340B Program
About UCI Health
UCI Health serves a substantial population comprising nearly 4 million individuals residing in Orange County, western Riverside County, and southeast Los Angeles County. As the sole academic health system in Orange County, UCI Health is committed to advancing medical knowledge, educating future healthcare professionals, and delivering the highest quality evidence-based healthcare. The primary facility, UCI Medical Center in Orange, is a 450+ bed acute care hospital offering advanced tertiary and quaternary care services, as well as a range of ambulatory and specialty medical clinics, along with behavioral health and rehabilitation units. UCI Health is notable for being home to Orange County's only federally designated comprehensive cancer center, a specialized high-risk perinatal/neonatal program, and a verified Level I trauma center for adults and Level II trauma center for pediatric patients, in addition to being a regional burn center. It is also proud to have the county's inaugural Joint Commission-certified comprehensive stroke center.
UCI Health is eligible for participation in the U.S. government's 340B program, a program mandating pharmaceutical companies to offer outpatient drugs to eligible healthcare organizations at substantially reduced prices. This eligibility is based on its substantial service to low-income Medicare and Medicaid patients.
In the fiscal year 2023, UCI Health provided approximately $80M in charity care and approximately $99M in uncompensated care, primarily focused on Medi-Cal beneficiaries and uninsured patients, aligning with the organization's financial assistance policy.
Given the absence of a county hospital, roughly 75 percent of UCI Health's patient base relies on government payers for insurance coverage. Notably, California possesses one of the nation's lowest Medicaid provider reimbursement rates, and the costs associated with specialty services often exceed the reimbursement received. Consequently, UCI Health bears the burden of uncompensated costs related to services in areas such as cancer care, trauma care, burn care, mental health services, organ transplant procedures, and emergency care.
Direct and indirect benefits of the 340B Program
Serving communities in Orange County and adjacent regions is one of UCI Health’s highest priorities. It reassesses the health needs of these communities and adopts a strategy for meeting those needs at least once every three years.
Among the benefits provided by UCI Health:
- Colonoscopies that employ artificial intelligence
- Increased access to care for the medically underserved and improved community health through preventive practices via:
-Federally qualified health centers in Santa Ana and Anaheim that draw well over 100,000 visits per year
-Primary care services, health screenings and vaccinations/immunizations targeted at the uninsured and underinsured
-Free and discounted healthcare services · Otherwise financially nonviable clinical offerings such as organ transplant (kidney and pancreas), behavioral health, Level I (adult) and Level II (pediatric) trauma, burn and emergency services
- Perinatal, cancer, obesity, and chronic disease support groups
- Lectures by internationally renowned subject-matter experts on groundbreaking research and disease outcomes
- Financial assistance for prescriptions and discharge prescriptions to avoid hospital readmissions
- Preventive care and mental health services, including meditation
- Fresh produce at the UC Irvine Family Health Center food pantry
- Transportation via taxi vouchers for needy patients
Potential Impact of Scaling Back the 340B Program
UCI Health operates as a self-sustaining institution and does not receive any operational funding from the state of California or the University of California system. Its primary sources of support are federally funded Medicaid DSH (Disproportionate Share Hospital) dollars and discounts obtained from drug manufacturers through the 340B program. These critical funds enable UCI Health to provide essential medical care to low-income and underserved patients facing severe medical conditions, regardless of their financial means.
The advantages derived from the 340B program empower UCI Health to offer clinical services that would otherwise be financially unfeasible, particularly to vulnerable patient populations. By realizing savings through the 340B program, UCI Health can extend access to medical facilities that deliver life-saving treatments for conditions such as cancer, HIV (Human Immunodeficiency Virus), hepatitis C, asthma, and kidney failure to Medicaid recipients and uninsured individuals. The absence of these funds would compel UCI Health to reduce the scope of its emergency medicine, trauma care, mental health services, and cancer treatments.
A few examples of UCI Health improving access and outcomes for patients
- A 36-year-old male with a history of multiple episodes of pancreatitis and large peripancreatic multiloculated fluid collection presented to the hospital with fever and interval increase in peripancreatic fluid collection. Patient had limited funding. To safely discharge the patient home and not have a prolonged hospitalization, the patient was provided with home IV antibiotics and home nursing to assist. UCI Health assisted in paying for these home services to assist the patient with a safe, timely discharge and hopefully prevent readmission.
- A 33-year-old, unhoused male was admitted for alcohol withdrawal monitoring. Patient was confused and unable to return to his previous living situation. UCI Health identified a recuperative care facility where the patient could go to receive room/board and additional resources and paid for the services
- A 40-year-old male DM (Diabetes Mellitus) with left great toe amputation presented with worsening of left 3rd toe and general fatigue. The patient had osteomyelitis and required 6 weeks of IV antibiotics with limited funding. UCI was able to secure an infusion company and home nursing services to allow the patient to return home safely to continue his outpatient treatment.
