NEW REPORT: Charity Care at 340B Hospitals is on a Downward Trend

WASHINGTON – Today, the Alliance for Integrity and Reform of 340B (AIR340B) released a report analyzing the latest charity care data, from fiscal year (FY) 2021 which demonstrates that 69% of 340B disproportionate share hospitals (DSHs) provide charity care at rates lower than the national average for all hospitals.

Reaching nearly $54 billion in annual sales at the discounted 340B prices, the 340B program continues to grow, yet there are no requirements around how 340B hospitals use the discounts they receive to help low-income patients afford their medications. This report confirms more than two thirds of 340B DSH hospitals are not using the program to provide charity care.

“This analysis once again shows that a ballooning 340B program has not translated into a stronger safety-net or improve access to care through higher charity care levels. Instead, we see soaring CEO salaries, hospitals padding their pockets with the savings, and vulnerable patients taking a backseat to profits,” said Bob Dold, former Congressman and AIR340B spokesman.

This is the fifth iteration of this report spanning nearly 10 years and the findings remain the same: Despite more hospitals generating more profit from the 340B program, most 340B hospitals provide below average levels of charity care.

The average national level of charity care for short-term acute care hospitals is 2.5%. In comparison, this analysis found:

  • 69% of 340B DSH hospitals provide charity care at rates lower than the national average.
  • 36% of 340B DSH hospitals provide charity care that represents less than 1% of their total operating costs in FY 2021, and the number of hospitals at this rate is increasing.
  • A small share of 340B DSH hospitals account for most of the charity care provided by all 340B hospitals – with just 25% of 340B DSH hospitals accounting for 80% of all charity care provided by all 340B DSH hospitals in FY 2021.
  • Non-340B short-term acute care hospitals in the United States have higher average charity care (2.6%) than 340B DSH hospitals (2.5%), on average.

The report concludes the standards enabling hospitals to qualify for the 340B program must be strengthened and aligned to ensure only hospitals helping high numbers of low-income and vulnerable patients qualify for the program. This includes requiring 340B hospitals to provide charity care to uninsured, low-income and vulnerable patients.


The Alliance for Integrity and Reform of 340B (AIR340B) is a coalition of patient

advocacy groups, clinical care providers, and biopharmaceutical innovators dedicated to

reforming and strengthening the 340B program to ensure it directly supports access to

outpatient prescription medicines for uninsured indigent patients.

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