EP448 (Part 2): 340B: Why Employers Should Probably Care About What's Happening Here, With Shawn Gremminger

This is Part 2 of Stacey Richter's deep dive into the 340B program with Shawn Gremminger — these episodes don't have to be listened to in order, so it's fine to start here. This part focuses on how 340B impacts employers, commercial plans, and other plan sponsors. As just one example of why employers should care: if an employee or member of a commercial plan gets a drug at a contract pharmacy participating in 340B, the employer does not get the rebate — the employer pays list price for that med. 340B is currently so gargantuan that it creates market distortions that bleed into the prices, and possibly the quality, of healthcare for everybody, all Americans. For more on the history and origins of the program, see Part 1 of this episode.

WHAT YOU'LL LEARN

✅ Why employers, Taft-Hartley plans, and other commercial payers should care about 340B — a program originally designed for Medicaid and safety-net providers

✅ Why an employer doesn't get the rebate when an employee fills a drug at a 340B contract pharmacy — and ends up paying list price instead

✅ How 340B's scale, a $53 billion program, creates market distortions that bleed into prices and possibly quality for everybody, not just Medicaid patients

✅ Findings from Zack Cooper, PhD's research on distorted pricing models at 340B hospitals

✅ Why employers need to stop playing the blame game and start engaging directly with how 340B affects their own plan spend

WHY THIS MATTERS

340B is currently so gargantuan that it creates market distortions that bleed into the prices — and possibly the quality — of healthcare for everybody, not just the low-income patients it was designed to help. That's Part 2's core argument: this isn't a niche Medicaid issue, it's a commercial-market cost driver hiding in plain sight.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

✉️ Enjoy this podcast? Subscribe to the free weekly newsletter

🫙 Support the podcast with a small donation to the Tip Jar

📺 Subscribe to our YouTube channel

🎤 Listen on Apple Podcasts

🎤 Listen on Spotify

=== CONNECT WITH THE RHV TEAM ===

✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X

00:00 Introduction.

09:11 Why do employers care about 340B, which is a Medicaid program?

11:30 Why do I care as an employer, even if I'm not Pharma?

12:44 Why is 340B causing employers to pay significantly more for healthcare?

14:36 Study by Zack Cooper, PhD.

15:06 Why are there distorted pricing models at 340B hospitals?

21:22 Why do employers need to stop playing the blame game?