Co-hosts Chelsea Violette and Logan Yoho dive into "Finding Your Place in 340B" with special guest Michael Gonzalez, Founder of FQHC 340B Compliance. From career journeys to industry insights, this episode unpacks the many paths within 340B and how you can carve out your own. Don't miss this engaging conversation.
Michael Gonzalez is a healthcare consultant with eight years of experience in 340B Program and pharmacy management services, offering comprehensive support including program coordination, audits, and pharmacy development. Previously, he served as audit manager at Terry Horne C.P.A. & Associates, where he conducted over 120 audits and provided expertise in FQHC financial advisory services during his four-year tenure.
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Welcome to the 340 Banter Podcast. Today,
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Michael, Chelsea, and I will be discussing all the opportunities you might have
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to advance your career within the 340B Program,
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but also, there are sometimes challenges, and you feel like you're getting pigeonholed
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into a position, so we'll discuss how you can change that and really grow your career.
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Music.
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One of the things that I really like about the 340B program is that it provides
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opportunities for career advancement.
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Coming from a retail background, before I got into the 340B space,
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I know a lot of pharmacists and technicians really feel stagnant or they've
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gotten to the point that they can't advance any further within the program.
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So I think that that's somewhere the 340B program is different than a lot of
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other areas inside of pharmacy.
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What about 340B makes it different and gives you those avenues for career advancement?
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Like what about it, as opposed to just typical retail pharmacy,
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gives you that advancement? I think it's just the structure of the way pharmacy
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is set up here in the current day that...
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There aren't a lot of positions to advance to.
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You get into a position, you might advance from a staff pharmacist to a pharmacist
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in charge or a pharmacy manager, but you might have one more step up in your district or region.
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So it just makes it really challenging. But I think the difference in 340B is
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that there are aspects of different areas within your covered entity that come into 340B.
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It combines so many different things, including finance, operations,
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clinical aspects, as well as others that I think that it just provides opportunities to grow.
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I think you just hit on one of the most important pieces that it can take aspects
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of what interests someone outside of the world of pharmacy and allow them to
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grow that interest out and build on it to better help the organization within the 340 program,
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increase the savings, better serve their patients.
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And I think that when we look at kind of pharmacy career paths in general,
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as a technician, your options are really going into retail or going into hospital.
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And then as a pharmacist, if you write out of pharmacy school,
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you can go right into retail or you can go into a residency,
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which now has some primary care, ambulatory care options in it or hospital based.
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But none of them are are kind
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of clinical hospital based but none of them are really focused
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on the 340b program so it's not a place where you're you're automatically taking
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that career path you everybody ends up kind of falling into 340b by accident
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because of a different interest yeah i don't know of anyone that went to school
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with the concept of i'm going to be a 340b specialist you know.
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I think one of the really cool things about 340B is that for folks that are
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self-motivated, there's endless opportunities, right?
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But the caveat is if you don't have that self-motivation, I think it can be
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difficult to advance because there's so much to learn. Vendors all operate differently.
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And so I think that's a key thing is like, if you want to excel in this place,
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you need to be self-motivated because there's going to be, there's not a lot
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of clear answers. and you have to do a lot of research to figure out what works
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for your program because you're going to be different than the one next to you.
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I don't know about you, but when I was in pharmacy school, I heard the mention of 340B once or twice,
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but I really didn't know what it was until I was out in the retail space working
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in a contract pharmacy, and I thought I knew 340B, but I really didn't.
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Yeah, I didn't go to pharmacy school, so you know, in accounting,
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we don't talk about 340B. Yeah, I mean, I never heard of 340B until,
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honestly, I was in residency.
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And like I said, fell into it because I was helping operate a program that was
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heavily supported by the 340B program.
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And I had to understand that in order to be able to help run our pharmacy operations.
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So, Michael, I think not just from the covered entity perspective,
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but also from the vendor perspective, there are roles for career advancement.
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So, I know we have a different method of bringing our employees up.
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So, what's your kind of theory of career advancement within the company?
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For our company you know again it goes back to that you need
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to be self-motivated even though we have a lot of these things
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outlined from how different vendors operate and
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we have a little bit more knowledge from a management perspective than
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most covered entities are going to have i still think it
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goes back to being self-motivated right because we have we have
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a lot of deliverables we we stay very busy as a
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team and we need people that you know
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aren't just checking the boxes and doing the steps so for
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me that's a huge thing but you don't have
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to be a pharmacist you don't have to be a pharmacy
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tech even you don't have to have a medical background 340b is
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is is weird and i think a lot of covered entity management make the assumption
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that because you're a pharmacist you know 340b right and that now i think you
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stack those two things together and that's the best you can have is a a pharmacist
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that does know 340b but as you said earlier you're not learning about it in school.
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So to assume because someone is a pharmacist that they're going to have this
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knowledge of 340B, that can get you in trouble if they've not been in a 340B program before.
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So I think it's a really cool aspect of this though is that you don't have to
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have the background to be a 340B expert.
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And 340B is less appropriate,
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it not that it's less but the compliance
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metrics on 340b are less about clinical and
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like did we prescribe the right drug right that's not necessarily
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the test work it's more of it really
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is more of an auditing feature you know do you know how to audit can you can
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you come up with creative ways to find things that may not be compliant and
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help of you know make that program efficient in your your organization so that
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you are you know testing these things everybody wants to be compliant.
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I don't have a single client that's like, hey, no, we don't care about compliance.
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It's just, I think the caveat on that is, is figuring out how to get there,
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figuring out how to find those issues.
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And again, that's going to happen. There's not a ton of vendor specific training
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that I can find online to know, okay, for TPA one, what report should I be running?
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What should I be testing as a health center?
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And so you have to be self-motivated. You have to be willing to ask questions you don't know.
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And I do that a lot, right? I'm always pinging you guys, hey,
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I'm not sure about this. What's your opinion on this?
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And I think you had to be willing to put yourself out there.
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And if you're willing to do that, whether that be at a CE, whether it be at
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a vendor, you just have a great opportunity.
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I think if we can build off of that, so you kind of given the perspective of
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as the individual who wants to be able to specialize or get into 340B, How can you do that?
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I think one of the challenging things about the 340B program is that it is so niche.
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There's an endless amount of details you can dig into the weeds on.
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And for many organizations, it can feel as though once you've kind of made your
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place within 340B, you don't really have any additional career advancement staying
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within that organization.
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So if we can kind of flip the conversation to from a managerial perspective,
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how do covered entities creatively make career ladders for staff that may have
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been entry level or pharmacy technician or finance background and they've grown
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into 340B, but how do you make that a career for them?
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Or what are we seeing different covered entities do to build a career ladder
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for those individuals so they don't feel stagnant or stuck?
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I think not being tied to a specific degree.
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And I think all centers do a very good job about that because if you've seen
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one 340B program, you've seen one 340B program along with one FQHC, you've seen one FQHC.
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But I think that we wear so many hats inside of an FQHC that we get better about
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that and we're open to that idea.
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But I think one of the best ways I've seen is bringing an idea,
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and it may not be a big enough idea to fund a whole position,
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but you can start off small.
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So you can start off and, for example, if it's a technician that's in a dispensing
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pharmacy within a covered entity, maybe they want to get involved in the 340B
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audits, and that may not be a full-time job, depending on the covered entity.
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So they take it as a part-time position and then slowly grow it and show their
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worth and show that they're providing a value that then they can make that into a full-time position.
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And I think that's true of other positions like a pharmacist.
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There might not be enough reimbursement as a clinical pharmacist it's challenging
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just due to the healthcare model.
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So by using a 340B position, you might be able to work one day a week as a clinical pharmacist,
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but then you show that clinical pharmacy aspect is driving prescriptions
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into your entity-owned pharmacy, and it's paying for itself in an indirect fashion.
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So I think there are those opportunities, just thinking about it may not be a
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full job change at once, but it's a stepwise fashion.
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And to bring it back from a managerial perspective, I think it starts with management
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getting a better understanding of the 340B program, right?
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Because again, it's so niche, it's so gray, there's so many nuanced things that
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I think they'll hire someone to do it.
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Assist with their 340B program, and then they don't take the time necessarily
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to understand it themselves.
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And so they think, okay, we got one person, this program is running,
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you know, we're purchasing drugs, our patients are getting these medications.
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It's good to go. And that's not the case.
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And, you know, we have a client that I work with out in Oregon,
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and once a week, which I'm not saying that you have to do it once a week,
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but once a week we have a meeting, and, you know, we got consultants from our
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team on the meeting, We have pharmacists from the health center on the meeting.
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You know, someone from the C-suite normally joins. Someone from the data analytics
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team normally joins. We have different dashboards.
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And the coolest thing is we're putting all these heads together to kind of give
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feedback based on different perspectives and different specialties that they work on.
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And that program has really become super efficient, you know,
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and now there's a lot of time involved in that.
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But even with restrictions going on, you know, we're still
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running a 340B program that's taking care of our patients and
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at this time they only have contract pharmacy. Now they're
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working on an in-house pharmacy and expand that but I
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think it's it's getting the rest of
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the team to have buy into the 340B program allows
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management to see that you know
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there's more avenues than just a one 340B coordinator
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and I think sometimes we get stuck there as health centers I just really think
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that it starts with education you know and it doesn't you don't have to know
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every detail as management, you know, how this vendor works how that vendor works
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but you got to understand the importance of this program, you got to understand
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what it means to your patients.
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And, understand that we need to have supporting staff in place and not just one
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person that does all the things and so for me that's that's the biggest piece
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from like if you're saying, from the top down, how do we build this out and build career avenues,
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is you need to have understanding first, right?
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I think some of the creative things that I've seen health centers specifically do to kind of grow out,
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we've had MAs or pharmacy technicians or other frontline staff members that
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want to grow within the 340B program,
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some creative kind of career paths that have come out I've seen prescription
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assistance technicians who kind of specialize in finding those other avenues
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of getting medications covered when patients can't afford their medications.
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We've seen prior authorization and refill technicians or MAs
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that help get those medications back faster for the patients, that helps support
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the 340B program, but also helps improve overall patient care.
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We've seen staff go from managing the 340B program and maybe an in-house pharmacy,
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so doing the audits there, to then growing into a role where they work with
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the contract pharmacies and work with different TPAs and different types of data.
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Instances where we've seen the individuals in the 340B program then move out
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and help manage the clinic-administered drugs out in the clinics themselves,
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doing the inventory reviews, working with the nursing staff on documentation,
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making sure that everything is operating the best for the healthcare team and
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for the patient, but also remaining 340B compliant and being able to grow out through there.
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Have you seen some other creative ways that health centers have incorporated that?
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Yeah, I think in the pharmacist line,
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something we're seeing now that I think is really great as a pharmacist is seeing
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pharmacies starting to be added to the C-suite level, either as a chief pharmacy
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officer or chief operations officer
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and we're even seeing a few health centers that have appointed a pharmacist as their CEO.
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And I think that that is somewhere where 340B is a little different than a lot
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of other programs in the health center because it is so financial and business focused
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it lends itself to once you grasp that 340B portion, you really understand the
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business of health centers. And I think that
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I think that C-suites that have recognized that have valued having a pharmacist on that level.
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And I've even seen from our clients, there's been situations that I've recognized
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where management doesn't have the understanding of 340B,
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they hired a coordinator and they just kind of said, hey, this is your baby
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now, you figure this out, you get it fine-tuned.
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And I've seen a lot of value come from people controlling their own futures
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and saying, okay, maybe management's not as knowledgeable right now of 340B
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as they should, I'm going to get them there, right?
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And so, and I think that the important thing on that, though,
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is not taking too much up at one time, right? Because everyone's overwhelmed already.
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But, you know, taking baby steps, hey, let's, let's train them on what our cash card does.
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Let's get management to understand. And then you just start taking those chunks.
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And so what you inevitably do is
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control your future by saying here's the value in the
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program here's me bringing more value to the program and
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and then you have the opportunity to say hey here's something that I can show
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you if if we open up an opportunity to say hey now we want to be the 340B director
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we still need an analytical person or an auditor to be in here testing claims
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but here's all the things I could do in this if i were to come up a level.
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And so I think there's the cool thing in 340B is that you don't have to only
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rely on the fact that management already knows the program.
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We have the opportunity to train them. We have an opportunity to do that.
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And sell our skills. Yeah. I mean, essentially, that's what we all do,
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right? We all need to go to work. We all need a paycheck.
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And so sell your skills and show, you know, a lot of times they just don't understand
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the value that you're adding to the program. So keep them informed.
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Keep them informed. Let them know the value you bring.
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And, you know, if they can see and recognize it, then I think it's pretty,
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I don't know that easy is the right word.
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I don't think anything in 340B is ever easy.
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You know, it gives you a better chance at advancing somewhere else in the CE-specific stuff.
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But I think you could roll the same thing on the vendor side.
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You know, a lot of people end up going vendor route.
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And if you're, you know, you're asking good questions in your meetings and you're
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going to conferences and you're talking to people and showing that you're willing
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to put yourself out there and you're willing to be self-motivated,
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you're a good candidate for that.
00:16:55.711 --> 00:16:59.771
And from a vendor perspective, a lot of those positions are remote positions.
00:16:59.971 --> 00:17:02.871
So if that's something that really interests someone, there's a lot of value
00:17:02.871 --> 00:17:08.271
there because vendors know I can't just find a 340B expert in my hometown, right?
00:17:08.331 --> 00:17:11.171
Like the same thing here. A lot of our consultants are remote.
00:17:11.771 --> 00:17:14.971
Because we see those skill sets out there and we say, hey, we need them,
00:17:15.051 --> 00:17:17.011
but I know they're not gonna move to Tennessee.
00:17:17.871 --> 00:17:20.091
So we're gonna set up a remote position. No offense to Tennessee.
00:17:20.091 --> 00:17:21.851
No offense to Tennessee, no offense at all.
00:17:23.212 --> 00:17:28.892
I think along that line, it's what I've seen a lot of times in the health center
00:17:28.892 --> 00:17:30.532
space is the pharmacist comes in.
00:17:30.852 --> 00:17:36.932
They may be the only pharmacist at the entity or the only person in the 340B program.
00:17:37.312 --> 00:17:42.432
And along with a technician, if it's in that role, is one of the values I've
00:17:42.432 --> 00:17:44.672
seen is just volunteering for stuff.
00:17:44.852 --> 00:17:50.192
At least in FQHC, you can say, we have a quality meeting once a month.
00:17:50.352 --> 00:17:53.332
Hey, can I join that? Most of the time, the answer is going to be yes.
00:17:53.592 --> 00:17:55.772
And you can really develop those positions.
00:17:56.112 --> 00:17:59.652
And something I did at my health center because advocacy is a huge love of
00:17:59.652 --> 00:18:03.192
mine, I just started volunteering to help in those kind of things.
00:18:03.412 --> 00:18:07.992
And then eventually was, in addition to my roles in the pharmacy realm,
00:18:08.032 --> 00:18:09.712
I was also our advocacy coordinator.
00:18:09.712 --> 00:18:16.172
But I think 340B lent itself to that because it was such a big issue when it
00:18:16.172 --> 00:18:19.032
comes to advocacy. It keeps us running.
00:18:19.332 --> 00:18:24.172
But I think just being prepared, knowing yourself, knowing what you like,
00:18:24.352 --> 00:18:26.612
and not being afraid to just ask.
00:18:27.172 --> 00:18:31.372
And I'm going to toss in just because I've been at a hospital out of the three of us.
00:18:31.472 --> 00:18:35.892
I'm going to toss in some other kind of creative ways that I've seen 340B positions
00:18:35.892 --> 00:18:40.332
grow within the hospital. because I've seen technicians grown into procurement
00:18:40.332 --> 00:18:43.412
specialists or purchasers or analysts.
00:18:43.652 --> 00:18:49.732
And then I've seen for larger health systems, them grow from a hospital-specific
00:18:49.732 --> 00:18:55.012
analyst or 340B specialist to one that's helping oversee the 340B program for
00:18:55.012 --> 00:19:00.792
the whole system and even becoming a trainer at the system level to help train the staff,
00:19:00.792 --> 00:19:04.472
whether it be technicians or pharmacists at each of the separate hospitals,
00:19:04.812 --> 00:19:08.832
on how to operate most compliantly within the 340B program.
00:19:08.972 --> 00:19:14.112
I've also seen things like pharmacy and 340B business managers or business directors
00:19:14.112 --> 00:19:17.512
that don't necessarily have to come from a pharmacy background.
00:19:17.692 --> 00:19:20.872
I've seen pharmacy technicians grow into some of those roles.
00:19:21.092 --> 00:19:25.912
I've seen finance folks grow into, you know, pharmacy and 340B finance directors,
00:19:26.192 --> 00:19:28.712
even though they don't have that pharmacy background.
00:19:28.872 --> 00:19:34.632
They've kind of come up through the 340B chain to be able to continue to grow
00:19:34.632 --> 00:19:39.732
their career, which I think is really cool, particularly for some folks to hear
00:19:39.732 --> 00:19:41.432
that are feeling like they might be stuck.
00:19:42.216 --> 00:19:45.656
And, you know, they've been pigeonholed in one position because that's all their
00:19:45.656 --> 00:19:50.736
organization has right now in terms of 340B. We have a relationship with a pharmacist
00:19:50.736 --> 00:19:55.596
at a large health system that she started as a pharmacist.
00:19:55.716 --> 00:20:01.816
She worked in 340B and then realized she had a skill and stepped into pharmacy informatics.
00:20:01.816 --> 00:20:06.556
And it's so important when you're dealing with accumulators and all the different
00:20:06.556 --> 00:20:12.516
purchasing nuances of working in a hospital that it's not a natural progression,
00:20:12.516 --> 00:20:15.516
but it's one of those unique things that can happen. Yeah.
00:20:15.656 --> 00:20:21.436
And I think another unique thing is like I've seen techs become pharmacy directors.
00:20:21.676 --> 00:20:24.776
You know what I mean? And usually you would think that's just for a pharmacist.
00:20:24.856 --> 00:20:26.796
And they do an awesome job.
00:20:26.916 --> 00:20:30.056
They got there because they were self-motivated. They took a lot of ownership
00:20:30.056 --> 00:20:34.176
of what they were doing. I've also seen pharmacy directors turn into CEOs because
00:20:34.176 --> 00:20:37.996
the program is so important to the overall community, to our patients,
00:20:38.176 --> 00:20:40.236
to the organization itself.
00:20:40.476 --> 00:20:44.296
But, you know, kind of as we're wrapping this up, one of the things I'd like
00:20:44.296 --> 00:20:49.116
to kind of pick your brains on are for someone who is newer to 340B or has been
00:20:49.116 --> 00:20:52.516
in 340B for some time and really wants that opportunity to grow.
00:20:53.236 --> 00:20:57.976
What are some skills specific to the 340B program that you should focus?
00:20:58.056 --> 00:20:59.236
Where do we see that value?
00:20:59.716 --> 00:21:02.636
Where's the value added and the things that you could go and, you know,
00:21:02.636 --> 00:21:05.676
everything's online now and though it may not have something
00:21:05.676 --> 00:21:10.476
for 340b specific maybe it's hey if you learn how to work this spreadsheet and,
00:21:10.476 --> 00:21:14.676
you know, use this function, you know, you're gonna you're gonna expedite the time
00:21:14.676 --> 00:21:19.176
in which that takes and so from your viewpoints what are skills that you can
00:21:19.176 --> 00:21:25.536
work on to help yourself advance in the 340b program? I think my skill would be your elevator speech.
00:21:26.183 --> 00:21:30.623
340B is really hard to explain to somebody that doesn't understand it.
00:21:30.743 --> 00:21:34.823
So use the opportunities in your family and your friend groups to explain what you do.
00:21:34.963 --> 00:21:41.123
It will get you more comfortable in selling yourself and showing how important
00:21:41.123 --> 00:21:43.803
your position is in your organization.
00:21:44.423 --> 00:21:47.823
And it's going to help in multiple areas. It's going to help when you're talking
00:21:47.823 --> 00:21:52.323
to leadership, when you're talking to your board, but then also talking to legislators
00:21:52.323 --> 00:21:56.543
and other policymakers in regards to the 340B program.
00:21:56.903 --> 00:22:01.283
I have to second that because one of the most proud moments in my marriage was
00:22:01.283 --> 00:22:04.563
hearing my husband accurately describe what I do in two sentences.
00:22:04.843 --> 00:22:10.363
I was amazed. I was so proud of him. But I think that the thirst and hunger
00:22:10.363 --> 00:22:16.243
to learn more is really important because I don't think that anybody knows everything
00:22:16.243 --> 00:22:19.003
there is to know about 340B. There's always more.
00:22:19.183 --> 00:22:24.083
There is no way to be a master of all within 340B. There's just not.
00:22:24.403 --> 00:22:30.383
So being thirsty and hungry to keep reaching out and learning more and reading
00:22:30.383 --> 00:22:34.903
what's out there and hearing from the thought leaders in the space is really
00:22:34.903 --> 00:22:38.443
important to continue to grow your own knowledge base and understanding.
00:22:38.723 --> 00:22:44.263
And then you mentioned Excel. I just think a level of comfort in Excel in general
00:22:44.263 --> 00:22:49.823
is really helpful because there's a lot of data in 340B and a lot of things to sift through.
00:22:50.023 --> 00:22:54.943
And even if you're not an expert at Excel, being comfortable finding your way
00:22:54.943 --> 00:22:58.623
around through it, even using some of the AI tools we have today to help you
00:22:58.623 --> 00:23:01.983
write an equation that you're like, I should be able to do this with data,
00:23:02.043 --> 00:23:04.003
but I don't know how yet. I wonder if there's a way.
00:23:04.749 --> 00:23:07.329
Being comfortable enough to kind of mess around and get there,
00:23:07.389 --> 00:23:11.709
I think is really helpful. I think that's where I have still a lot to learn is Excel.
00:23:11.929 --> 00:23:14.189
That's definitely somewhere where I'm trying to grow.
00:23:14.409 --> 00:23:19.729
It's really important. And I think not being afraid to say, I don't know,
00:23:19.989 --> 00:23:25.249
but knowing where to go for the answer. So building that network. Yeah.
00:23:25.949 --> 00:23:29.009
Network's super important. That's been important for us as a firm.
00:23:29.249 --> 00:23:32.209
But piggybacking on like the ownership
00:23:32.209 --> 00:23:35.169
and there's going after it and going to get it I think
00:23:35.169 --> 00:23:38.349
a really important thing is you can't think of 340B as
00:23:38.349 --> 00:23:41.349
just a pharmacy program right because that happens
00:23:41.349 --> 00:23:45.629
so much we lock it into it's pharmacy that's what it is and though it is pharmacy
00:23:45.629 --> 00:23:51.009
there's so much you know you can learn just kind of a caveat there, the accounting
00:23:51.009 --> 00:23:55.289
can be fairly difficult for one in-house pharmacies accounting usually has a
00:23:55.289 --> 00:23:58.949
difficult time tracking that and the other contract pharmacies because there's
00:23:58.949 --> 00:23:59.729
different models, right?
00:23:59.729 --> 00:24:05.869
So you may use vendor one and they're a pay upon dispense or a pay upon 340B eligibility match.
00:24:06.069 --> 00:24:09.829
And vendor two is pay upon replenishment. And so from the accounting records,
00:24:09.989 --> 00:24:11.169
that makes it very difficult.
00:24:11.389 --> 00:24:16.429
And so I think there's a lot, and my opinion is skewed because I'm an accountant, right?
00:24:16.509 --> 00:24:21.209
So I see value there, but like learn how to track that and to post.
00:24:21.429 --> 00:24:24.929
And if you can help your finance team out with that because I guarantee that
00:24:24.929 --> 00:24:26.209
that's a struggle that they have.
00:24:26.209 --> 00:24:29.029
Yeah there's more value for you so I mean even
00:24:29.029 --> 00:24:32.049
if you think about your quality compliance legal like
00:24:32.049 --> 00:24:34.729
there's so many other things that play into it that i think that you can
00:24:34.729 --> 00:24:38.109
grow into 340b from those different you
00:24:38.109 --> 00:24:40.889
know ladders yeah there's there's so much
00:24:40.889 --> 00:24:44.229
opportunity to learn I'm still learning you know we we've been doing this
00:24:44.229 --> 00:24:48.449
for several years now and have a large network of clients that we work with
00:24:48.449 --> 00:24:52.589
but, you know, we learn stuff every day and so i think that's just an important
00:24:52.589 --> 00:24:58.189
life lesson don't stop learning always try to learn excel and you know control your own future.
"340B spans multiple areas within the covered entity, including finance, operations, and clinical, offering significant opportunities for growth."
Meet Logan Yoho, PharmD, BCACP, 340B ACE, and co-host of the 340Banter Podcast. With nearly a decade of experience in the 340B industry, Logan is dedicated to helping health centers optimize and maintain successful, compliant 340B Programs. As Director of Advocacy and Education at FQHC 340B Compliance, he focuses on implementing entity-owned pharmacies and guiding advocacy efforts for 340B. Logan’s extensive background includes leading the pharmacy and 340B programs at Hopewell Health Centers, serving as Apexus 340B University Faculty, and chairing the Ohio 340B FQHC Consortium. Logan’s leadership and expertise have earned him multiple awards, and he brings a wealth of knowledge to every episode of 340Banter.
Meet Chelsea Violette, PharmD, BCACP, 340B ACE, and your co-host for the 340Banter Podcast. With over a decade of experience in pharmacy and 340B Program management, Chelsea brings a wealth of knowledge to the table. As Chief Operating Officer at FQHC 340B Compliance, she works tirelessly to support health centers across the country, ensuring they have the tools and strategies they need to succeed. Chelsea’s hands-on experience as a 340B Consultant and Pharmacy Manager, combined with her expertise as a subject matter expert for the Apexus 340B Prime Vendor Program, makes her a trusted voice in the world of 340B compliance. Tune in for her practical insights, guidance, and lively discussions on all things 340B.
00:00:00.017 --> 00:00:03.077
Welcome to the 340 Banter Podcast. Today,
00:00:03.337 --> 00:00:07.397
Michael, Chelsea, and I will be discussing all the opportunities you might have
00:00:07.397 --> 00:00:09.957
to advance your career within the 340B Program,
00:00:09.957 --> 00:00:15.637
but also, there are sometimes challenges, and you feel like you're getting pigeonholed
00:00:15.637 --> 00:00:20.717
into a position, so we'll discuss how you can change that and really grow your career.
00:00:21.360 --> 00:00:41.360
Music.
00:00:40.697 --> 00:00:46.137
One of the things that I really like about the 340B program is that it provides
00:00:46.137 --> 00:00:48.397
opportunities for career advancement.
00:00:49.137 --> 00:00:52.557
Coming from a retail background, before I got into the 340B space,
00:00:52.837 --> 00:00:56.837
I know a lot of pharmacists and technicians really feel stagnant or they've
00:00:56.837 --> 00:01:00.277
gotten to the point that they can't advance any further within the program.
00:01:00.457 --> 00:01:04.737
So I think that that's somewhere the 340B program is different than a lot of
00:01:04.737 --> 00:01:06.317
other areas inside of pharmacy.
00:01:06.577 --> 00:01:10.977
What about 340B makes it different and gives you those avenues for career advancement?
00:01:11.137 --> 00:01:14.857
Like what about it, as opposed to just typical retail pharmacy,
00:01:15.057 --> 00:01:19.737
gives you that advancement? I think it's just the structure of the way pharmacy
00:01:19.737 --> 00:01:22.677
is set up here in the current day that...
00:01:23.733 --> 00:01:26.573
There aren't a lot of positions to advance to.
00:01:26.733 --> 00:01:31.733
You get into a position, you might advance from a staff pharmacist to a pharmacist
00:01:31.733 --> 00:01:39.893
in charge or a pharmacy manager, but you might have one more step up in your district or region.
00:01:40.033 --> 00:01:46.333
So it just makes it really challenging. But I think the difference in 340B is
00:01:46.333 --> 00:01:53.293
that there are aspects of different areas within your covered entity that come into 340B.
00:01:53.293 --> 00:01:57.633
It combines so many different things, including finance, operations,
00:01:57.973 --> 00:02:03.673
clinical aspects, as well as others that I think that it just provides opportunities to grow.
00:02:03.673 --> 00:02:10.053
I think you just hit on one of the most important pieces that it can take aspects
00:02:10.053 --> 00:02:14.593
of what interests someone outside of the world of pharmacy and allow them to
00:02:14.593 --> 00:02:22.213
grow that interest out and build on it to better help the organization within the 340 program,
00:02:22.213 --> 00:02:24.373
increase the savings, better serve their patients.
00:02:24.373 --> 00:02:30.493
And I think that when we look at kind of pharmacy career paths in general,
00:02:30.513 --> 00:02:35.213
as a technician, your options are really going into retail or going into hospital.
00:02:35.653 --> 00:02:40.353
And then as a pharmacist, if you write out of pharmacy school,
00:02:40.513 --> 00:02:43.433
you can go right into retail or you can go into a residency,
00:02:43.433 --> 00:02:49.873
which now has some primary care, ambulatory care options in it or hospital based.
00:02:49.873 --> 00:02:52.833
But none of them are are kind
00:02:52.833 --> 00:02:56.113
of clinical hospital based but none of them are really focused
00:02:56.113 --> 00:03:00.753
on the 340b program so it's not a place where you're you're automatically taking
00:03:00.753 --> 00:03:06.013
that career path you everybody ends up kind of falling into 340b by accident
00:03:06.013 --> 00:03:10.193
because of a different interest yeah i don't know of anyone that went to school
00:03:10.193 --> 00:03:13.133
with the concept of i'm going to be a 340b specialist you know.
00:03:14.037 --> 00:03:18.617
I think one of the really cool things about 340B is that for folks that are
00:03:18.617 --> 00:03:23.017
self-motivated, there's endless opportunities, right?
00:03:23.137 --> 00:03:28.117
But the caveat is if you don't have that self-motivation, I think it can be
00:03:28.117 --> 00:03:33.217
difficult to advance because there's so much to learn. Vendors all operate differently.
00:03:33.737 --> 00:03:38.077
And so I think that's a key thing is like, if you want to excel in this place,
00:03:38.077 --> 00:03:41.057
you need to be self-motivated because there's going to be, there's not a lot
00:03:41.057 --> 00:03:44.697
of clear answers. and you have to do a lot of research to figure out what works
00:03:44.697 --> 00:03:47.217
for your program because you're going to be different than the one next to you.
00:03:47.457 --> 00:03:53.697
I don't know about you, but when I was in pharmacy school, I heard the mention of 340B once or twice,
00:03:53.697 --> 00:03:59.077
but I really didn't know what it was until I was out in the retail space working
00:03:59.077 --> 00:04:03.257
in a contract pharmacy, and I thought I knew 340B, but I really didn't.
00:04:03.837 --> 00:04:06.737
Yeah, I didn't go to pharmacy school, so you know, in accounting,
00:04:06.777 --> 00:04:10.737
we don't talk about 340B. Yeah, I mean, I never heard of 340B until,
00:04:10.897 --> 00:04:12.097
honestly, I was in residency.
00:04:12.557 --> 00:04:18.137
And like I said, fell into it because I was helping operate a program that was
00:04:18.137 --> 00:04:20.677
heavily supported by the 340B program.
00:04:20.677 --> 00:04:25.217
And I had to understand that in order to be able to help run our pharmacy operations.
00:04:25.217 --> 00:04:31.117
So, Michael, I think not just from the covered entity perspective,
00:04:31.417 --> 00:04:36.277
but also from the vendor perspective, there are roles for career advancement.
00:04:36.317 --> 00:04:42.517
So, I know we have a different method of bringing our employees up.
00:04:42.697 --> 00:04:46.257
So, what's your kind of theory of career advancement within the company?
00:04:47.517 --> 00:04:50.297
For our company you know again it goes back to that you need
00:04:50.297 --> 00:04:53.117
to be self-motivated even though we have a lot of these things
00:04:53.117 --> 00:04:56.017
outlined from how different vendors operate and
00:04:56.017 --> 00:04:59.817
we have a little bit more knowledge from a management perspective than
00:04:59.817 --> 00:05:02.617
most covered entities are going to have i still think it
00:05:02.617 --> 00:05:05.537
goes back to being self-motivated right because we have we have
00:05:05.537 --> 00:05:08.337
a lot of deliverables we we stay very busy as a
00:05:08.337 --> 00:05:11.337
team and we need people that you know
00:05:11.337 --> 00:05:14.217
aren't just checking the boxes and doing the steps so for
00:05:14.217 --> 00:05:17.357
me that's a huge thing but you don't have
00:05:17.357 --> 00:05:20.197
to be a pharmacist you don't have to be a pharmacy
00:05:20.197 --> 00:05:23.957
tech even you don't have to have a medical background 340b is
00:05:23.957 --> 00:05:29.177
is is weird and i think a lot of covered entity management make the assumption
00:05:29.177 --> 00:05:34.057
that because you're a pharmacist you know 340b right and that now i think you
00:05:34.057 --> 00:05:38.057
stack those two things together and that's the best you can have is a a pharmacist
00:05:38.057 --> 00:05:42.297
that does know 340b but as you said earlier you're not learning about it in school.
00:05:42.477 --> 00:05:46.237
So to assume because someone is a pharmacist that they're going to have this
00:05:46.237 --> 00:05:50.977
knowledge of 340B, that can get you in trouble if they've not been in a 340B program before.
00:05:51.717 --> 00:05:55.717
So I think it's a really cool aspect of this though is that you don't have to
00:05:55.717 --> 00:05:57.817
have the background to be a 340B expert.
00:05:58.117 --> 00:06:00.317
And 340B is less appropriate,
00:06:00.948 --> 00:06:04.148
it not that it's less but the compliance
00:06:04.148 --> 00:06:07.928
metrics on 340b are less about clinical and
00:06:07.928 --> 00:06:10.928
like did we prescribe the right drug right that's not necessarily
00:06:10.928 --> 00:06:14.188
the test work it's more of it really
00:06:14.188 --> 00:06:17.788
is more of an auditing feature you know do you know how to audit can you can
00:06:17.788 --> 00:06:21.928
you come up with creative ways to find things that may not be compliant and
00:06:21.928 --> 00:06:27.368
help of you know make that program efficient in your your organization so that
00:06:27.368 --> 00:06:31.168
you are you know testing these things everybody wants to be compliant.
00:06:31.368 --> 00:06:35.128
I don't have a single client that's like, hey, no, we don't care about compliance.
00:06:35.668 --> 00:06:40.468
It's just, I think the caveat on that is, is figuring out how to get there,
00:06:40.668 --> 00:06:42.168
figuring out how to find those issues.
00:06:42.668 --> 00:06:47.028
And again, that's going to happen. There's not a ton of vendor specific training
00:06:47.028 --> 00:06:52.168
that I can find online to know, okay, for TPA one, what report should I be running?
00:06:52.288 --> 00:06:53.788
What should I be testing as a health center?
00:06:54.348 --> 00:06:58.608
And so you have to be self-motivated. You have to be willing to ask questions you don't know.
00:06:59.948 --> 00:07:03.848
And I do that a lot, right? I'm always pinging you guys, hey,
00:07:03.928 --> 00:07:05.948
I'm not sure about this. What's your opinion on this?
00:07:06.188 --> 00:07:08.448
And I think you had to be willing to put yourself out there.
00:07:08.568 --> 00:07:13.668
And if you're willing to do that, whether that be at a CE, whether it be at
00:07:13.668 --> 00:07:16.408
a vendor, you just have a great opportunity.
00:07:16.748 --> 00:07:21.028
I think if we can build off of that, so you kind of given the perspective of
00:07:21.028 --> 00:07:27.648
as the individual who wants to be able to specialize or get into 340B, How can you do that?
00:07:27.848 --> 00:07:34.788
I think one of the challenging things about the 340B program is that it is so niche.
00:07:35.148 --> 00:07:39.948
There's an endless amount of details you can dig into the weeds on.
00:07:40.208 --> 00:07:46.128
And for many organizations, it can feel as though once you've kind of made your
00:07:46.128 --> 00:07:50.668
place within 340B, you don't really have any additional career advancement staying
00:07:50.668 --> 00:07:51.668
within that organization.
00:07:51.668 --> 00:07:58.108
So if we can kind of flip the conversation to from a managerial perspective,
00:07:58.528 --> 00:08:05.728
how do covered entities creatively make career ladders for staff that may have
00:08:05.728 --> 00:08:11.308
been entry level or pharmacy technician or finance background and they've grown
00:08:11.308 --> 00:08:14.008
into 340B, but how do you make that a career for them?
00:08:14.008 --> 00:08:18.548
Or what are we seeing different covered entities do to build a career ladder
00:08:18.548 --> 00:08:21.688
for those individuals so they don't feel stagnant or stuck?
00:08:22.518 --> 00:08:26.118
I think not being tied to a specific degree.
00:08:26.558 --> 00:08:31.298
And I think all centers do a very good job about that because if you've seen
00:08:31.298 --> 00:08:37.318
one 340B program, you've seen one 340B program along with one FQHC, you've seen one FQHC.
00:08:37.678 --> 00:08:45.618
But I think that we wear so many hats inside of an FQHC that we get better about
00:08:45.618 --> 00:08:48.478
that and we're open to that idea.
00:08:48.478 --> 00:08:54.218
But I think one of the best ways I've seen is bringing an idea,
00:08:54.498 --> 00:08:57.978
and it may not be a big enough idea to fund a whole position,
00:08:57.998 --> 00:08:59.998
but you can start off small.
00:09:00.158 --> 00:09:05.138
So you can start off and, for example, if it's a technician that's in a dispensing
00:09:05.138 --> 00:09:10.238
pharmacy within a covered entity, maybe they want to get involved in the 340B
00:09:10.238 --> 00:09:13.538
audits, and that may not be a full-time job, depending on the covered entity.
00:09:13.538 --> 00:09:19.138
So they take it as a part-time position and then slowly grow it and show their
00:09:19.138 --> 00:09:25.098
worth and show that they're providing a value that then they can make that into a full-time position.
00:09:25.098 --> 00:09:29.198
And I think that's true of other positions like a pharmacist.
00:09:29.598 --> 00:09:35.398
There might not be enough reimbursement as a clinical pharmacist it's challenging
00:09:35.398 --> 00:09:38.458
just due to the healthcare model.
00:09:38.458 --> 00:09:46.978
So by using a 340B position, you might be able to work one day a week as a clinical pharmacist,
00:09:47.078 --> 00:09:51.878
but then you show that clinical pharmacy aspect is driving prescriptions
00:09:51.878 --> 00:09:57.818
into your entity-owned pharmacy, and it's paying for itself in an indirect fashion.
00:09:57.818 --> 00:10:01.698
So I think there are those opportunities, just thinking about it may not be a
00:10:01.698 --> 00:10:06.418
full job change at once, but it's a stepwise fashion.
00:10:07.018 --> 00:10:14.518
And to bring it back from a managerial perspective, I think it starts with management
00:10:14.518 --> 00:10:16.918
getting a better understanding of the 340B program, right?
00:10:17.058 --> 00:10:22.118
Because again, it's so niche, it's so gray, there's so many nuanced things that
00:10:22.118 --> 00:10:23.778
I think they'll hire someone to do it.
00:10:24.850 --> 00:10:29.170
Assist with their 340B program, and then they don't take the time necessarily
00:10:29.170 --> 00:10:31.810
to understand it themselves.
00:10:32.130 --> 00:10:34.650
And so they think, okay, we got one person, this program is running,
00:10:35.130 --> 00:10:38.010
you know, we're purchasing drugs, our patients are getting these medications.
00:10:38.810 --> 00:10:40.590
It's good to go. And that's not the case.
00:10:40.670 --> 00:10:43.810
And, you know, we have a client that I work with out in Oregon,
00:10:43.810 --> 00:10:48.210
and once a week, which I'm not saying that you have to do it once a week,
00:10:48.290 --> 00:10:52.290
but once a week we have a meeting, and, you know, we got consultants from our
00:10:52.290 --> 00:10:55.190
team on the meeting, We have pharmacists from the health center on the meeting.
00:10:55.470 --> 00:10:59.550
You know, someone from the C-suite normally joins. Someone from the data analytics
00:10:59.550 --> 00:11:01.790
team normally joins. We have different dashboards.
00:11:02.070 --> 00:11:06.790
And the coolest thing is we're putting all these heads together to kind of give
00:11:06.790 --> 00:11:10.370
feedback based on different perspectives and different specialties that they work on.
00:11:10.870 --> 00:11:14.690
And that program has really become super efficient, you know,
00:11:14.790 --> 00:11:16.970
and now there's a lot of time involved in that.
00:11:17.510 --> 00:11:20.510
But even with restrictions going on, you know, we're still
00:11:20.510 --> 00:11:23.270
running a 340B program that's taking care of our patients and
00:11:23.270 --> 00:11:26.310
at this time they only have contract pharmacy. Now they're
00:11:26.310 --> 00:11:29.830
working on an in-house pharmacy and expand that but I
00:11:29.830 --> 00:11:32.770
think it's it's getting the rest of
00:11:32.770 --> 00:11:36.810
the team to have buy into the 340B program allows
00:11:36.810 --> 00:11:39.970
management to see that you know
00:11:39.970 --> 00:11:43.010
there's more avenues than just a one 340B coordinator
00:11:43.010 --> 00:11:48.810
and I think sometimes we get stuck there as health centers I just really think
00:11:48.810 --> 00:11:52.510
that it starts with education you know and it doesn't you don't have to know
00:11:52.510 --> 00:11:55.790
every detail as management, you know, how this vendor works how that vendor works
00:11:55.790 --> 00:11:59.830
but you got to understand the importance of this program, you got to understand
00:11:59.830 --> 00:12:01.110
what it means to your patients.
00:12:01.990 --> 00:12:07.150
And, understand that we need to have supporting staff in place and not just one
00:12:07.150 --> 00:12:11.570
person that does all the things and so for me that's that's the biggest piece
00:12:11.570 --> 00:12:15.390
from like if you're saying, from the top down, how do we build this out and build career avenues,
00:12:15.630 --> 00:12:18.350
is you need to have understanding first, right?
00:12:18.870 --> 00:12:24.810
I think some of the creative things that I've seen health centers specifically do to kind of grow out,
00:12:24.930 --> 00:12:30.110
we've had MAs or pharmacy technicians or other frontline staff members that
00:12:30.110 --> 00:12:31.950
want to grow within the 340B program,
00:12:31.950 --> 00:12:37.650
some creative kind of career paths that have come out I've seen prescription
00:12:37.650 --> 00:12:44.030
assistance technicians who kind of specialize in finding those other avenues
00:12:44.030 --> 00:12:47.570
of getting medications covered when patients can't afford their medications.
00:12:47.570 --> 00:12:54.350
We've seen prior authorization and refill technicians or MAs
00:12:55.413 --> 00:12:59.673
that help get those medications back faster for the patients, that helps support
00:12:59.673 --> 00:13:03.553
the 340B program, but also helps improve overall patient care.
00:13:03.713 --> 00:13:09.473
We've seen staff go from managing the 340B program and maybe an in-house pharmacy,
00:13:09.673 --> 00:13:13.813
so doing the audits there, to then growing into a role where they work with
00:13:13.813 --> 00:13:19.473
the contract pharmacies and work with different TPAs and different types of data.
00:13:20.433 --> 00:13:25.533
Instances where we've seen the individuals in the 340B program then move out
00:13:25.533 --> 00:13:30.253
and help manage the clinic-administered drugs out in the clinics themselves,
00:13:30.673 --> 00:13:34.653
doing the inventory reviews, working with the nursing staff on documentation,
00:13:35.033 --> 00:13:39.713
making sure that everything is operating the best for the healthcare team and
00:13:39.713 --> 00:13:45.193
for the patient, but also remaining 340B compliant and being able to grow out through there.
00:13:45.733 --> 00:13:49.253
Have you seen some other creative ways that health centers have incorporated that?
00:13:49.253 --> 00:13:51.853
Yeah, I think in the pharmacist line,
00:13:52.193 --> 00:13:58.113
something we're seeing now that I think is really great as a pharmacist is seeing
00:13:58.113 --> 00:14:03.253
pharmacies starting to be added to the C-suite level, either as a chief pharmacy
00:14:03.253 --> 00:14:05.513
officer or chief operations officer
00:14:05.693 --> 00:14:11.393
and we're even seeing a few health centers that have appointed a pharmacist as their CEO.
00:14:11.393 --> 00:14:16.893
And I think that that is somewhere where 340B is a little different than a lot
00:14:16.893 --> 00:14:21.473
of other programs in the health center because it is so financial and business focused
00:14:21.533 --> 00:14:27.193
it lends itself to once you grasp that 340B portion, you really understand the
00:14:27.193 --> 00:14:30.693
business of health centers. And I think that
00:14:31.611 --> 00:14:36.651
I think that C-suites that have recognized that have valued having a pharmacist on that level.
00:14:37.251 --> 00:14:42.751
And I've even seen from our clients, there's been situations that I've recognized
00:14:42.751 --> 00:14:46.151
where management doesn't have the understanding of 340B,
00:14:46.271 --> 00:14:51.451
they hired a coordinator and they just kind of said, hey, this is your baby
00:14:51.451 --> 00:14:53.571
now, you figure this out, you get it fine-tuned.
00:14:54.051 --> 00:14:58.011
And I've seen a lot of value come from people controlling their own futures
00:14:58.011 --> 00:15:02.311
and saying, okay, maybe management's not as knowledgeable right now of 340B
00:15:02.311 --> 00:15:05.151
as they should, I'm going to get them there, right?
00:15:05.351 --> 00:15:08.171
And so, and I think that the important thing on that, though,
00:15:08.251 --> 00:15:12.251
is not taking too much up at one time, right? Because everyone's overwhelmed already.
00:15:12.711 --> 00:15:17.391
But, you know, taking baby steps, hey, let's, let's train them on what our cash card does.
00:15:17.471 --> 00:15:20.931
Let's get management to understand. And then you just start taking those chunks.
00:15:21.331 --> 00:15:25.491
And so what you inevitably do is
00:15:25.491 --> 00:15:28.171
control your future by saying here's the value in the
00:15:28.171 --> 00:15:32.091
program here's me bringing more value to the program and
00:15:32.091 --> 00:15:36.471
and then you have the opportunity to say hey here's something that I can show
00:15:36.471 --> 00:15:42.031
you if if we open up an opportunity to say hey now we want to be the 340B director
00:15:42.031 --> 00:15:46.391
we still need an analytical person or an auditor to be in here testing claims
00:15:46.391 --> 00:15:49.651
but here's all the things I could do in this if i were to come up a level.
00:15:50.911 --> 00:15:58.311
And so I think there's the cool thing in 340B is that you don't have to only
00:15:58.311 --> 00:16:00.591
rely on the fact that management already knows the program.
00:16:00.791 --> 00:16:04.111
We have the opportunity to train them. We have an opportunity to do that.
00:16:04.791 --> 00:16:08.591
And sell our skills. Yeah. I mean, essentially, that's what we all do,
00:16:08.691 --> 00:16:10.891
right? We all need to go to work. We all need a paycheck.
00:16:11.371 --> 00:16:15.071
And so sell your skills and show, you know, a lot of times they just don't understand
00:16:15.071 --> 00:16:18.411
the value that you're adding to the program. So keep them informed.
00:16:18.631 --> 00:16:20.591
Keep them informed. Let them know the value you bring.
00:16:21.091 --> 00:16:24.971
And, you know, if they can see and recognize it, then I think it's pretty,
00:16:25.191 --> 00:16:27.491
I don't know that easy is the right word.
00:16:27.631 --> 00:16:30.111
I don't think anything in 340B is ever easy.
00:16:30.271 --> 00:16:36.211
You know, it gives you a better chance at advancing somewhere else in the CE-specific stuff.
00:16:36.371 --> 00:16:39.291
But I think you could roll the same thing on the vendor side.
00:16:39.451 --> 00:16:41.771
You know, a lot of people end up going vendor route.
00:16:42.231 --> 00:16:46.311
And if you're, you know, you're asking good questions in your meetings and you're
00:16:46.311 --> 00:16:50.431
going to conferences and you're talking to people and showing that you're willing
00:16:50.431 --> 00:16:52.971
to put yourself out there and you're willing to be self-motivated,
00:16:53.111 --> 00:16:55.551
you're a good candidate for that.
00:16:55.711 --> 00:16:59.771
And from a vendor perspective, a lot of those positions are remote positions.
00:16:59.971 --> 00:17:02.871
So if that's something that really interests someone, there's a lot of value
00:17:02.871 --> 00:17:08.271
there because vendors know I can't just find a 340B expert in my hometown, right?
00:17:08.331 --> 00:17:11.171
Like the same thing here. A lot of our consultants are remote.
00:17:11.771 --> 00:17:14.971
Because we see those skill sets out there and we say, hey, we need them,
00:17:15.051 --> 00:17:17.011
but I know they're not gonna move to Tennessee.
00:17:17.871 --> 00:17:20.091
So we're gonna set up a remote position. No offense to Tennessee.
00:17:20.091 --> 00:17:21.851
No offense to Tennessee, no offense at all.
00:17:23.212 --> 00:17:28.892
I think along that line, it's what I've seen a lot of times in the health center
00:17:28.892 --> 00:17:30.532
space is the pharmacist comes in.
00:17:30.852 --> 00:17:36.932
They may be the only pharmacist at the entity or the only person in the 340B program.
00:17:37.312 --> 00:17:42.432
And along with a technician, if it's in that role, is one of the values I've
00:17:42.432 --> 00:17:44.672
seen is just volunteering for stuff.
00:17:44.852 --> 00:17:50.192
At least in FQHC, you can say, we have a quality meeting once a month.
00:17:50.352 --> 00:17:53.332
Hey, can I join that? Most of the time, the answer is going to be yes.
00:17:53.592 --> 00:17:55.772
And you can really develop those positions.
00:17:56.112 --> 00:17:59.652
And something I did at my health center because advocacy is a huge love of
00:17:59.652 --> 00:18:03.192
mine, I just started volunteering to help in those kind of things.
00:18:03.412 --> 00:18:07.992
And then eventually was, in addition to my roles in the pharmacy realm,
00:18:08.032 --> 00:18:09.712
I was also our advocacy coordinator.
00:18:09.712 --> 00:18:16.172
But I think 340B lent itself to that because it was such a big issue when it
00:18:16.172 --> 00:18:19.032
comes to advocacy. It keeps us running.
00:18:19.332 --> 00:18:24.172
But I think just being prepared, knowing yourself, knowing what you like,
00:18:24.352 --> 00:18:26.612
and not being afraid to just ask.
00:18:27.172 --> 00:18:31.372
And I'm going to toss in just because I've been at a hospital out of the three of us.
00:18:31.472 --> 00:18:35.892
I'm going to toss in some other kind of creative ways that I've seen 340B positions
00:18:35.892 --> 00:18:40.332
grow within the hospital. because I've seen technicians grown into procurement
00:18:40.332 --> 00:18:43.412
specialists or purchasers or analysts.
00:18:43.652 --> 00:18:49.732
And then I've seen for larger health systems, them grow from a hospital-specific
00:18:49.732 --> 00:18:55.012
analyst or 340B specialist to one that's helping oversee the 340B program for
00:18:55.012 --> 00:19:00.792
the whole system and even becoming a trainer at the system level to help train the staff,
00:19:00.792 --> 00:19:04.472
whether it be technicians or pharmacists at each of the separate hospitals,
00:19:04.812 --> 00:19:08.832
on how to operate most compliantly within the 340B program.
00:19:08.972 --> 00:19:14.112
I've also seen things like pharmacy and 340B business managers or business directors
00:19:14.112 --> 00:19:17.512
that don't necessarily have to come from a pharmacy background.
00:19:17.692 --> 00:19:20.872
I've seen pharmacy technicians grow into some of those roles.
00:19:21.092 --> 00:19:25.912
I've seen finance folks grow into, you know, pharmacy and 340B finance directors,
00:19:26.192 --> 00:19:28.712
even though they don't have that pharmacy background.
00:19:28.872 --> 00:19:34.632
They've kind of come up through the 340B chain to be able to continue to grow
00:19:34.632 --> 00:19:39.732
their career, which I think is really cool, particularly for some folks to hear
00:19:39.732 --> 00:19:41.432
that are feeling like they might be stuck.
00:19:42.216 --> 00:19:45.656
And, you know, they've been pigeonholed in one position because that's all their
00:19:45.656 --> 00:19:50.736
organization has right now in terms of 340B. We have a relationship with a pharmacist
00:19:50.736 --> 00:19:55.596
at a large health system that she started as a pharmacist.
00:19:55.716 --> 00:20:01.816
She worked in 340B and then realized she had a skill and stepped into pharmacy informatics.
00:20:01.816 --> 00:20:06.556
And it's so important when you're dealing with accumulators and all the different
00:20:06.556 --> 00:20:12.516
purchasing nuances of working in a hospital that it's not a natural progression,
00:20:12.516 --> 00:20:15.516
but it's one of those unique things that can happen. Yeah.
00:20:15.656 --> 00:20:21.436
And I think another unique thing is like I've seen techs become pharmacy directors.
00:20:21.676 --> 00:20:24.776
You know what I mean? And usually you would think that's just for a pharmacist.
00:20:24.856 --> 00:20:26.796
And they do an awesome job.
00:20:26.916 --> 00:20:30.056
They got there because they were self-motivated. They took a lot of ownership
00:20:30.056 --> 00:20:34.176
of what they were doing. I've also seen pharmacy directors turn into CEOs because
00:20:34.176 --> 00:20:37.996
the program is so important to the overall community, to our patients,
00:20:38.176 --> 00:20:40.236
to the organization itself.
00:20:40.476 --> 00:20:44.296
But, you know, kind of as we're wrapping this up, one of the things I'd like
00:20:44.296 --> 00:20:49.116
to kind of pick your brains on are for someone who is newer to 340B or has been
00:20:49.116 --> 00:20:52.516
in 340B for some time and really wants that opportunity to grow.
00:20:53.236 --> 00:20:57.976
What are some skills specific to the 340B program that you should focus?
00:20:58.056 --> 00:20:59.236
Where do we see that value?
00:20:59.716 --> 00:21:02.636
Where's the value added and the things that you could go and, you know,
00:21:02.636 --> 00:21:05.676
everything's online now and though it may not have something
00:21:05.676 --> 00:21:10.476
for 340b specific maybe it's hey if you learn how to work this spreadsheet and,
00:21:10.476 --> 00:21:14.676
you know, use this function, you know, you're gonna you're gonna expedite the time
00:21:14.676 --> 00:21:19.176
in which that takes and so from your viewpoints what are skills that you can
00:21:19.176 --> 00:21:25.536
work on to help yourself advance in the 340b program? I think my skill would be your elevator speech.
00:21:26.183 --> 00:21:30.623
340B is really hard to explain to somebody that doesn't understand it.
00:21:30.743 --> 00:21:34.823
So use the opportunities in your family and your friend groups to explain what you do.
00:21:34.963 --> 00:21:41.123
It will get you more comfortable in selling yourself and showing how important
00:21:41.123 --> 00:21:43.803
your position is in your organization.
00:21:44.423 --> 00:21:47.823
And it's going to help in multiple areas. It's going to help when you're talking
00:21:47.823 --> 00:21:52.323
to leadership, when you're talking to your board, but then also talking to legislators
00:21:52.323 --> 00:21:56.543
and other policymakers in regards to the 340B program.
00:21:56.903 --> 00:22:01.283
I have to second that because one of the most proud moments in my marriage was
00:22:01.283 --> 00:22:04.563
hearing my husband accurately describe what I do in two sentences.
00:22:04.843 --> 00:22:10.363
I was amazed. I was so proud of him. But I think that the thirst and hunger
00:22:10.363 --> 00:22:16.243
to learn more is really important because I don't think that anybody knows everything
00:22:16.243 --> 00:22:19.003
there is to know about 340B. There's always more.
00:22:19.183 --> 00:22:24.083
There is no way to be a master of all within 340B. There's just not.
00:22:24.403 --> 00:22:30.383
So being thirsty and hungry to keep reaching out and learning more and reading
00:22:30.383 --> 00:22:34.903
what's out there and hearing from the thought leaders in the space is really
00:22:34.903 --> 00:22:38.443
important to continue to grow your own knowledge base and understanding.
00:22:38.723 --> 00:22:44.263
And then you mentioned Excel. I just think a level of comfort in Excel in general
00:22:44.263 --> 00:22:49.823
is really helpful because there's a lot of data in 340B and a lot of things to sift through.
00:22:50.023 --> 00:22:54.943
And even if you're not an expert at Excel, being comfortable finding your way
00:22:54.943 --> 00:22:58.623
around through it, even using some of the AI tools we have today to help you
00:22:58.623 --> 00:23:01.983
write an equation that you're like, I should be able to do this with data,
00:23:02.043 --> 00:23:04.003
but I don't know how yet. I wonder if there's a way.
00:23:04.749 --> 00:23:07.329
Being comfortable enough to kind of mess around and get there,
00:23:07.389 --> 00:23:11.709
I think is really helpful. I think that's where I have still a lot to learn is Excel.
00:23:11.929 --> 00:23:14.189
That's definitely somewhere where I'm trying to grow.
00:23:14.409 --> 00:23:19.729
It's really important. And I think not being afraid to say, I don't know,
00:23:19.989 --> 00:23:25.249
but knowing where to go for the answer. So building that network. Yeah.
00:23:25.949 --> 00:23:29.009
Network's super important. That's been important for us as a firm.
00:23:29.249 --> 00:23:32.209
But piggybacking on like the ownership
00:23:32.209 --> 00:23:35.169
and there's going after it and going to get it I think
00:23:35.169 --> 00:23:38.349
a really important thing is you can't think of 340B as
00:23:38.349 --> 00:23:41.349
just a pharmacy program right because that happens
00:23:41.349 --> 00:23:45.629
so much we lock it into it's pharmacy that's what it is and though it is pharmacy
00:23:45.629 --> 00:23:51.009
there's so much you know you can learn just kind of a caveat there, the accounting
00:23:51.009 --> 00:23:55.289
can be fairly difficult for one in-house pharmacies accounting usually has a
00:23:55.289 --> 00:23:58.949
difficult time tracking that and the other contract pharmacies because there's
00:23:58.949 --> 00:23:59.729
different models, right?
00:23:59.729 --> 00:24:05.869
So you may use vendor one and they're a pay upon dispense or a pay upon 340B eligibility match.
00:24:06.069 --> 00:24:09.829
And vendor two is pay upon replenishment. And so from the accounting records,
00:24:09.989 --> 00:24:11.169
that makes it very difficult.
00:24:11.389 --> 00:24:16.429
And so I think there's a lot, and my opinion is skewed because I'm an accountant, right?
00:24:16.509 --> 00:24:21.209
So I see value there, but like learn how to track that and to post.
00:24:21.429 --> 00:24:24.929
And if you can help your finance team out with that because I guarantee that
00:24:24.929 --> 00:24:26.209
that's a struggle that they have.
00:24:26.209 --> 00:24:29.029
Yeah there's more value for you so I mean even
00:24:29.029 --> 00:24:32.049
if you think about your quality compliance legal like
00:24:32.049 --> 00:24:34.729
there's so many other things that play into it that i think that you can
00:24:34.729 --> 00:24:38.109
grow into 340b from those different you
00:24:38.109 --> 00:24:40.889
know ladders yeah there's there's so much
00:24:40.889 --> 00:24:44.229
opportunity to learn I'm still learning you know we we've been doing this
00:24:44.229 --> 00:24:48.449
for several years now and have a large network of clients that we work with
00:24:48.449 --> 00:24:52.589
but, you know, we learn stuff every day and so i think that's just an important
00:24:52.589 --> 00:24:58.189
life lesson don't stop learning always try to learn excel and you know control your own future.
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