#164 - The Future of 340B: Rebates, Regulations, and Rural Healthcare at Risk

In this special edition of The ASHHRA Podcast, co-hosts Bo Brabo and Luke Carignan sit down with three powerhouse voices from RxBenefits—Rhiannon Klein, Sarah Hearn, and Sarah McHale—to unpack the latest seismic shift in the 340B Drug Pricing Program and what it means for hospitals, health systems, and the communities they serve.

What’s at Stake?
HRSA’s newly announced pilot rebate model for 340B—initially affecting 10 IRA drugs—threatens to upend the way covered entities access drug discounts. Instead of receiving upfront savings, hospitals must now purchase at Wholesale Acquisition Cost (WAC) and then request rebates from manufacturers. That shift could mean:

• Increased administrative burden and FTE needs
• Delayed cash flow—up to 55 days before rebate funds are received
• Expanded manufacturer access to sensitive claims data
• Greater leverage for drug companies to deny rebates or restrict program access

Why Healthcare HR Leaders Should Care
This is more than a pharmacy or finance problem. The ripple effects of reduced 340B savings could force rural hospitals to cut services—or close entirely—impacting patient access, workforce health, and community stability. 

Key Insights from the Conversation:

• How the rebate model could snowball to cover more drugs and further erode 340B benefits
• Why data transparency requirements may be a double-edged sword for covered entities
• The connection between Medicaid disenrollment under the “One Big Beautiful Bill” and loss of 340B eligibility
• The growing threat to rural healthcare sustainability, with hundreds of hospitals already at risk of closure

Call to Action:
The panel urges healthcare leaders to educate themselves, cross-collaborate internally, and engage in advocacy now. With HRSA accepting comments on the pilot program until September 2, there’s still a window to voice concerns—both formally and publicly.

📢 This episode is a must-listen for healthcare executives, HR leaders, pharmacy directors, and policy advocates who want to protect access to affordable care and preserve the safety net for vulnerable populations.

For AP3 Group Stop Loss Interest, contact ASHHRA Executive Director, Jeremy Sadlier at jeremy.sadlier@ashhra.org or 312.985.7062.