Avanti340B What If Series: Rethinking 340B Reviews
Why Regular Accumulator Checks Are Key to Strengthening 340B Program Oversight
Introduction
In our world of 340B compliance, we frequently receive questions around the sufficiency of a team’s annual audit scope. Transaction testing just isn’t enough—particularly if you are seeing issues with your split billing software, which controls all purchasing. What if your team could proactively address accumulator issues before they lead to costly errors or lost savings?
This “What If” scenario explores how one hospital, previously limiting external oversight to annual contract pharmacy audits, dramatically improved its 340B performance by subscribing to Avanti340B, Rx|X’s quarterly review service. With quarterly evaluations in place, the hospital reduced errors, mitigated compliance risk, and strengthened its overall program integrity.
Background
For many years, this covered entity’s internal monitoring plan included testing a high number of transactions each month, but lacked a formalized process to audit its mixed-use accumulator—the core engine driving 340B purchasing decisions. Perhaps they investigated certain accumulations, but not routinely or comprehensively. As a result, compliance gaps persisted, undetected until annual audits revealed significant errors. Each year brought operational disruptions, and missed savings opportunities.
Despite internal efforts, the organization remained in a reactive cycle—identifying problems only after they had financial and compliance consequences. Leadership recognized the need for a proactive approach that would allow for early detection, correction, and long-term improvement.
Exploring the Solution
Through Avanti340B, Rx|X delivers a fully managed, quarterly data review platform tailored to the unique complexities of 340B programs with an independent perspective. Avanti340B serves as an internal auditing engine, helping organizations regularly assess performance, monitor third-party administrator (TPA) accuracy, and maintain program integrity. In summary, Avanti340B complements and enhances the work of TPAs by offering a robust, independent layer of oversight, actionable insights, and an ongoing auditing framework.
Core features include:
Data validation and reconciliation
Exception reporting to flag discrepancies and risks
Comprehensive audit trails to support defensible compliance documentation
These insights provide covered entities with a clear, actionable view of their 340B program performance—empowering them to stay ahead of potential issues and reduce the burden of annual audits.
Program Impact
By adopting Avanti340B, the covered entity shifted from a reactive to a proactive compliance model. Rather than scrambling to prepare for a once-a-year audit, the organization submitted data to Rx|X on a quarterly basis. Rx|X handled the analysis, flagged concerns early, and provided actionable feedback—allowing the hospital to make timely corrections throughout the year.
The outcome was transformative:
Significantly improved audit performance
Reduced financial impact.
Increased operational confidence and compliance assurance
Conclusion
Avanti340B enhances the oversight and accountability of TPAs while providing a robust, independent layer of program monitoring. By moving to quarterly reviews, covered entities gain the ability to identify issues early, stay audit-ready year-round, and continuously strengthen their 340B programs.
What if your team could experience the same results? With Avanti340B, that future is not only possible—it’s within reach.