14:44] — Michelle's Example of System-to-System Collaboration Shared compounded syringes (from a 503B facility) with another hospital to prevent waste Highlights real-world benefits of PAG networking   [15:52] — Addressing National Challenges Together Theresa: PAG roundtables help uncover shared struggles (e.g., DSCSA serialization issues) Members provide actionable advice on what's working in their systems Reinforces “we're all in the same boat”   [16:50] — Supporting and Elevating Pharmacy Technicians Jackie's goal: Support technicians and recognize the value they bring Committee exists to uplift and empower pharmacy buyers/techs [17:05] — Michelle: Worked with leadership to create a tiered technician level system Helps techs gain skills, feel valued, and earn raises Improves career satisfaction and retention   [17:46] — Closing Reflections Theresa: Being part of Vizient is “an honor and a privilege” Values shared knowledge and strong relationships [18:00] — Michelle: Gratitude for collaboration and guidance over the years Vizient connections were vital for adapting to the buyer role   VerifiedRx Listener Feedback Survey: We would love to hear from you - Please click here   Subscribe Today! 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In this special 2025 U.S. Policy Highlights edition of the Vital Health Podcast, we look back at our most important discussions on Most Favored Nation (MFN) drug pricing and its knock-on effects for jobs, state budgets, and the generic supply chain. Over the past year, proposals to link U.S. prices to those in other countries have collided with inflation pressures, tariff debates, and reshoring efforts, creating new uncertainty for manufacturers, payers, and policymakers. In an environment where expectations about future returns are shifting, and the rules of the game are still being defined, this episode is designed as a year-end guide to what MFN-style policies could mean in practice and how to think about the tradeoffs. Throughout 2025, we our research on MFN-style reference pricing with a series of podcast episodes where host Duane Schulthess sat down with leaders across the generic, distribution, and policy landscape. In this highlights episode, we revisit several of those conversations: Kirsten Axelsen: Part D Shift, IRA Penalties, and Access Risks Patrick Kelly: Inside the Generic Supply Chain Squeeze John Murphy: Generics, Biosimilars, and U.S. Policy VT’s Grumpies (Harry Bowen, Joe Hammang) Talk MFN Key Topics: MFN Mechanics Explained: How tying U.S. prices to the lowest GDP-adjusted price in a reference basket translates into steep cuts for top-spend medicines in Medicare Parts B and D and shapes expectations across commercial and Medicaid contracts. Jobs, Earnings, & State Budgets: What our modeling suggests about potential impacts on employment, earnings, and tax revenue under MFN-style reference pricing, and how those effects concentrate in R&D-intensive regions and manufacturing hubs. Spillovers Into Medicaid, 340B, & ASP: Why MFN in Medicare does not stay in Medicare, how Medicaid best price and 340B ceilings pull discounts across programs, and what lower ASP add-ons could mean for hospital and community oncology margins. Generics, Shortages, & Tariffs: How razor-thin margins for sterile injectables and generic manufacturers interact with purchaser consolidation, tariff shocks, and price referencing, raising the risk of exits, inventory write-downs, and persistent shortages. Global Competition & Offshoring: How aggressive reference pricing can accelerate shifts in trials, licensing, and high-value manufacturing to countries that offer more predictable returns, and what that implies for long-run U.S. competitiveness. Alternatives To MFN: Ideas from our guests on value-based approaches, targeted incentives, and other tools that can improve affordability without hollowing out domestic capacity, innovation, and resilience in the generic and biosimilar supply chain. Opinions expressed are those of the speakers.See omnystudio.com/listener for privacy information.

In this episode, Greg and Rob recap key developments in the 340B space from 2025.  They'll discuss the flurry of activity in recent months related to 340B rebates, project the impact of the OBBB on DSH hospitals, share insights from HRSA audit trends over the last year, and offer commentary on one of the few high points for 340B providers this year – state legislative activity. Also, Rob offers a heartfelt pep talk for 340B folks at the end of the episode – so make sure you listen through to the end! Medi-Cal Provider Guidance on 340B Rebates:  https://mcweb.apps.prd.cammis.medi-cal.ca.gov/news/33779 Email us at 340BUnscripted@spendmend.com with your questions and comments!

340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.With monumental movement on 340B rebates, changes in Medicare and Medicaid payments, and evolving audit priorities, 2025 has been a transformative year in the world of 340B. We sit down with 340B Health Senior Manager of Policy and Compliance Rebecca Swartz to chronicle some of the biggest developments of such an eventful year and forecast what to expect in 2026.Rebates Take ShapeSwartz says 2025 will go down as the year that a rebate model shifted from a hypothetical approach pushed by drugmakers into a fully developed model with implementation criteria. The Health Resources & Services Administration (HRSA) approved plans for 340B rebate models set to take effect in January for nine of 10 drugs subject to the 2026 Medicare maximum fair prices. Rebates for the remaining drug on that list will kick in April 1. Swartz discusses how hospitals should prepare for this pilot program, which is set to upend decades of established 340B operations and impose intense financial and logistical burdens on safety-net hospitals nationwide.Medicaid, IRA Changes Set To Impact 340B HospitalsThis year also saw massive changes to Medicaid funding as well as Medicare pay changes under the implementation of the Inflation Reduction Act (IRA). Swartz says these developments are projected to shrink safety-net hospital margins even further. Renewed congressional focus is putting 340B in a high-profile spot, with potentially significant implications for the program and hospitals in the coming months.2026 Tips for HospitalsSwartz says she's identified two areas as more of a focus for HRSA audits this year: expanded scrutiny of offsite and on-site trial balances and the ways covered entities list shipping addresses. To prepare for possible shakeups in 2026, she recommends that covered entities begin and maintain cross-functional planning across departments and closely monitor denials, delays, and other costs from new rebate programs in addition to monitoring wholesale acquisition cost (WAC) changes and contract pharmacy developments.Resources340B Health Year-in-Review Webinar: 2025 Highlights and What's on the Horizon

The status quo is expensive, exhausting, and unsustainable—so we set out a practical playbook to do better in 2026. Nathan Kaufman shares ten no‑nonsense resolutions for health system leaders who want measurable outcomes, stronger teams, and smarter payer strategies without falling for vendor hype or wishful thinking.We get specific about capital discipline and why “mission” can't justify chronic losses that drain resources from services that actually improve patient care. We talk through what it takes to win the talent war by treating physicians as true partners, then dive into dyad leadership that cuts across supply chain, HR, and IT to remove friction and accelerate results. Culture becomes operational with real-time metrics, fast feedback loops, and leaders spending more time in the field and less time in meetings that signal low trust and unclear decisions.Payment strategy is front and center. We explain how to use 340B responsibly to close funding gaps, why some value-based schemes are a race to the bottom, and how to negotiate Medicare Advantage so contracts yield at least 100% of Medicare after accounting for administrative burden. Affordability demands that we take significant cost out by removing layers, standardizing clinical pathways, and focusing on core services rather than chasing panaceas like provider-owned health plans or sponsored “research” that flatters a product.If you're ready to lead with data, align teams, and make tough calls that protect patient access and quality, this conversation is your roadmap. Subscribe, share with a colleague who needs a dose of operational courage, and leave a review telling us which resolution you'll tackle first.Support the showEngage the conversation on Substack at The Common Bridge!

Sitting at the intersection of healthcare policy, hospital finance, and patient access, the 340B drug discount program is a hot button issues in the pharmacy space. The program is critically important to providers that serve high volumes of low income and vulnerable patient populations, but it's drawing increasing scrutiny.340B was established in 1992 as part of the Public Health Services Act to help providers stretch scarce resources, expand services, and improve access to care for those most in need. It does this by requiring pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at significant discounts to safety net hospitals and other covered entities – including federally qualified health centers (FQHCs), HIV clinics, homeless clinics and more. Covered entities are reimbursed for the full cost of the medication and use that margin to offset losses from caring for low‑income, uninsured, and underinsured patients. It's become a critical component to their operating budgets.The program has grown substantially since its inception, with increasing numbers of hospitals and entities participating. This expansion has led to questions about whether the program is being used as intended or stretched beyond its original purpose.Ted Slafsky – one of the nation's leading experts on 340B – joined Keith Figlioli for this episode of Healthcare is Hard to unpack this complex and critical program. For 22 years, Ted served as president and CEO of 340B Health, a Washington D.C.-based association of over 1400 hospitals nationwide participating in the 340B program. In 2020, he started 340B Report, the only news outlet in the country focused exclusively on the 340B program.Some of the topics Ted and Keith discussed include:Balancing oversight and operational efficiency. The 340B program faces growing calls for transparency and accountability, with proposals for more detailed reporting on how hospitals and clinics use the savings. While oversight is important to ensure compliance and integrity, Ted warns that excessive administrative requirements could overwhelm providers and divert resources away from patient care. The challenge is finding a balance that promotes trust without creating an operational burden.Dispelling Myths. One common misconception about 340B is that it's a direct patient discount program. Ted addressed this myth, explaining how the discount is intended for providers to give them more resources to reach and serve more patients. The other myth Ted addressed is how the program is described – mostly by the pharmaceutical industry – as a “markup scheme.” He doesn't think that's a fair depiction and explained that revenue from commercially insured patients is essential for offsetting the cost of treating uninsured and underinsured patients, making the program a lifeline for safety-net providers.An uncertain future. The 340B program faces significant uncertainty as policymakers consider major changes. Recent efforts to replace upfront drug discounts with a rebate model could strain the financial stability of small and rural providers, while federal proposals to cut Medicare Part B reimbursement add further pressure. At the same time, state legislatures are enacting a patchwork of laws to protect providers and restore contract pharmacy discounts, creating complexity across the country. Ted advises providers to not simply hope for the best. He urges hospitals and health centers to engage directly with lawmakers and their staff by inviting them to visit facilities where they can see the program's impact and its role in supporting vulnerable populations.To hear Ted and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

In the final session of The Profit Playbook: Ending 2025 Like a Badass, Heather Haro is joined by Julie Crozier, RPh and Amanda Gaddy, RPh of Secure 340B to break down critical changes coming to 340B rebates and Medicare Fair Pricing (MFP) rebates in 2026. This session explains how overlapping rebates work, what changes on January 1, and what independent pharmacies must do now to protect cash flow, margins, and patient access.   **Show Notes:** 1. **Introduction** [0:00] 2. **Introduction of Secure 340B Experts** [3:27] 3. **Overview of 340B and MFP Rebates** [7:01] 4. **Detailed Explanation of Rebate Processes* [41:07] 5. **Impact of Wholesale Acquisition Cost (WAC) Decreases* [41:29] 6. **Q&A Session and Additional Clarifications* [43:48] 7. **Final Remarks and Contact Information* [46:11]     ----- #### **Becoming a Badass Pharmacy Owner Podcast is a Proud to be Apart of the Pharmacy Podcast Network**

As the 340B Rebate Model Pilot approaches, hospitals and health systems are preparing for one of the most significant shifts the program has faced in years. In this episode, Jim Jorgensen is joined by Kristin Fox-Smith, Managing Director, and Jerame Hill, Chief Strategy Officer at Visante, to break down what the new rebate model means for covered entities.   This conversation is especially important for hospital executives as the rebate model directly impacts cash flow, staffing needs, operational risk, and financial planning. The group discusses the real-world implications of HRSA's guidance, including increased data and reconciliation complexity, ongoing uncertainty as January 1 approaches, and the decisions leaders may soon face. Listeners will also hear practical insight on how to prepare now to reduce risk and protect organizational performance.

Advisory Board is here to do two things: tackle the toughest questions keeping healthcare leaders up at night, and push leaders' thinking on the questions they aren't asking – but should be. In 2025, we navigated a landscape of major shifts, from policy changes, the growing presence of AI, drug innovations, and more. As we head into 2026, we are keeping that momentum going to deliver the insights you need to stay ahead. That's why this week, hosts Rachel (Rae) Woods and Abby Burns pass the microphone to six Advisory Board researchers to preview their top questions and topics on our research agenda for the new year. They'll unpack what they're researching, why it matters, and why these topics deserve your attention. [1:30] Ty Aderhold on cutting through the AI hype [4:15] Monica Westhead on margin management and hospital efficiency [7:08] Sally Kim on cutting costs and scaling health plan operations [9:45] Sebastian Beckmann on prioritizing sustainable growth through smarter forecasting and analytics [14:08] Kaci Plattenburg on rethinking service line growth strategies [16:27] Chloe Bakst on navigating the pharmacy policy shakeup We're here to help: Read Advisory Board's 2026 research agenda The state of the industry: Key insights for 2026 249: What is 340B, and why is it in the hot seat 267: Care variation reduction: A $100B opportunity What's driving — or slowing — service line growth? 270: Service line snapshot: What every health leader needs to know 276: The AI gold rush is changing how humans (and clinicians) make decisions [Tools] Use Advisory Board tools to inform your strategy for growth, cost control, and more. We want to hear from you. What are your challenges? Where are you seeing opportunities? Email us at podcasts@advisory.com Learn about Advisory Board Research Membership. How the collaborative care model improves access to behavioral healthcare How We Approach Behavioral Health Integration | evolvedMD A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Send us a textFederally Qualified Health Centers (FQHCs) care for more than 30 million Americans, yet many people have never heard of them or understand how they stay afloat. A major piece of their financial survival is the 340B drug pricing program, which has quietly become one of the most important funding mechanisms in the safety net and it is under growing pressure.Scott Seidelmann, CEO of Nuvem, joins CareTalk hosts David E. Williams and John Driscoll to discuss how FQHCs serve underserved communities, why 340B has become essential to their operations, and what policy changes could make or break their ability to deliver care.

In this episode of Healthcare Americana, host Christopher Habig talks with neurosurgeon and healthcare policy leader Dr. Anthony DiGiorgio about the growing crisis around prior authorizations. They discuss how complicated approval processes delay urgent care, burden physicians, and put patients at risk. Dr. DiGiorgio explains why smarter, low-friction models such as gold-carding and stronger subspecialty board oversight could help rebuild trust between physicians and payers. The conversation also covers the 340B drug discount program, which Dr. DiGiorgio has testified about before Congress. He explains how a program originally designed to help low-income patients has become a major revenue source for large hospital systems and often increases costs for Medicaid, Medicare, and private insurance. Together, they offer a clear and accessible look at what is broken in these systems and what meaningful reform could achieve.More on Freedom Healthworks & FreedomDoc HealthSubscribe at https://healthcareamericana.com/More on Dr. Anthony DiGiorgioFollow Healthcare Americana: Instagram & LinkedIN

340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.Some of the most consequential changes for 340B this year came not from Washington D.C., but from statehouses across the country. We speak with Tom O'Donnell, senior vice president of government relations at 340B Health, to recap some of the biggest changes on the state legislative level throughout this year and to preview what might come from the states in 2026.Seven States Enact New Reporting LawsThis year, Colorado, Hawaii, Idaho, Indiana, Ohio, Rhode Island, and Vermont have added new 340B reporting laws, increasing the list of states with such mandates to 10. O'Donnell says the first reporting requirements that Minnesota enacted in 2023 have influenced newer requirements in the other states. He notes hospitals' continuing concerns about the burdens and possible repercussions of focusing on several specific types of reporting data, including breakdowns by payer type and most frequently used drugs.Hybrid Bills Combine Protections With Reporting MandatesFive states that passed new 340B laws in 2025 did so with a twist. Colorado, Hawaii, Maine, Rhode Island, and Vermont passed combination bills with both contract pharmacy protections with new reporting mandates. O'Donnell says he's also concerned that statehouses are shoehorning in amendments to original statutes to ramp up concerning reporting requirements.Model Legislation Could Mean More Debate in 2026While Minnesota has served as a reference for reporting mandates for other states, model legislation from the American Legislative Exchange Council (ALEC) has created more opportunities for state legislators to push proposals that would limit or scrutinize 340B. O'Donnell says this reflects part of the latest efforts from drugmakers to take their 340B priorities to sympathetic lawmakers at the state level, and it underscores the importance of informing and supporting hospitals on how to push back against these bills.Resources:HRSA Approves Novartis's 340B Rebate Pilot ProposalState Policy & Advocacy Communications Resource Center

In this episode, Greg and Rob are joined by Katheryne Richardson of the Beacon team, to discuss frequently questions about the upcoming 340B rebate model.  They'll cover the differences between Beacon applications, commonly asked questions regarding data submission, and tips for covered entities to consider as the implementation date approaches. Come see us at Booth #1545 during this year's ASHP Midyear Clinical Meeting!

Rural Health News is a weekly segment of Rural Health Today, a podcast by Hillsdale Hospital. News sources for this episode: American Hospital Association, “AHA, other file suit to block unlawful 340B changes threatening patient care,” December 1, 2025, https://www.aha.org/news/headline/2025-12-01-aha-others-file-suit-block-unlawful-340b-changes-threatening-patient-care. Bridget Early, “Home health providers hit with Medicare pay cut,” December 1, 2025, https://www.modernhealthcare.com/politics-regulation/mh-medicare-home-health-pay-2026-cms/#, Modern Healthcare. Celli Horstman, Arnav Shah, “The State of Rural Primary Care in the United States,” November 17, 2025, https://www.commonwealthfund.org/publications/issue-briefs/2025/nov/state-rural-primary-care-united-states?mkt_tok=NzEwLVpMTC02NTEAAAGeOB9y6SbuBxye3wQ7igjy1BVe5GMJxaV9fCloFJmQfS-T6mbVfjH7QWw88rhSoHiy3G1b3YS0OFamdkSiphiBb7XyLWJP3BOoGozzQcWDe1J4qOk, The Commonwealth Fund. Erica Cerutti, “The state of rural primary care: 4 notes,” November 19, 2025, https://www.beckershospitalreview.com/quality/hospital-physician-relationships/the-state-of-rural-primary-care-4-notes/, Becker's Clinical Leadership. Rural Health Today is a production of Hillsdale Hospital in Hillsdale, Michigan and a member of the Health Podcast Network. Our host is JJ Hodshire, our producer is Kyrsten Newlon, and our audio engineer is Kenji Ulmer. Special thanks to our special guests for sharing their expertise on the show, and also to the Hillsdale Hospital marketing team. If you want to submit a question for us to answer on the podcast or learn more about Rural Health Today, visit ruralhealthtoday.com.

In this episode, ​​Laura Dyrda, Vice President and Editor-in-Chief at Becker's Healthcare, shares the top stories she is tracking, including the major 340B program shakeup and escalating workforce challenges.

Not gonna give much of an introduction here because this is a short bonus level set, but I did just wanna call everyone's attention to the "arms race" created by our status quo purchasing and selling of many things, pharmaceuticals included. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. For example, raise the list price of a drug to maximize rebates, because the higher the list, the bigger the discount you can give, which then exacerbates patient affordability because coinsurance is often based on list price. But then Pharma starts offering co-pay cards, which messes up the whole PBM (pharmacy benefit manager) plan to drive patients to their highest-rebate products (ie, the most profitable products). So then maximizers and accumulators enter the chat, and prior auths ramp up because plans start having to raise premiums after enough 340B drugs with high lists and no rebates, and then there's no cost containment and raise deductibles and around and around we go. Meanwhile, is this drug fundamentally worth the list price or even the net price? Is it an effective drug? What's the right price to be paying for this drug? Should be the operative question, right? Just like what's the quality and appropriateness of any medical service? Maybe we should just quit it and just pay for value. And with that, let me introduce Sarah Emond, CEO of ICER (Institute for Clinical and Economic Review), and I will let Sarah tell the rest of the story. Also mentioned in this episode are Institute for Clinical and Economic Review (ICER); Cora Opsahl; 32 BJ Health Fund; Payerset; Aventria Health Group; Dea Belazi, PharmD, MPH; and Tom Nash. For a list of healthcare industry acronyms and terms that may be unfamiliar to you, click here.   You can learn more at ICER.org and follow Sarah on LinkedIn.   Sarah K. Emond, MPP, is president and chief executive officer of the Institute for Clinical and Economic Review (ICER), a leading nonprofit health policy research organization, with 25 years of experience in the business and policy of healthcare. She joined ICER in 2009 as its first chief operating officer and third employee and has worked to grow the organization's approach, scope, and impact over the years. Prior to joining ICER, Sarah spent time as a communications consultant, with six years in the corporate communications and investor relations department at a commercial-stage biopharmaceutical company and several years with a healthcare communications firm. Sarah began her healthcare career in clinical research at Beth Israel Deaconess Medical Center in Boston. A graduate of the Heller School for Social Policy and Management at Brandeis University, Sarah holds a Master of Public Policy degree with a concentration in health policy. Sarah also received a bachelor's degree in biological sciences from Smith College. Sarah speaks frequently at national conferences on the topics of prescription drug pricing policy, comparative effectiveness research, and value-based healthcare.   02:28 What is ICER? 02:47 What does the Institute for Clinical and Economic Review do? 05:09 The importance of still showing up, even when others don't understand or disagree. 06:51 EP293 ("Game Theory Gone Wild") with Dea Belazi, PharmD, MPH. 09:04 Why it's important to think about population health and how our choices impact affordability for everyone.   You can learn more at ICER.org and follow Sarah on LinkedIn.   @sarahkemond discusses #ICER and the status quo of #pharmaceuticaldrug #pricing on our #healthcarepodcast. #healthcare #podcast #financialhealth #patientoutcomes #primarycare #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Stacey Richter (INBW43), Olivia Ross (Take Two: EP240), John Quinn, Dr Sam Flanders and Shane Cerone (EP492), Elizabeth Mitchell (EP491), Shane Cerone and Dr Sam Flanders (Part 1), Dan Greenleaf (Part 2), Dan Greenleaf (Part 1), Mark Cuban and Cora Opsahl  

In this episode, Scott Becker highlights seven major healthcare developments, including Providence's transformation efforts, CHS's strategic shift, the growing role of pharmacy, legal challenges to 340B changes, and more.

In this episode, Greg and Rob catch up on some clarifications gained around the upcoming 340B rebate model, including purchasing requirements and developments with select chain retail pharmacies updating their policies. Additionally, they discuss the CMS CY2026 OPPS final rule that was just published, including potential implications for 340B hospitals. CMS Hospital Drug Acquisition Cost Survey Info: https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient-pps/outpatient-prospective-payment-system-opps-drug-acquisition-cost-survey Come see us at booth #1545 at the ASHP Clinical Midyear Meeting December 8-11 in Las Vegas!

The fellas are reveling in the Democratic Party's absolute chaos, starting with the government shutdown. Anonymous Democratic senators confess they would vote to reopen the government but are "terrified of getting the guillotine" from the deranged grassroots—a direct admission that their base is driving the insanity. The Civil War's second front is a primary race for a chance to challenge Susan Collins in Maine, and it is a certified freak show. Chuck Schumer's establishment candidate, an ancient, unrelatable governor, is facing off against a Bernie bro who called himself an "Antifa super soldier." Maybe Graham Platner would get further in politics with less 1942 SS tattoos.  Secretary of the Army Dan Driscoll gives us a behind-the-scenes look at the aggressive, transformational change happening at the Army. Driscoll doesn't hold back, detailing the utter waste of taxpayer money caused by decades of calcified bureaucracy, like how the Army pays double for chicken because of an absurd 1930s mandate. He explains how he and the Chief of Staff are cutting $48 billion in expected spending to prioritize the modern warfighter, focusing on next-generation technology, and why President Trump's “peace through strength” approach and air cover have been vital to these efforts. 00:00 - Government Shutdown Drama: "Guillotine" Fear06:06 - Shutdown as Virginia Strategy09:50 - Merkley's 15-Hour Yawn-Fest & Katherine Clark's "Leeeverage" Gaffe16:10 - Maine Senate Primary: Nazi Tattoos, Antifa Soldiers, and the Establishment's Pick44:48 - King of the Hill: George Conway vs. Sarah Longwell58:33 - Secretary of the Army Dan DriscollOur Sponsors:➢Tell Republicans in Congress stop Dick Durbin's takeover of your credit card before it's too late - https://electronicpaymentscoalition.org/➢Big tax-exempt hospitals abuse the 340B markup program, tell congress to fix 340B.https://phrma.org/340Bmarkup➢Find out the true power of America's oil and natural gas. Go to https://lightsonenergy.org/➢The Partnership to Fight Chronic Disease wants to act sooner on Alzheimer's, not later. Learn more at https://www.pfcdalz.org/➢Want to make a difference in your community? https://takeonesmallstep.org/ Join AFP's grass-roots efforts at https://afpvolunteer.com/ Learn more about your ad choices. Visit podcastchoices.com/adchoices