Hospitals Brace For 340B IOUs, Prescription Equity Remains A Theory, And Senators Attempt To Invent Transparency

Hey all,

Happy Tuesday! Across stories about the 340B rebate pilot, racial disparities in prescription drug use, and hospital price transparency legislation, a familiar theme emerges—Americans are paying more, getting less, and still struggling to see where the money goes. Whether it’s safety-net hospitals bracing for cash flow hits, Black patients facing higher disease burdens but lower drug access, or consumers trying to decode mystery medical bills, the system seems to specialize in keeping costs high and clarity low. Until those incentives change, expect plenty more headlines about “reform” that somehow never lowers the tab.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Modern Healthcare) 340B Rebate Pilot and Hospital Backlash 

The Health Resources and Services Administration has launched a voluntary pilot to shift the 340B Drug Pricing Program from upfront discounts to post-purchase rebates for certain high-cost medicines, raising fears among safety-net providers about cash flow disruption, operational strain, and increased administrative burdens. While drugmakers and some policymakers see the move as a way to prevent duplicate discounts, reduce Medicaid costs, and refocus the program on the most vulnerable patients, hospitals warn that paying full price upfront and waiting for rebates could upend budgets and staffing. Stakeholders have urged HRSA to extend comment and application deadlines before the Jan. 1 launch. Full Article.

(JAMA Health Forum) State-, Race-, and Condition-Level Prescription Drug Utilization

An in-depth analysis of 2019 US prescription drug data shows stark racial disparities—White populations had the highest per capita use and spending, while Black populations had significantly lower utilization relative to their disease burden, even after adjusting for age and prevalence. The granular breakdown by state, payer, and condition offers a detailed map of where and how inequities persist, providing a rich resource for policymakers, researchers, and health equity advocates to target interventions and close the pharmacoequity gap. Naturally, none of this will be fixed until someone notices that PBMs and big insurers have turned Medicaid into a very polite money-printing machine. Full Article

(Healthcare Brew) Senate Bill on Hospital Price Transparency

A new bipartisan bill introduced by Sens. Roger Marshall and John Hickenlooper aims to finally enforce full hospital price transparency by requiring providers to publicly disclose negotiated insurance rates, cash prices, and itemized bills signed by hospital and insurer executives. The legislation targets longstanding issues of hidden, inconsistent medical costs—which can vary dramatically for the same procedure—and seeks to empower patients, employers, and insurers to reduce waste and fraud, potentially saving up to $1 trillion in healthcare spending. Should be fascinating to watch this move through Congress, especially when “nonprofit” health systems just happen to be the first, second, or third largest employer in every state. Full Article