For more than 25 years, the 340B drug discount program has helped safety-net providers stretch their resources by providing significant discounts on prescription drugs. 340B eligible providers, called Covered Entities or CEs, rely on these resources to fund critical services in the community, like uncompensated care, substance abuse clinics, and vaccines.

340B is an important part of the safety net, CEs are far more likely to treat low-income patients than non-340B hospitals and clinics. The savings add up – the discounts are often approximately 50% of the cost of the medication. As CEs continue to serve the underserved, protecting and maximizing the revenue from this program is more important than ever.

Gain Confidence in Your 340B Program with Caravan Health

In our unique 340B model, Caravan Health uses value-based contract data to identify all eligible 340B claims to generate revenue and improve care coordination, all while staying compliant with federal rules. We run some of the most successful accountable care organisations for rural and safety net providers. Now we’re using these same core competencies to help CEs maximize the full potential of the 340B drug discount program.

Data-driven Results

Caravan’s referral prescription compliance program, vetted by 340B pharmacy and legal experts, uncovers hidden opportunities for brand and specialty drug discounts, doubling the number of both profitable contract pharmacies and eligible prescriptions.

Benefits of Caravan's 340B Program:

  • Referral prescription expansion
  • Contract pharmacy optimization
  • Highest standards of compliance
  • Improved patient safety
  • Expansions or additions to projects/strategic initiatives 

Caravan Health 340B Research Unveils Substantial Referral Claim Opportunities

In a recent case study, Caravan Health found its CE clients were only contracted with 43 out of 441 qualifying pharmacy locations which covered only 40% of eligible prescriptions. Clients were missing out on nearly $35 million in 340B savings – in one of the nation’s leading pharmacy chains. 

Download our case study to learn how Caravan Health uncovered this remarkable data and how we are helping our clients more than double their 340B savings.

In the Caravan Health 340B program, we work with your electronic medical record system and your third-party administrator to import encounter data and all eligible claims, including potential referral prescription claims. Our system reaches back 12 months to capture potential eligible claims for CE patients seen by a referred provider in the previous 12 months. Those claims can be reviewed and made compliant for 340B discounts.

Each claim is tested against HRSA audit criteria for acceptance and detailed documentation of all audit criteria is copied into the EMR for all eligible claims. Ineligible claims on eligible patients are documented to capture subsequent prescriptions while validated claims are processed for discounts.

Most importantly, the CE care team is alerted about new prescriptions and emerging conditions for follow up.

Prescription Validation Process

Frequently Asked Questions

What is 340B and how does it work?

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.

Who qualifies for 340B?
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.

Why is value-based payment important to maximizing 340B discounts?
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.

How does 340B and ACOs help with patient care?
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.

How does the Caravan Health 340B program work?
Our compliant program verifies the appropriate patient care coordination, management, and documentation for every processed claim. Through our proprietary data analytics platform, Caravan 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 sizeable financial opportunity for everyone from the smallest to the largest Covered Entity.

Speak with a Caravan expert

Contact us

attention

NEWS: Signify Health Completes Acquisition of Caravan Health

ACO insights delivered right to you

Thank you

Sign up for our newsletter of data-driven news and stories from the latest in ACOs, value-based care, and population health.

  • Real-time insight into alternative payment model trends
  • Strategies and practices that drive results
  • Leadership lessons from health care and beyond
  • Perspectives on the changing health care landscape

By sharing your email you agree to our Privacy Policy

newsletter signup