Program Maximization

Program expansion may include a review of your contract pharmacy network and exploring additional revenue opportunities such as referrals, specialty pharmacy options, and split bill additions.

We review your current program to identify growth opportunities, including referrals, specialty pharmacy partnerships, and split-bill additions. We also evaluate TPA configurations to ensure they are optimized. Our goal is to maximize savings and revenue while maintaining full compliance.

Benchmarking, Restructuring, and Transitioning 340B TPA Relationships

Across multiple engagements, ACI has helped hospitals evaluate and optimize their third-party administrator (TPA) relationships to improve financial performance, reduce unnecessary administrative costs, and better align contracts with market standards.

The Challenge

In one instance, a hospital had been with the same 340B TPA for several years without benchmarking its contract. In another, a health system was operating under an outdated TPA structure with elevated administrative fees and limited contractual protections.

Across both situations, common challenges included:

• Lack of recent market benchmarking for TPA fees and terms
• Administrative costs above market benchmarks
• Limited performance protections within existing contracts
• Suboptimal net 340B program performance

Our Approach

ACI conducted a vendor-neutral review of each organization’s TPA structure, focusing on both financial and operational performance. This included:

• Benchmarking administrative fees and contract terms against market standards
• Evaluating TPA performance, structure, and alignment with program goals
• Identifying opportunities for cost reduction and contract improvement
• Supporting seamless transitions to better-aligned TPA partners when appropriate
• Ensuring continuity of program operations throughout any changes

ACI’s established relationships across the 340B TPA landscape enabled efficient evaluation and transition processes without disruption to program operations.

The Outcome

Across these engagements:

• One organization reduced annual TPA administrative fees from $116,000 to $12,000 (nearly 90% reduction)
• Another increased average monthly 340B revenue from $65,000 to $137,000 following a TPA transition
• Both organizations improved overall program efficiency and financial performance without operational disruption

The ACI Difference

ACI takes a vendor-neutral, data-driven approach to evaluating and optimizing TPA relationships. By combining market benchmarking with deep operational expertise and established industry relationships, ACI helps covered entities ensure their TPA structures are aligned with both current market standards and long-term program goals.