Heath Veuleman, a Healthcare Strategist for Seersucker Strategies, has expressed concerns about various hospital cost centers, including 340B profits, facility fees, provider taxes, and higher site-based Medicare payments. He said that these elements contribute to inflated prices for patients and taxpayers. This statement was made on the social media platform X.
"This year hospitals and health systems will make ~$100B on 340B," said Veuleman. "A program that's supposed to save patients money, yet somehow only pads health system CEO pockets. In any other industry, we'd call this money laundering. You're being taken advantage of by the biggest group of goobers, gomers, and grifters in the entire world."
According to Veuleman, policy debates in Washington are currently centered around three key areas: site-neutral payment, 340B oversight, and Medicaid financing through provider taxes. He noted that nearly every state in the U.S., except Alaska, utilizes provider taxes to help finance Medicaid. Federal rules cap these taxes, and Congress periodically considers tightening them, highlighting why these mechanisms are presently under scrutiny.
The Government Accountability Office (GAO) has reported that hospitals participating in the 340B program can achieve significant margins on Medicare Part B drugs. This is because payments are based on average sales prices while 340B entities acquire drugs at deeper discounts. The GAO's findings underscore oversight gaps and financial incentives that may encourage the use of higher-priced drugs—indicating that program savings might benefit providers more than patients.
Market dynamics favor large chains and Pharmacy Benefit Managers (PBMs). According to the Drug Channels Institute, approximately 32,069 pharmacy locations—nearly 60% of the U.S. pharmacy industry—now operate as 340B contract pharmacies. The five largest companies (CVS, Walgreens, Walmart, Express Scripts/Cigna, Optum Rx/UnitedHealth) control 76.1% of contract-pharmacy relationships. PBM-affiliated specialty pharmacies are experiencing rapid growth.
Veuleman is characterized by Seersucker Strategies as an expert in healthcare delivery and financing with over two decades of experience in hospital administration. He advises governments, corporations, and providers on consumer-centric care and reimbursement models. His expertise lies in policy development, compliance issues, and practice design—experience pertinent to evaluating payment incentives and cost structures.
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