UCI Health serves nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.
The only academic health system in Orange County, it is dedicated to the discovery of new medical frontiers, the teaching of future healers and the delivery of the finest evidence-based care. Its main campus, UCI Medical Center in Orange, is a 417-bed acute care hospital providing tertiary and quaternary care, ambulatory and specialty medical clinics, and behavioral health and rehabilitation units.
UCI Health features Orange County’s only federally designated comprehensive cancer center, high-risk perinatal/neonatal program, and verified Level I (adult) and Level II (pediatric) trauma center and regional burn center. It also boasts the county’s first Joint Commission-certified comprehensive stroke center.
About the 340B Program
UCI Health is eligible for the U.S. government’s 340B program – which requires pharmaceutical companies to supply outpatient drugs to qualifying healthcare organizations at significantly reduced prices – because it serves a disproportionate share of low-income Medicare and Medicaid patients.
In fiscal 2018, it provided $77.4 million in charity care and about $95.1 million in uncompensated care, largely to Medi-Cal and uninsured patients in accordance with the organization’s financial assistance policy. Since there is no county hospital, about 75 percent of UCI Health patients are insured by government payers. California has one of the lowest Medicaid provider reimbursement rates in the country, and the prices of specialty services are much higher than the reimbursement received.
As a result, UCI Health incurs uncompensated costs for cancer, trauma, burn, mental health, organ transplant and emergency care.
Direct and Indirect Benefits of the 340B Program
Serving communities in Orange County and adjacent regions is one of UCI Health’s highest priorities. It reassesses the health needs of these communities and adopts a strategy for meeting those needs at least once every three years.
Among the benefits provided by UCI Health:
- Colonoscopies that employ artificial intelligence
- Increased access to care for the medically underserved and improved community health through preventive practices via:
- Federally qualified health centers in Santa Ana and Anaheim that draw well over 100,000 visits per year
- A 39-foot-long mobile health clinic on wheels
- Primary care services, health screenings and vaccinations/immunizations targeted at the uninsured and underinsured
- Free and discounted healthcare services
- Otherwise financially nonviable clinical offerings such as organ transplant (kidney and pancreas), behavioral health, Level I (adult) and Level II (pediatric) trauma, burn and emergency services
- Perinatal, cancer, obesity and chronic disease support groups
- Lectures by internationally renowned subject-matter experts on groundbreaking research and disease outcomes
- Financial assistance for prescriptions and discharge prescriptions to avoid hospital readmissions
- Preventive care and mental health services, including meditation
- Fresh produce at the UC Irvine Family Health Center food pantry
- Transportation via taxi vouchers for needy patients
A few examples of UCI Health improving access and outcomes for patients:
- A 29-year-old man who experienced uncontrollable muscle contractions was able to get deep brain stimulation treatment to address his dystonia. A team of more than a dozen experts in the field gathered to review this case and perform the CT-guided surgery with the ROSA robot system in conjunction with the microelectrode recording device. After two procedures, the patient was able to walk with perfect posture while keeping his head still, ride a bicycle and play tennis – all activities that were previously not possible.
- Expansion of the kidney transplant program has allowed more patients to get the transplants they desperately need. The UCI Health nephrology team also supports peritoneal dialysis and hemodialysis, which help prolong the lives of people with kidney failure, including those waiting for a kidney donor or who aren’t candidates for transplantation. Surgeons, nephrologists, social workers, dietitians, pharmacists, nurse coordinators, data analysts, quality specialists and administrative staff all help to ensure improved outcomes and patient satisfaction.
- UCI Health’s SeniorHealth Center provides comprehensive care to over 3,500 patients via more than 10,000 annual visits. A multidisciplinary team of six physicians, a physician assistant, a nurse practitioner, clinical psychologists, a pharmacist, nurses, social workers and a health coach collaborate to address the holistic needs of seniors. The 360-Degree Caregiving Solution was developed to facilitate partnerships with patients and families and explore problems with accessing community resources, obtaining pharmacy refills, utilizing the UCI patient portal, etc.
Potential Impact of Scaling Back the 340B Program
UCI Health is a self-supporting institution that receives no operating funds from the state of California or the University of California system. It relies heavily on federally funded Medicaid DSH dollars and drug manufacturers 340B discounts to treat low-income, underserved patients suffering from the most acute medical conditions, regardless of their ability to pay.
The 340B benefits allow UCI Health to make otherwise financially nonviable clinical services available to vulnerable patient populations.
Savings from 340B benefits enable UCI Health to give Medicaid and uninsured patients access to medical facilities that provide lifesaving treatments for such illnesses as cancer, HIV, hepatitis C, asthma and kidney failure. Without these dollars, UCI Health would be forced to scale back its emergency medicine, trauma, mental health and cancer services.