Survey finds nearly one in four 340B dollars invested in rural care, helping keep health centers open and expand telehealth, mobile, and school-based services
Washington, D.C. — A new research brief released today by Advocates for Community Health (ACH) finds that the majority of the nation’s largest community health centers rely on savings from the federal 340B Drug Pricing Program to maintain and expand access to care for rural patients facing significant access challenges.
The ongoing survey, conducted over the past several months among ACH member organizations, so far includes responses from 28 large community health centers operating across 23 states, Puerto Rico, and the District of Columbia and collectively serving millions of patients. The findings confirm that health centers reinvest every dollar of 340B savings back into patient care, often in ways that are essential to sustaining health care access in rural communities.
“Our research shows clearly that the 340B program is a lifeline for rural patients,” said Amanda Pears Kelly, CEO of Advocates for Community Health. “These savings are not abstract, and they translate directly into open health center doors, accessible telehealth services, transportation support, and care delivered where patients live, learn, and work.”
Key Findings
The survey revealed that, on average, nearly one-quarter of all 340B savings are directed toward services for rural patients with access challenges. In total, 77 percent of ACH respondents reported using 340B savings to support rural health services, with five health centers allocating more than 70 percent of their savings specifically to rural care.
The most common rural-focused uses of 340B savings include:
- Maintaining clinic sites that would otherwise not be financially viable (95%)
- Providing telehealth services (95%)
- Operating mobile access clinics (90%)
- Offering transportation assistance (90%)
- Supporting school-based clinics (86%)
Beyond rural care, health centers also invest 340B savings in chronic disease management and prevention, capital improvements to support care delivery, and specialty and behavioral health services—investments that improve health outcomes and strengthen local health care infrastructure.
“These are services with a proven impact,” the brief notes. Telehealth, for example, has been shown to improve access to specialty care for rural patients, while mobile clinics and transportation services help reduce missed appointments and prevent worsening health outcomes.
The brief also warns that ongoing erosion of the 340B program, including the forthcoming 340B Rebate Model Pilot Program, poses a serious threat to rural health care access. Increased financial and administrative burdens, combined with anticipated Medicaid changes, rising insurance costs, and stagnant federal funding for community health centers, could destabilize the safety net many rural communities rely on.
“Without 340B, many of these services—and in some cases entire rural health center sites—would be at risk,” the brief concludes. “The consequences for rural patients would be severe.”
ACH calls for strengthening and protecting the 340B Drug Pricing Program to ensure community health centers can continue providing essential, preventive, and life-saving care to rural and underserved populations nationwide.
The survey remains open to all community health centers through the end of the first quarter of 2026. To learn more, please contact Molly Grady, ACH’s Director of Policy & Government Affairs at mgrady@advocatesforcommunityhealth.org.
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About Advocates for Community Health (ACH)
Established in 2021, Advocates for Community Health (ACH) is a nonpartisan, nonprofit membership organization of community health centers dedicated to forward-thinking and ambitious federal policy and advocacy on behalf of health centers, their patients, and their communities. To learn more, visit advocatesforcommunityhealth.org.