A Pioneer Institute-CancerCare analysis of CMS data for the first quarter of 2025 found hospitals in the 340B drug-discount program spent 2.16% of operating expenses on charity care for low-income patients, compared with 2.82% at non-340B hospitals.
For uninsured patients, charity care accounted for 1.6% of operating expenses at 340B hospitals, versus 2.26% at non-340B hospitals, the report said. It calls for more transparency, auditable reporting of 340B revenue and a requirement that participating hospitals provide more charity care than nonparticipants.
The American Hospital Association called the report misleading, arguing that charity care alone does not show how hospitals serve patients and communities. The AHA says 340B hospitals have provided nearly $100 billion in total community benefits, including behavioral-health clinics, diabetes counseling, food banks and free or discounted drugs. Participating providers retain savings from outpatient-drug discounts of 25% to 50%, but are not legally required to spend them on charity care.
