Episode Summary
Kaitlyn Weckhorst Wood came into 340B sideways. She started in Oklahoma Medicaid as a pharmacy analyst, moved to an academic health center as a 340B program manager, and now sits on the vendor side as a 340B Pharmacy Account Executive at SunRx, working with covered entities ranging from single-site clinics to large health systems. That path is why this conversation is unusually direct: she has run a program, and she now sells to people running them. Her central argument is that covered entities spend too much time reacting to pricing changes, legislation, and the next threat to program benefits, when the work that actually protects a program is small, repeatable, and available right now. Her sharpest example is a report most teams have never run. When she asks covered entities whether they can pull an eRx report from their EMR, roughly half cannot, and that report is what tells them where prescriptions actually go after a patient leaves the building. Rural programs often discover their scripts are being filled thirty miles away rather than at the pharmacy next door, which means the contract pharmacy network they built does not match where their patients actually go.
Show Notes
- Roughly half of covered entities cannot say how to run an eRx report from their EMR.
- That report shows where prescriptions actually go once a patient leaves the building.
- Rural covered entities often discover their scripts are filled thirty miles away rather than at the pharmacy next door.
- A contract pharmacy network built without that data is built on assumption.
- The fallout report matters as much as the capture report, because what failed to capture is where the fixable problems live.
- Fallout usually traces to something specific: a value not ingesting from the EMR, a stale provider panel, or configurations that no longer match the patient definition.
- Automated ordering through a TPA does not confirm you paid the correct 340B price.
- Pricing file errors happen, and set-and-forget ordering means nobody notices.
- The 340B program belongs to the covered entity, not to the third-party administrator.
- A TPA account executive said that plainly on the record.
- 340B is what you make it, and limited oversight produces limited outcomes.
- One covered entity changed its EMR without telling anyone and lost six months of program savings.
- Nothing broke loudly, which is exactly why it went unnoticed.
- When evaluating a TPA, partnership terms matter more than feature lists.
- Ask what the partnership looks like once the contract is signed.
- Find out whether you get a dedicated account executive or a ticketing queue.
- Ask your TPA what records they maintain for you and how they will support a HRSA audit.
- Ask before the audit, not during it.
- Documentation is a year-round habit, not an audit-week scramble.
- Knowing where records live matters as much as holding them yourself.
- Decreasing program savings is the earliest warning sign that a program is losing control.
- Small covered entities should tell partners plainly how much capacity they actually have.
- When one person is the CFO and the clinical pharmacist, 340B does not get their full attention.
- AI can surface trends and flag problems early, but it does not remove human oversight.
- There is no 340B operational playbook, which is why peer conversations and podcasts fill the gap.
- A patient who could not afford diabetes medication paid nothing at a campus pharmacy she was pointed toward.
- They were 39 weeks pregnant, and they did not know the help existed.
- The single most practical habit is internal and external communication.
- You never know what you might find out, just by asking questions.