Study questions whether 340B nonprofit hospitals are expanding care in underserved areas

A new Health Equity Collaborative white paper says nonprofit hospitals in the 340B Drug Pricing Program have mostly expanded in more advantaged communities, not the nation’s highest-need areas. The analysis argues the findings point to a need for more transparency and accountability in how 340B resources are used.

Why it matters: - The 340B Drug Pricing Program was designed to help providers serve low-income and vulnerable patients. - The Health Equity Collaborative says the latest findings raise questions about whether the program is reaching the communities Congress intended to support. - The report argues that stronger transparency and eligibility rules could better align 340B with health equity goals.

What happened: - The Health Equity Collaborative released a white paper on July 30, 2026, in Washington, D.C. - The report examines whether 340B nonprofit hospitals expanded unprofitable care or concentrated growth in underserved communities. - The analysis covers hospital participation and expansion from 2015 to 2024. - The report is titled "Nonprofit Hospitals Do Not Use the 340B Program to Expand Unprofitable Care: 340B Nonprofit Hospitals Do Not Expand Unprofitable Care in Socioeconomically Disadvantaged Communities." - The full white paper is available here.

The details: - The analysis found that 64% of counties where nonprofit hospitals newly entered the 340B Program were classified as socioeconomically advantaged or moderately advantaged under the CDC Social Vulnerability Index. - Nearly 70% of counties with child sites affiliated with hospitals that joined the 340B Program during the study period were also in socioeconomically advantaged or moderately advantaged communities. - Public hospitals, not nonprofit hospitals, were associated with a higher likelihood of offering outpatient psychiatric care after joining 340B. - Nonprofit hospitals showed no comparable increase in unprofitable services after participation in the program. - The study specifically looked at investment in high-need services such as psychiatric care. - Amy Hinojosa, a Health Equity Collaborative founding member, said the research raises questions about whether current incentives consistently advance the program’s mission.

Between the lines: - The findings suggest 340B participation may be easier to scale in communities that are already relatively advantaged. - The contrast between public and nonprofit hospitals points to different incentives or operating patterns inside the program. - The report’s policy recommendations focus less on expanding 340B and more on proving that existing benefits reach patients in need.

What's next: - The Health Equity Collaborative is urging policymakers, healthcare leaders, researchers and patient advocates to review the findings. - The group wants more reporting on 340B-generated revenue and how hospitals spend those funds on patient care. - The organization also wants HRSA to collect and publish the governmental contracts nonprofit hospitals use to qualify for the program. - The report calls for eligibility standards that better reflect charity care, uncompensated care and Medicaid-related financial losses. - Hinojosa said the goal should be to ensure every dollar generated through 340B advances health equity while preserving the program’s role in the safety net.

The bottom line: - The study argues 340B nonprofit hospitals are not consistently using the program to expand unprofitable care in underserved communities, and that policymakers should tighten oversight to prove the program is doing what it was meant to do.