Navigating Change with Confidence
Federal policy changes are projected to significantly reduce Medicaid spending and coverage over the next decade, with millions of Americans expected to lose health insurance. New federal regulations and CMS marketplace rules are accelerating these losses—shrinking the Medicaid and exchange populations that qualify your hospital for 340B benefits.
340B eligibility hinges on your DSH adjustment percentage and SSI ratio—metrics that directly shrink as Medicaid coverage declines.
For hospitals like yours, these shifts translate into immediate operational challenges:
- Medicaid days reductions from redeterminations can push hospitals below the Disproportionate Share Hospital (DSH) threshold, risking 340B eligibility
- Enhanced compliance requirements demand airtight documentation as regulatory scrutiny intensifies
- Loss of 340B savings could force hospitals to scale back charity care, screenings, rural outreach, and community benefit programs
As uninsured numbers surge and Medicare cuts loom, maintaining your 340B program eligibility and maximizing its benefits has never been more essential to your financial health and mission.
Protecting 340B Eligibility: Strategic Support for Hospitals
The solution isn't hoping these challenges disappear; it's taking strategic action to protect your eligibility metrics now. Our Medicaid eligibility and enrollment expertise directly supports your 340B program by strengthening the metrics that matter most. We deliver a comprehensive suite of services to help hospitals protect and optimize their 340B status.
Our consultative approach navigates the complexities—from point-of-care insurance discovery to post-discharge support—identifying and enrolling patients who qualify for coverage, recovering millions in revenue while reducing uncompensated care and protecting your 340B status.
Automated Medicaid Eligibility Discovery
Our platform identifies missed Medicaid days across all types, ensuring hospitals capture every opportunity to boost their DSH percentage.
SSI/SSDI Enrollment Support
We help patients qualify for Social Security benefits, which directly impact the SSI ratio and, by extension, 340B eligibility.
Strategic Risk Assessment
Our analytics and insights help hospitals understand how CMS changes affect their eligibility, enabling proactive planning and advocacy.
End-to-End Enrollment Services
From initial screening to documentation and follow-up, we manage the full lifecycle of eligibility and enrollment—reducing administrative burden and improving outcomes.