340B prime vendor program: Health center decision making and barriers to participation

This study addresses why approximately 40% of Federally Qualified Health Centers (health centers) do not participate in the Prime Vendor discount prescription drug program despite being available to health centers at no cost. The Prime Vendor Program (PVP) reduces the cost of outpatient prescription drugs for health centers, provides discounts on other drugs and medical devices, and supports health centers with technical assistance in implementing the program. Health centers are ambulatory care clinics that provide primary care to vulnerable populations in medically underserved areas throughout the country. Given the medical needs of health center patients, the difficult financial situation of many health centers, and the apparent cost savings provided by the program, it seems logical that more health centers would choose to participate in the program. Using both quantitative and qualitative analyses, this study examines the characteristics of health centers that do and do not choose to participate in the program, and the decision making factors considered by health center executives when determining whether or not to participate in the program. The quantitative portion of the uses logistic regression to identify the differences in health centers that do and do not participate in the program. The qualitative portion uses a single-state, multi-site case study of health centers in Vermont to uncover the rationale used by health center executives in their decision making regarding participation in the PVP. Strategic choice is the theoretical framework used to evaluate health center decision making regarding participation in the PVP