340B ESP Success: Marshall County Hospital Unlocks Over $80,000 In Savings In 4 Months

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340B ESP Success: Marshall County Hospital Unlocks Over $80,000 In Savings In 4 Months

December 2023

Case Study: Marshall County Hospital Optimizes 340B ESP, Unlocking $81,000 in Savings in 4 months

In Benton, Kentucky, Marshall County Hospital is a community pillar. Thousands of residents depend on the 25-bed critical access hospital (CAH) for inpatient and outpatient safety net services, which are largely funded with savings from participation in the 340B drug pricing program.

The health of Marshall County Hospital's community depends on the health of its 340B program.

"The savings generated from Marshall County Hospital's 340B program mean a lot to the community," said Dennis Killian, PharmD, PhD, 340B ACE. Dr. Killian is a 340B expert at CPS and an extension of the Marshall County Hospital team as a consultant and ESP strategist.

Over the years, we've helped our colleagues at Marshall County Hospital prepare for HRSA audits and maximize their 340B program compliance, savings, and performance. However, things became a little more complicated recently.

Contract pharmacy restrictions can complicate 340B program performance. 

25+ drug manufacturers now have contract pharmacy restrictions impacting covered entities like Marshall County Hospital. Each requirement is different, sometimes needing detailed and nuanced claims documentation to qualify for full 340B benefits. 

While covered entities can document and submit information electronically through the 340B ESP portal, the process can be complex.

"If you coordinate a 340B program, it can feel daunting," said Dr. Killian. "You have all of your other responsibilities...plus now you have to determine how to register and use this new system? And then figure out all the details and unique workflows needed for the different claims? For nearly 30 manufacturers? And things are constantly changing? It can feel nearly impossible."

The Marshall County Hospital team wanted to ensure its 340B program was ready for the future so its team didn't have to face these kinds of challenges. So, they called some familiar faces for help.

Marshall County Hospital optimizes its 340B ESP program and unlocks thousands in net-new savings.

The hospital's leadership team turned to its CPS team for 340B ESP support. 

Dr. Killian paints the scene: "After a recent audit preparation meeting, we're all reviewing numbers and findings together to see where the 340B program performance could improve. And we all see some  concerning trendlines as the contract pharmacy restrictions mount. We realize: We've got to see if there's anything more we can do with ESP." 

Turns out, there was.

ESP optimization quickly yielded the hospital thousands of dollars in net new savings. From one manufacturer. In less than a month.

"We're still in the process of getting optimized, but I have a feeling things are only going to get better from here," Dr. Killian said.

How'd they do it?

"Together," Dr. Killian emphasizes. "We created a custom 340B ESP plan with the Marshall team, for the Marshall team. Our goal is to 'demystify' ESP so that the team has everything they need to optimize their 340B benefit and program performance."

From there, Team CPS helped Marshall County Hospital:

  • Successfully register for ESP
  • Set up and optimize their 340B ESP configuration and workflows
  • Evaluate their contract pharmacy relationships
  • Work with TPAs to analyze opportunities and navigate designations
  • Acquire HIN numbers to unlock savings


"There was one instance where we were seeing flat-line or negative savings projections without ESP," Dr. Killian said. "In just a few weeks, we were realizing $21,000 in true net savings - just by unlocking and optimizing one retailer in ESP." 

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Today - after just four months - ESP optimization for two retailers has helped Marshall County Hospital unlock over $80,000 in net new savings. Those savings are set to be reinvested back into the community.

ESP optimization has helped Marshall County Hospital unlock $81,000 in net new savings in just 4 months.

The early results of Marshall County Hospital's ESP optimization program have surpassed expectations, though many uncertainties remain for most 340B programs across the country, which could impact the future. 

"Contract pharmacy restrictions have increased this year, and we expect things will continue to intensify next year," Dr. Killian explained. "Covered entities may want to prioritize different strategies for maximizing 340B program savings," he continued.

So how can you stay ahead? With the right partner by your side.

"In my experience, the right partner can help you see all your options and be there with you to execute and evolve as things change. When it comes to patients and community health, every penny is an investment."

How could your hospital benefit from 340B ESP assistance?

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