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340B Pulse

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by NorthArcHealth

17 episodes

Updated Daily

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Podcast Overview

340B Pulse is a NorthArc Health podcast powered by PureLogics. Built on nearly two decades of experience developing healthcare systems, data platforms, and compliance-driven environments, this podcast focuses on the real operational side of 340B including claims validation, reporting gaps, manufacturer requirements like ESP and Beacon, and program defensibility. This is not about noise or high-level theory. It’s about operator-level conversations — how 340B programs actually function, where friction shows up, and what it takes to run them effectively in the real world.

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Publishing Since

4/3/2026

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Recent Episodes

July 27, 2026

Checking the Checker: The Hidden Cost of 340B Rebates | Celeste Fowler

340B rebate readiness is the operational work of identifying, validating, submitting, and reconciling 340B claims under a rebate-based model, then confirming that the rebate a covered entity is owed is the rebate it actually receives. Celeste Fowler, Executive Director of Pharmacy 340B at Piedmont Healthcare, joins 340B Pulse to explain why that work is far bigger than the "five-hour myth" suggests. Everyone's talking about 340B rebate model litigation and manufacturer policy. Almost nobody's talking about who actually checks whether the rebate check that comes back is correct.On this episode of 340B Pulse, host Muhammad Atif sits down with Celeste Fowler, Executive Director of Pharmacy 340B at Piedmont Healthcare, to get past the policy headlines and into what a rebate-based 340B model actually demands operationally. Celeste has spent her career building this kind of program from the ground up, starting as what she calls a "one-woman show" at a single community hospital and now leading a health-system program across multiple facilities.She explains why the widely repeated "five-hour myth" undersells the real work, why more submitted data doesn't automatically create more transparency, why standardization has to be the fixed recipe underneath every program's unique implementation, where AI genuinely earns its place versus where clinical judgment can't be replaced, and what it takes to "check the checker" on a manufacturer's rebate payment before a covered entity can trust it.<ul><li>Why the "five-hour myth" may actually describe five hours a day, not five hours a month, if rebate readiness is done correctly</li><li>Why data integrity and security, not policy uncertainty, is the operational risk healthcare leaders are missing</li><li>What it actually takes to reconcile pharmacy, revenue-cycle, and EMR data that was never built to talk to each other</li><li>Why standardization is the fixed compliance foundation underneath every covered entity's unique 340B program</li><li>Where AI and automation genuinely help in 340B operations, and where human clinical judgment has to stay in the loop</li><li>What "checking the checker" means for a covered entity's cash flow and financial sustainability</li><li>How to build cross-departmental governance and vendor accountability across a health system</li></ul> 00:00 — Cold open: the real cost of rebate readiness 00:30 — Welcome to 340B Pulse 03:35 — Celeste Fowler's path into 340B leadership 07:34 — What healthcare leaders are missing operationally 12:34 — The five-hour myth, explained 14:16 — Mapping the real data gaps behind every claim 18:02 — Why standardization is the core of a defensible program 20:02 — Where AI and automation actually help 25:45 — Data security, AI vendors, and patient trust 28:35 — Financial sustainability and checking the checker 35:18 — Governance and vendor accountability at health-system scale 37:47 — Rapid fire: what rebate readiness actually takes 41:47 — 340B training, coalitions, and building a support network 45:11 — Celeste's final perspective for healthcare leaders 46:03 — Connect with Celeste Fowler What is the five-hour myth in 340B rebate readiness? It's the idea that preparing for a rebate-based 340B model only takes a few extra hours a month. Celeste says that number really only covers uploading a file, and that doing the work behind it properly could take closer to five hours a day.What does "checking the checker" mean? It means a covered entity has to independently confirm that the rebate a manufacturer pays back actually matches what was owed, instead of just trusting the number that comes in.Why does standardization matter so much for 340B programs? Because it gives every site the same compliance baseline, so when something looks off, a team can actually trace it back to the cause instead of guessing whether it's a real problem or just normal variation.#HealthcareCompliance#PharmacyOperations#AIinHealthcare#HealthcareInnovation#HealthcareDataSecurity

July 20, 2026

The Cash Cow Mistake: What 340B Leaders Get Wrong About Savings | David Dunson

340B savings don't become mission impact automatically. Someone has to decide where the money goes, defend that decision to a board, and be ready to prove it to a regulator. This episode shows exactly what that looks like in practice.In this episode, Mohammad Atif sits down with David Dunson, in-house pharmacist and 340B program leader at Tug River Health Association, a six-clinic rural health center with one mobile unit serving McDowell County, West Virginia, the poorest county in the state and among the poorest in the country. David walks through the real allocation calls behind Tug River's 340B program: choosing to fund a dormant dental program over whole-facility backup generators after Hurricane Helene, rebudgeting a full year ahead of the Medicare Part D rebate program's impact on net savings, and running a monthly cross-departmental 340B committee that keeps every department's priorities visible to the board.He also delivers a candid, occasionally blunt take on where the industry gets 340B wrong: the "cash cow" mentality that leaves organizations blindsided when savings drop, why documentation has to be audit-ready at all times rather than assembled after the fact, and an optimistic but grounded view of where AI actually fits into 340B operations today.00:00 - Introduction to 340B Pulse and the Cold-Open Hook Reel 00:39 - What Happens to 340B Savings After They Arrive? 01:31 - Meet the Host: Why 340B Pulse Exists 03:04 - Introducing David Dunson and Tug River Health Association 03:34 - From Board Member to In-House Pharmacy Owner: David's 25-Year Path 05:19 - Inside Tug River: Six Clinics, One Mobile Unit, McDowell County 06:34 - Defining Mission Impact: Every Patient Gets Care 08:30 - Getting Departments Aligned Around a Shared Mission 09:56 - Reviving a Dormant Dental Program With 340B Savings 11:53 - Competing Priorities: Generators vs. Dental Care After Hurricane Helene 13:54 - Leading Under Uncertainty: The Medicare Part D Rebate Program 16:31 - The $1,100-to-$2,000 Reality of Serving Tug River's Patients 17:23 - Why 340B Should Never Be Treated Like a Cash Cow 18:05 - Governance: Presenting Best-Case and Worst-Case Scenarios to the Board 18:53 - Documentation, HRSA's Patient Definition, and Audit Readiness 23:04 - The Real Cost of Managing a 340B Program 24:43 - Manufacturer Reporting and Working With a TPA 28:15 - Where AI Fits Into 340B Operations 29:58 - Patient Privacy Concerns and Building Trust in AI 31:40 - Preparing the Board for the 340B Coalition Conference 32:53 - Rapid Fire Round With David Dunson 34:32 - Final Perspective: Mission Impact vs. Growth for Growth's Sake 36:03 - How to Connect With David Dunson 36:44 - Closing ThoughtsWhat is 340B mission impact? 340B mission impact is the result of a covered entity's leadership making intentional, documented, and defensible decisions about how 340B savings are allocated, so that the savings translate into measurable patient outcomes rather than simply being absorbed into general operations.What is the biggest mistake covered entities make when planning 340B allocations?The biggest mistake is treating 340B like a permanent cash cow, budgeting as if net savings will remain stable indefinitely, which leaves an organization unprepared and financially exposed the moment a policy change or reduction in savings actually happens.What does strong 340B governance look like, according to David Dunson? According to David Dunson, strong 340B governance means running a standing cross-departmental committee that meets monthly, and presenting a board with multiple scenarios, what leadership expects, what it hopes happens, and what might happen instead, rather than a single optimistic projection.#340BMissionImpact #340BPulse #NorthArcHealth #340BProgram #RuralHealthcare #HealthcareCompliance #CommunityHealthCenters #PharmacyOperations #CoveredEntity #AIinHealthcare

July 13, 2026

Zero Discount, Half the Diabetes Rate: The 340B Blind Spot in Rural Kentucky | Ronnah Alexander

A rural 340B program is a network of independent contract pharmacies functioning as an extension of the care team, not a single in-house pharmacy counter. Ronnah Alexander, BSPharm, MBA, ACE, who leads the 340B program at Health First Community Health Center in western Kentucky, explains how that model actually runs day to day, and how a device that gets zero 340B discount became one of the highest-impact uses of program savings her clinic has made. In this episode, Ronnah who's spent 36 years in pharmacy and nearly a decade specifically in 340B walks host Muhammad Atif through what it actually takes to run a rural 340B program: treating contract pharmacies as a real extension of the care team, absorbing growing manufacturer reporting requirements without losing focus on patients, and funding a continuous glucose monitor program entirely out of program savings even though the device itself gets no 340B discount at all. That program helped cut her clinic's uncontrolled diabetic rate from 33 percent to 19 percent in two years.She's candid about where the program is straining, too: a shrinking charity-care ceiling, the confusion left behind when the 340B rebate model paused, and which patients still fall through the cracks even when the program works exactly as designed. She closes with a direct message for policymakers not a request for more money, but a request for a single, coordinated plan.Why rural 340B programs depend on independent contract pharmacies instead of in-house pharmacies How a contract pharmacy helped an incarcerated patient complete his Hepatitis C treatment Why keeping a drug's price down can actually push its own 340B price up How a device that gets zero 340B discount cut uncontrolled diabetes nearly in half Which patients are most likely to fall through the cracks even with 340B in place What Ronnah wants policymakers to understand about rural 340B before the next round of restrictions lands00:00 Introduction to 340B Pulse 00:33 Ronnah Alexander's journey into 340B 06:04 What 340B actually looks like in rural Kentucky 09:08 Contract pharmacies as an extension of the care team 11:32 Handling growing manufacturer compliance requirements 13:31 The 340B rebate model: relief and new confusion 17:29 Patient impact: insulin and chronic disease access 20:43 The CGM program and cutting uncontrolled diabetes in half 25:57 Manufacturer restrictions from the inside 27:51 Transparency, ESP, and duplicate-discount avoidance 29:39 Preparing for the future of 340B 32:15 Ronnah's advice to policymakers 33:20 Rapid fire round 34:22 Closing and how to connect with RonnahWhy do rural 340B covered entities rely on contract pharmacies? Because most rural clinic locations don't have enough patient volume to justify the cost of an in-house pharmacy, pharmacist, and technician, so covered entities partner with locally owned independent pharmacies instead.Does a continuous glucose monitor qualify for a 340B discount? No a CGM is a device, not a drug, so it receives no 340B discount. Some covered entities fund patient access to CGMs directly out of 340B program savings instead.What does Ronnah Alexander want policymakers to understand about rural 340B? That covered entities need one single, coordinated blueprint for how the program should run, instead of a continuous stream of individual manufacturer and policy changes that leave them reacting one at a time with no ability to plan ahead.

17 total episodes available

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Frequently asked questions

Have a different question and can't find the answer you're looking for? Reach out to our support team by sending us an email and we'll get back to you as soon as we can.

What is 340B Pulse?: 340B Pulse is a NorthArc Health podcast powered by PureLogics.

Built on nearly two decades of experience developing healthcare systems, data platforms, and compliance-driven environments, this podcast focuses on the real operational side of 340B including claims validation, reporting gaps, manufacturer requirements like ESP and Beacon, and program defensibility.

This is not about noise or high-level theory.

It’s about operator-level conversations — how 340B programs actually function, where friction shows up, and what it takes to run them effectively in the real world.
How often does this podcast release new episodes?: This podcast updates daily.
Where can I listen to this podcast?: This podcast is available on 4 platforms including Apple Podcasts, Spotify, and more. You can also use the RSS feed directly.
Does this podcast accept guests?: Yes, this podcast regularly features guests.

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