340B Optimization
The 340B program is one of the most valuable financial tools available to eligible health systems. It is also one of the most scrutinized.
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The Challenge
The 340B program generates significant drug cost savings for eligible covered entities, but the regulatory environment surrounding it has never been more complex. Manufacturer restrictions on discount availability, contract pharmacy locations, ongoing litigation, evolving HRSA guidance, and growing audit activity have made compliance and optimization a full-time discipline — one that most pharmacy teams are managing alongside their regular responsibilities.
Organizations that treat 340B programs as a set-it-and-forget-it are exposed. Eligibility gaps, split billing errors, GPO prohibition violations, and contract pharmacy arrangements that don't reflect the current manufacturer restriction landscape can erode savings, trigger repayment obligations, and create audit risk that is difficult and costly to resolve.
Why This Matters Now
- Manufacturer restrictions on medication discounts and contract pharmacy continue to evolve, requiring active management of which drugs are available through which arrangements
- HRSA audit activity has increased, and covered entities without current, complete compliance documentation face meaningful risk
- Split billing errors remain one of the most common sources of 340B program liability, particularly for health systems with complex inpatient and outpatient populations
- TPA contracts and platform capabilities vary significantly, and organizations that haven't evaluated their arrangements recently may be leaving savings on the table
- WAC reduction strategies have become increasingly important as manufacturer restrictions limit access for certain drugs
How We Help
Acuvance Coker helps covered entities protect, optimize, and sustain their 340B programs in a regulatory environment that requires continuous attention. Our work includes:
- Program eligibility and registration support to ensure your covered entity status is current, accurate, and structured to capture the full scope of eligible patients and locations
- Contract pharmacy strategy to evaluate your current arrangements against the manufacturer restriction landscape and identify opportunities to expand or restructure access
- Split billing optimization to ensure accurate identification of 340B-eligible dispensing across inpatient and outpatient populations, minimizing leakage and liability
- Covered entity compliance, including policy development, staff training, and documentation practices that support ongoing regulatory requirements
- Audit preparation and support to assess your current compliance posture, close documentation gaps, and prepare your team for HRSA review
- WAC reduction strategy to identify and pursue medication cost savings opportunities
- Manufacturer restrictions management to maintain current visibility into restriction status across your drug portfolio and adjust your program accordingly
- TPA evaluation and optimization to assess whether your third-party administrator is delivering the platform capabilities, reporting, and support your program requires
- GPO prohibition compliance to ensure your purchasing practices across 340B-eligible drugs remain within program requirements
What Makes Our Approach Different
340B programs are not programs you optimize once. Manufacturer restrictions and requirements change. HRSA guidance evolves. Patient populations shift. The covered entities that sustain strong 340B program performance are the ones with the operational infrastructure to respond when conditions change, not just when an audit arrives.
Our team works at the intersection of compliance and financial performance. We help you protect what you have while identifying where additional savings are available within the program's boundaries, and treat those as connected objectives rather than competing ones.
Because our pharmacy practice spans formulary, purchasing, and outpatient operations, we understand how 340B program eligibility and WAC-reduction strategies connect to your broader pharmacy financial picture. That context shapes the recommendations we make.
What You Gain
- A 340B program structured to capture the full scope of savings your covered entity status supports
- Contract pharmacy arrangements that reflect the current manufacturer restriction landscape
- Split billing accuracy that minimizes leakage and reduces liability exposure
- Compliance documentation and audit readiness that holds up under HRSA review
- A TPA relationship delivering the platform capabilities and reporting your program requires
- Active management of manufacturer restrictions so your program adapts as conditions change
- WAC reduction savings that offset losses
- A 340B program connected to your broader pharmacy financial strategy, not managed in isolation
Why Trust Coker
For more than three decades, Coker has been a trusted partner to healthcare leaders and investors, delivering clarity, compliance, and confidence through every stage of the transaction and beyond.
Positive outcomes are possible for you and your patients.
We approach every engagement with a results-driven mindset, leveraging our deep industry expertise and data-driven insights to develop strategies that drive meaningful, measurable improvements in performance.
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Solutions We Offer
We partner with clients to navigate the dynamic challenges of managing a high-performing physician enterprise.
