340B hospitals could face a significant hit to drug revenue next year. Under CMS' proposed 2027 outpatient payment rule, Medicare would cut reimbursement for provider-administered 340B drugs by roughly 37%, beginning Jan. 1, 2027. The change would significantly reduce the margin 340B-covered hospitals earn on these drugs. Although Medicare is simultaneously increasing reimbursement for non-drug services, covered entities with high Medicare infusion volumes will likely see their total reimbursement decline.

While the proposal could change when CMS issues its final rule, the capabilities needed to prepare are smart moves regardless of the outcome. Health systems that take steps to strengthen their drug purchasing, management, and site-of-care strategies will be better positioned for what is shaping up to be a challenging reimbursement and policy environment.

Here are five actions leaders should prioritize, along with tools and case studies to help put them into practice.