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A new report accuses 340B hospitals of spending less on charity care than non-participating hospitals, despite receiving steep drug discounts. The analysis from the Pioneer Institute and CancerCare found 340B hospitals spent 2.16% of operating expenses on charity care vs. 2.82% at non-340B hospitals. The findings arrive as lawmakers and the Trump administration push for major reforms to the controversial drug discount program.
340B hospitals are giving back less — at least when it comes to charity care
A new report from the Pioneer Institute and CancerCare is putting 340B hospitals under scrutiny, finding that they spend significantly less on charity care than their non-participating counterparts — despite pocketing steep discounts on drug purchases. The analysis, which used CMS cost data from Q1 2025, compared thousands of hospitals and called for greater transparency, auditable reporting of 340B revenue, and a requirement that 340B hospitals provide more charity care than non-340B hospitals.
Hospitals are pushing back. The American Hospital Association called it "another in a long line of misleading studies," arguing that 340B savings fund a wide range of community benefits — from behavioral health clinics to food banks — that charity care metrics alone don't capture. By AHA's own count, 340B hospitals have delivered nearly $100 billion in total community benefits.
By the Numbers
Why it matters: The 340B program is under mounting scrutiny from both parties, with multiple legislative proposals and HHS reform efforts already in motion. This report adds fresh momentum to calls for greater accountability — and could accelerate reforms that reshape how safety-net hospitals operate and serve vulnerable patients.
