Healthcare Leaders Explore Outpatient Reimbursement Strategies for Specialized Therapies

The University of California's Health Services Committee meeting on July 13, 2025, focused on critical discussions surrounding outpatient care reimbursement and potential partnerships with the state of California regarding pharmacy benefit management (PBM).

A significant portion of the meeting highlighted the strong reimbursement rates for outpatient therapies, particularly under the 340B program. Committee members noted that these reimbursements are essential for covering shortfalls in other areas of healthcare services. The discussion emphasized the importance of managing outpatient therapies effectively, especially for high-cost medications, such as those used in hemophilia treatment, which can exceed one million dollars. The committee underscored the need to maximize outpatient delivery to recover costs that are not reimbursed in inpatient settings.

Additionally, the committee explored the possibility of collaborating with the state of California on its existing PBM program. Members acknowledged that the state has established a well-designed program with significant rebates, which could provide substantial benefits if the university could align with it. The conversation indicated a strong interest in further exploring these opportunities to enhance financial sustainability and improve patient care.

In conclusion, the meeting underscored the importance of outpatient reimbursement strategies and the potential for strategic partnerships with state programs to optimize healthcare delivery and financial management within the University of California's health services. The committee plans to continue investigating these avenues to ensure effective patient care and financial viability.