This post is part of NACHC’s 340B Spotlight Blog Series. The 340B Drug Pricing Program is an essential source of support for Community Health Centers, allowing them to stretch increasingly scarce federal resources and reinvest in patient care. Learn more about 340B and read other blogs in the series. Elizabeth Linderbaum is NACHC’s Deputy Director of Regulatory Affairs.
Thundermist Health started a little over 50 years ago in Woonsocket, RI, with two doctors running a medical center out of a storefront. Now, they serve over 50,000 patients a year as the second largest community health center in the state. Spread across three counties, they operate nine buildings across the state plus have three school-based health centers. The 340B program drug pricing program has helped them expand building space and services to accommodate the growing number of patients they serve.
The 340B program began in 1992 with the intention to help certain safety net providers expand already scarce resources through receiving discounted pricing on specific medications. These providers could then reinvest these savings thanks to the 340B program into services that tremendously benefit their patients and offer their patients discounted drugs.
Thundermist’s patient population has grown significantly, especially within the last five years. Savings from the 340B program have allowed them to redesign their buildings to serve these patients through expansion renovations that increase the number of exam rooms. For example, their dental location in West Warwick will be double its original size after full renovation. This will enable them to see more patients from their dental care waiting list, which consists of around 1000 patients, and increase access to affordable dental care for more Rhode Islanders. Thundermist has also been able to renovate one of its main locations in Woonsocket, creating more exam space which increased their capacity by 25%. This translates to being able to better meet community needs by offering more primary care and behavioral health care visits. Along with enhancing their buildings and increasing in size, 340B savings also has allowed them to hire more staff to function at their highest capacity. The staffing expansion translates to caring for an additional 10,000+ patients in the last five years.
Investing in Social Drivers of Health Needs
Additionally, Thundermist attributes 340B savings to meet general patient needs related to social drivers of health. Social drivers of health refer to the nonmedical conditions that impact people’s lives; things such as where someone lives, or their access to transportation or food are examples of these factors. To better address such needs of their patients, Thundermist seeks to address these barriers, for instance through funding patient transportation. While Rhode Island is a small state, the health center’s service area covers a wide range of zip codes. Thundermist helps pay for Uber Health for their patients that have transportation reliability issues.
340B savings also go toward addressing food insecurity. Thundermist provides a food pantry at specific locations to offer healthy, fresh options for their patients and host farmer’s markets in local areas that are known as food deserts. This is especially important for some of their patients with diabetes who lack access to healthy and fresh meals. Thundermist leverages partnerships with local community-based organizations to meet social drivers of health-related needs as well. They have a long-standing partnership with House of Hope, a local service organization, to offer the service “Shower to Empower,” where a mobile van goes around the community to allow people experiencing homelessness the opportunity to have a free warm shower, a haircut, or get access to medical or social services. Thundermist collects a lot of social drivers of health data to help them make staff hiring decisions so they can best address patient needs.
The flexibility that allows health centers to freely allocate 340B savings is integral to the spirit of the program. Health centers like Thundermist Health know the communities and the patients they serve intimately, enabling them to know which services need more investment to positively impact patient care. This is especially crucial given that many of these social drivers of health interventions are not reimbursed by health insurance but remain important in improving patient outcomes. As restrictions imposed by pharmaceutical manufacturer against covered entity contract pharmacies continue, it is imperative to show what is at stake for health centers like Thundermist Health and its patients if 340B savings go away.
Learn more about the manufacturer restrictions on the 340B program.
Let’s continue to beat the drum and support the 340B program!
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A special thank you to Corrine Hill, former Chief Administrative and Compliance Office at Thundermist Health, for sitting down and talking with us.