Improve Quality Outcomes with ACOs and 340B

Even though many covered entities (CE) act as the primary care provider, they often only claim 340B prescriptions written by their doctors in their CE locations, missing many of the prescriptions written on their patients by other prescribers. Since 1996, the Health Resources and Services Administration has allowed CEs to claim referral prescriptions if the CE is actively managing the patient's condition before and after the prescription as long as the relationship is documented in the EMR, and a contract exists with the referring provider. Finding those referral prescriptions in contract pharmacies is not trivial, with capture rates reported to range from 1-10%. 

ACO participation knows about every service provided and prescription filled by their patients. They easily meet the HRSA audit criteria for referrals by actively managing all conditions in attributed patients and coordinating all care. With proper documentation, ACO participation can increase 340B net discounts for Medicare patients. These savings can be used to provide patient discounts, additional population health staff, and/or fund the risk reserves required to participate in the value-based arrangements. 

Speaker: Patti Schnieder, Vice President of Business Development at Caravan Health, part of Signify Health

By attending this webinar, participants will be able to: 

• Learn hidden opportunities in the 340B program for ACO participants
• Review how to implement audit-ready strategies for improving claims capture
• Understand how to use 340B net discounts to expand your primary care service

This event qualifies for one ACHE qualified education credit.

Content is tailored to guide SRH and certified RHCs not currently participating in VBC to prepare for and position their organizations to be effective participants in a health system focused on value. Live HELP Webinars events are intended for qualifying SRH and certified RHCs; eligibility requirements apply to attend the event live.