Door County Medical Center | Wisconsin

The Value of the 340B Program Case Study

Who is Door County Medical Center?

Door County Medical Center (DCMC) has been serving the people of Door and Kewaunee counties in Wisconsin for more than 80 years. Through its critical access hospital, five rural health clinics, three rehabilitation centers and 175 physicians on staff, DCMC provides a wide range of services from primary care and general surgery to specialty care like obstetrics and gynecology, podiatry, orthopedics and behavioral health. Without Door County Medical Center, patients would lose local access to health care services, and some would need to travel over an hour away to access specialty care.

One of the hospital’s top priorities is to keep care local. To ensure its rural community can access the care it needs, DCMC entered a partnership with Hospital Sisters Health Systems (HSHS) in 2016. Through this partnership, DCMC has been able to increase patient access to care. For example, HSHS specialty physicians travel from Green Bay to Door County, so specialty care is accessible to patients closer to home.

Who Does Door County Medical Center Treat?

Door County Medical Center treats a wide range of patients, from local residents to the large tourist population that visits the peninsula over the summer. Located in the third-oldest county in Wisconsin by average resident age, a large proportion of DCMC’s patients are elderly and face unique health challenges that often require regular, and sometimes complex care. Approximately 62% of DCMC’s patients are insured by Medicare, and 7% are covered by Medicaid. 
 

“Birthing centers are important for rural communities 
and allow us to have a much more healthy, vibrant community. 
This program would absolutely go away  without 340B savings.”

Brian Stephens
Door County Medical Center CEO

What 340B Means to Door County 
Medical Center’s Rural Community

Door County Medical Center first began participating in the 340B Drug Pricing Program nearly 20 years ago when it qualified as a critical access hospital in 2006. Since that time, the program savings generated have had a tremendous impact on its community. DCMC identified two of the peninsula’s most pressing health care needs, access to birthing services and access to dental care, and used the hospital’s 340B savings to support programs that fill those gaps in care.

Birthing Center - Today, DCMC dedicates a significant amount of its 340B savings to operating its birthing center. In recent years, six birthing centers in Wisconsin have closed due to financial instability. Given DCMC’s isolated location on a peninsula, residents living on the northern end would be forced to drive two hours to Green Bay to give birth if it weren’t for the DCMC local birthing center. With just 120 births each year, DCMC loses roughly $1 million annually and would be forced to close its birthing center due to low volume without the financial support from the 340B program. This vital federal benefit has enabled DCMC to recruit OB-GYNs, support nurses’ training and retention and establish a teleNICU in partnership with HSHS to care for newborns that need additional specialized care.

Local Dental Clinic -Throughout Wisconsin, most dentists do not treat patients who are uninsured or underinsured. This resulted in many patients landing in DCMC’s emergency department with painful and expensive dental issues. To prevent these emergent situations and ensure all patients could access timely dental care — regardless of their ability to pay — DCMC established a local dental clinic and hired its own dentists, all funded by 340B savings. Today, the dental clinic has transitioned under the stewardship of a local Federally Qualified Health Center, and DCMC remains proud of the role it played in establishing local access to dental services for patients without insurance or with Medicaid.

340B Hospitals Need Support

The 340B program is critical to rural and critical access hospitals like Door County Medical Center. The savings generated have allowed DCMC to increase patient access to affordable, high-quality care. But, unfortunately, an increasing number of restrictions imposed by drug companies are burdening hospitals and have resulted in negative impacts on patients. For example, in Door County, a large retail pharmacy recently notified the hospital that it will not participate in the Health Resources and Services Administration’s new 340B Rebate Model Pilot Program, a decision that could wipe out approximately $600,000 in savings for DCMC to provide care to its patients.

Despite facing worker shortages, Door County Medical Center has now dedicated an employee solely to ensuring compliance with all the changing drug company restrictions and contracts. In addition, DCMC has had to expend its limited resources to retain a legal firm to provide recourse when there are changes to the 340B program, placing significant financial and administrative burdens on this small, rural hospital.

The 340B program costs taxpayers zero dollars but has an enormous positive impact on improving care in America’s rural and vulnerable communities. The federal government must reject efforts by drug companies to weaken the 340B program. It’s crucial that lawmakers protect the 340B program so our nation’s most at-risk patients and communities can maintain access to the care they need as Congress intended.