We are excited to share real stories from our 340B Referral Capture clients in our new series. Check back each month to read a new Q&A and glean insights from your peers in 340B. Interested in being featured? Please contact your par8o account representative.
Devon R. has been serving West Cecil Health Center for 8 years, most recently as 340B program manager and board liaison. The Federally Qualified Health Center (FQHC) is located in Maryland, northeast of Baltimore, and serves about 7,000 patients annually across two locations with primary care, behavioral health, dental care and lab work services.
The 340B covered entity began capturing referral prescriptions with par8o in September 2019. par8o 340B Referral Capture identifies prescriptions written by referred-to specialists, allowing organizations to capture additional 340B-eligible prescriptions, which helps health centers like West Cecil continue to care for underserved, uninsured and underinsured populations. Since then, par8o has captured more than 275 additional prescriptions for its program, amounting to more than $80,000 in recovered 340B funding.
Devon met with par8o to discuss West Cecil’s involvement with the 340B program, how par8o has supported its 340B program, and how it has adapted health center operations during the pandemic.
Tell me about yourself and your organization. Who do you serve, what is your role and what is your day-to-day like?
WCHC is a Federally Qualified Health Center that serves residents of the Cecil and Harford County communities, regardless of ability to pay. As the program manager, I oversee the day-to-day operations of the 340B program. This includes monitoring the program process throughout the month; ensuring compliance by completing our monthly audits for each of our three TPAs; and working referral claims with chart audits to ensure we have both a referral and a consult note for scripts written by a specialist. I review our policies to ensure they are accurate and active.
In light of the current 340B environment, I meet regularly with our TPAs to ensure we are modifying our program to minimize risk with manufacturers while ensuring our patients are still able to receive the medications they need at an affordable price.
What “pandemic operations” advice have you learned from 2020 that you would like to share with other health centers?
Utilize technology as much as possible. Before the pandemic, we all worked on site with telework as an idea we would consider in the future once we caught up on all our work. But, we know there is always more work.
The pandemic forced us to adopt teleworking capabilities within weeks. Our organization was already mostly using laptops and cloud-based platforms for operations, which made the transition much easier. We also began meeting virtually more often, which helped with communication. Daily huddles with managers and weekly full staff meetings occurred for the first few months.
As this became more normal, the frequency of meetings slowed, and now we meet with managers weekly and have full staff meetings every other week. Because the environment is still rapidly changing, we do not plan to reduce these frequencies yet.
"par8o has tremendously supported WCHCs 340B program by being the go-to for questions on industry standards."
Tell me about some of your biggest successes with your 340B program.
In the past 8 months, WCHC created the 340B program manager role, whose tasks were previously divided between a few staff members. Teleworking made these processes more difficult to track among multiple individuals and positions were repurposed to create the program manager role. Shortly after the role creation, WCHC completed an external 340B audit, passing with minor recommendations for improvement. For an organization that did not have a 340B department to create a role and pass an audit in less than 6 months, that was a big win for us.
How has par8o supported your organization’s 340B program?
par8o has tremendously supported WCHCs 340B program by being the go-to for questions on industry standards. When we first contracted with par8o, we were just starting to understand the complexity of the 340B program, and par8o helped us review policies, clarified industry standard operations where 340B guidance was vague, and simplified the referral capture process for us. In a time when our organization was seeking additional funding, par8o made that burden much easier to carry.
Have you seen any measurable impacts as far as patient care as a result of your partnership with par8o?
This is not a metric WCHC yet measures, however we hope to begin monitoring medication adherence within the next year as we consider how to better improve our on-site pharmacy operations.
What are some of your biggest challenges with the 340B program right now?
Navigating the political/manufacturer environment is definitely a challenge right now. Six months ago, the 340B program remained relatively unchanged. In the last 6 months, on top of the pandemic, FQHCs have had to navigate ever-changing 340B regulations or be faced with non-compliance and risk losing our program, and therefore our funding.
How does 340B funding specifically help your organization?
Our 340B funding goes right back into our organization to provide patient care services. WCHC provides dental services which is often a net-zero service due to the great need for dental care and great lack of dental insurance coverage in our area. Additional 340B funding allows WCHC to provide ancillary services such as this.
What is your No. 1 tip for HRSA compliance?
Don’t be afraid to ask for help. The 340B world can be very vague and often left up to interpretation. par8o has been a great resource for us to bounce ideas off of if we have an idea that we need a second opinion on. Apexus is another great resource as well as the NACHC Noddlepod group for FQHCs which allows 340B managers a place to discuss anything-and-everything 340B.
Everyone in the 340B world started out not knowing anything about 340B, and everyone I have asked for help has been incredibly gracious in passing along knowledge and additional resources.
What do you wish you knew when you first started working on 340B?
That being an “expert” means you still have questions. When you first come into 340B it can be intimidating with how much information is out there, and the requirements of health centers to maintain compliance.
I remember first thinking, “I just need to get all the training done so that I’ll know everything about this.” But after having been working in the 340B world for about three years and now being the 340B program manager, I still have questions on ways to improve and optimize our program.
What are some of your goals for 2021?
Our 2021 goals are to improve the way we care for patients virtually by utilizing remote health monitoring equipment, and to improve technology functionality. When we are better able to utilize technology to care for our patients, we can track medication adherence and improved clinical outcomes. This will help us identify patients experiencing barriers to medication access and navigate those hurdles to find the best option for the patient. We would also like to automate some of our 340B functions to have the program work for us instead of putting as much work into the program.