A Strategic Collaboration for Sustained 340B Success at Benefis Health System
Benefis Health System is a nonprofit healthcare organization based in Great Falls, Montana, committed to delivering high-quality care across a broad and often underserved region. Since its founding in the mid-1990s, the system has grown to include a 220-bed hospital, multiple outpatient clinics, and two Critical Access Hospitals (CAHs).
Despite its reach and impact, Benefis faces the resource constraints and staffing challenges common to rural health systems. This is particularly impactful in specialized areas like 340B program management. When internal expertise became difficult to replace, Benefis turned to Visante for support. This was the start of a partnership that would grow far beyond a temporary solution.
The Challenge: A Staffing Crisis Meets Compliance Complexity
In 2021, Benefis faced a significant staffing disruption when both of its 340B analysts left within a year. The organization was left without the specialized knowledge required to sustain a successful 340B program. Due to the niche expertise involved and the broader pharmacy staffing crisis during the pandemic, Benefis struggled to recruit qualified replacements.
“Considering the breadth and complexity of our program and its importance to the organization and our patients – it was a stressful time. I decided I needed to think outside the box and came across Visante. I distinctly remember my first conversation with Kristin and thinking ‘Wow, this person really knows her stuff, and the 340B program top to bottom.’ She explained how Visante would comprehensively support our needs. It was a moment of relief, and excitement about the potential of our program with Visante as our partner,” said Jamie Leonard, Director of Pharmacy at Benefis Health System.
The Solution: A Partnership for Customized & Attentive 340B Expertise
Benefis connected with Visante for a six-month partnership. Just eight weeks in, the urgency of a HRSA audit and the growing complexity of program compliance confirmed that this collaboration was crucial for the program’s long-term success.
The Visante team went beyond filling a staffing gap. Instead, we became a fully integrated extension of Benefis’ 340B operations, shifting from a temporary solution to a long-term strategic partner. What began as a six-month engagement grew into a four-year collaboration centered on operational excellence, program sustainability, and forward-thinking compliance strategy.
Visante’s 340B Solutions for Benefis’ Challenges
Visante addressed immediate compliance concerns and long-term program goals through:
1. HRSA Audit Support
Just weeks after engaging Visante, Benefis received a HRSA audit notice. Given the recent staffing changes and limited internal experience with the audit process, this could have significantly disrupted operations.
Visante immediately stepped in to provide comprehensive support by reviewing critical documentation, facilitating mock Q&A sessions, and preparing the team for the complexities of the audit. This proactive approach resulted in minimal findings and gave Benefis the confidence to navigate the process successfully.
“They recognized that had we not been involved, they would have been in a really difficult spot to try and support a HRSA audit,” shared Tracy Smith, Senior Consultant at Visante.
2. EMR Consolidation
Visante played a critical role in transitioning Benefis from five disparate electronic medical records (EMRs) to a single Epic system. Acting as a liaison between Benefis IT, Epic analysts, pharmacy operations, and third-party administrators (TPAs), Visante helped ensure that data integrations and workflows were optimized for 340B compliance.
The team identified and resolved legacy data issues, including significant National Drug Code (NDC) billing mismatches. Visante invested more than 120 hours in matching and correcting NDC records within the Charge Description Master (CDM), ultimately strengthening downstream data flow, improving compliance, and enhancing revenue integrity.
3. TPA Implementation & Transition
As Benefis worked through its EMR conversion, Visante simultaneously guided the onboarding of a new third-party administrator (TPA) for both CAHs. Coordinating a TPA transition during such a major system overhaul introduced additional complexity, but Visante ensured alignment across teams and timelines.
We identified a key issue: the previous TPA continued qualifying claims even after its contract had ended. Visante worked with the covered entity, the TPA, and legal stakeholders to quantify the impact and determine an appropriate course of remediation. This attention to detail helped protect Benefis from compliance risk during a vulnerable period.
4. Medicaid Carve-In Optimization
Visante led Benefis through the transition from Medicaid carve-out to carve-in, a complex shift involving both federal and Montana-specific requirements. The team collaborated with IT, Revenue Cycle, and Epic teams to ensure correct billing practices and compliance. Financial modeling and proactive planning contributed to a measurable reduction in Wholesale Acquisition Cost (WAC) spend, which refers to the full price paid for medications when 340B discounts are not applied.
“We’ve done carve-ins in almost every state. We know how to guide the process and deliver real savings,” said Gene Harber, Program Director at Visante.
5. ESP & Manufacturer Restriction Management
To help Benefis navigate evolving manufacturer restrictions, Visante evaluated ESP claim submission value, managed designations, and developed a dashboard to monitor ongoing impact. The team also submitted retrospective ESP data, helping recover previously lost revenue.
6. Cyberattack Recovery
In the wake of the Change Healthcare cyberattack, Visante quickly developed interim manual upload workflows using Epic Willow Ambulatory data. This solution allowed Benefis to continue qualifying 340B claims and maintain program integrity.
7. WAC Spend Reduction
Visante established weekly purchasing reviews with the Benefis team to track trends, flag non-compliant WAC purchases, and adjust workflows accordingly. These targeted strategies led to consistent year-over-year reductions.
“There are so many outside influences that impact the 340B program and most of them are outside your control. Having a partner like Visante helps you stay steady through it all,” Tracy Smith explained.
Results: Stronger Compliance, More Confidence, and Financial Wins
Through close collaboration and a deep understanding of 340B program dynamics, Visante helped Benefis achieve measurable improvements in revenue, compliance, and long-term program sustainability.
Together, we expanded specialty pharmacy services to offset federal revenue constraints, minimized audit findings during periods of significant transition, and increased overall resilience by embedding strategic external support.
- 2021: Increased contract pharmacy revenue by 20%
- 2022: Increased contract pharmacy revenue by 7% and decreased WAC spend by 3%
- 2023: Increased contract pharmacy revenue by 24% and decreased WAC spend by 3% through retrospective ESP submissions
- 2024: Increased contract pharmacy revenue by 3% and decreased WAC spend by 13% by identifying optimization opportunities and transitioning to carve-in on 10/1/2024
Benefis demonstrates the value of embedding specialized expertise into complex pharmacy operations. By trusting Visante to lead through change—HRSA audits, EMR conversions, cyberattacks, and carve-in transitions—they gained operational continuity and strategic growth.
“I strive to operate our 340B program in a proactive way by constantly looking for optimization opportunities to offset all the headwinds we’ve been facing. Visante not only brings expertise and experience, the team has been open minded and responsive to my ideas and requests, while at the same time ensuring compliance as the top priority. As we tackled the big challenges mentioned above, my Visante team consistently supported us, and dug in and did the work with full ownership of our program success. I’m continually impressed and grateful,” shared Jamie Leonard
Building a Stronger 340B Program Takes the Right Partner
From staffing shortages to a complex EMR transition, Benefis Health System faced multiple challenges that could have jeopardized the integrity of its 340B program. Rather than take a short-term approach, Benefis chose to invest in a strategic partnership with Visante. Through four years of collaboration, the organization not only maintained compliance under pressure but also strengthened operations, optimized financial performance, and positioned its 340B program for long-term sustainability.
If your organization is facing 340B complexity, Visante can help you build a program that’s resilient, compliant, and ready for what’s next. Contact us today to explore how we can support your 340B strategy!