The 340B fight is real and worth having. But while your team defends the program’s future, it may be quietly underusing it in the present — and that’s the loss you can actually stop today.
Cura Consulting Group Analysis · 2026
The external threats are stacking: manufacturers restricting contract pharmacies and imposing new claims-data requirements, states moving to cut Medicaid reimbursement for 340B drugs, CMS proposing rebate models. These are genuine, and they warrant your attention and your advocacy. But they are largely outside your control, and they are mostly about the future.
The controllable, present-tense question is different: of the 340B savings you are entitled to right now, what percentage are you actually capturing? In the centers we work with, the answer is almost never 100% — and the gap is usually invisible, because the standard TPA report shows what was captured, not what was missed.
Eligible prescriptions that never matched to an eligible encounter. Contract pharmacies quietly underperforming. Split-billing logic failing silently. None of it shows up as a problem. All of it is money you’ve already earned the right to.
Why this matters more, not less, in a year of threats
When every other revenue source is contested, 340B capture is the closest thing to certain money your center has — you’re entitled to it, and the only question is whether you catch it. Fully capturing what you’re already owed is the lowest-risk, highest-certainty revenue available, and it’s the buffer that helps you absorb the external hits.
Protect the program’s future through advocacy — and in parallel, close your present-day capture gap. Defend the future; capture the present.
See the gap between what you’re entitled to and what you’re capturing.
See your capture gap → lighthousehealthai.com/early-warning-check
Figures reflect published 2026 industry benchmarks (NACHC, KFF, CMS, HRSA, and industry revenue-cycle sources) and Cura Consulting Group analysis. Illustrative; individual center results vary. Not financial or legal advice.
