Heath Veuleman, a Healthcare Strategist for Seersucker Strategies, has expressed concerns about various hospital cost centers, including 340B profits, facility fees, provider taxes, and higher site-based Medicare payments. He said that these elements contribute to inflated prices for patients and taxpayers – an issue garnering attention in New York. This statement was made on the social media platform X.
“This year hospitals and health systems will make ~$100B on 340B,” said Veuleman. “A program that’s supposed to save patients money, yet somehow only pads health system CEO pockets. In any other industry, we’d call this money laundering. You’re being taken advantage of by the biggest group of goobers, gomers, and grifters in the entire world.”
According to KFF, policy debates in Washington are currently centered around the three key areas Veuleman flagged: site-neutral payment, 340B oversight, and Medicaid financing through provider taxes. It notes that nearly every state in the U.S., except Alaska, utilizes provider taxes to help finance Medicaid. Federal rules cap these taxes, and Congress periodically considers tightening them, highlighting why these mechanisms are presently under scrutiny.
Milliman’s July 2025 analysis indicates that outpatient drug spending at 340B Disproportionate Share Hospitals (DSH) is significantly higher per patient compared to non-340B DSH hospitals. In Medicare Fee-for-Service (FFS) in 2022, the average outpatient drug spend per hospital patient was $961 at 340B DSH hospitals versus $360 at non-340B DSH hospitals, a difference of approximately 2.7 times. The study primarily attributes this gap to a more expensive drug mix in 340B settings and notes that this pattern persists even after controlling for observable patient factors and service categories.
In New York, 113 hospitals participate in 340B and maintain more than 6,100 contracts with pharmacies nationwide, yet only 24% of those contract pharmacies are in medically underserved areas and 86% of 340B hospitals deliver charity-care levels below the national average. New York Medicaid policy now requires 340B-purchased drugs billed to Medicaid to be claimed at actual acquisition cost with explicit 340B identifiers, reflecting growing concern over transparency and whether program dollars are truly easing prescription costs for low-income New Yorkers.
Veuleman is characterized by Seersucker Strategies as an expert in healthcare delivery and financing with over two decades of experience in hospital administration. He advises governments, corporations, and providers on consumer-centric care and reimbursement models. His expertise lies in policy development, compliance issues, and practice design—experience pertinent to evaluating payment incentives and cost structures.
