340B Referral Capture Services

Maximize 340B Savings with Compliant, Custom Referral Capture – Empowering Health Centers and Hospitals. As a healthcare leader – whether you’re an FQHC executive, a hospital compliance officer, or a pharmacy director – you know every eligible prescription in the 340B Drug Pricing Program is an opportunity to stretch resources and serve patients better. 340B referral capture is the key to unlocking those extra savings by capturing prescriptions from referred care while staying audit‐ready and patient‑focused. Cooper Strategy’s expert services help you implement a tailored, compliant, and patient-centered 340B referral capture program that boosts revenue and reinforces quality care.

With decades of 340B experience and a team of certified experts (including 340B ACEs, PharmDs, and MBAs), Cooper Strategy delivers the finest 340B referral capture assistance in the industry. We combine deep regulatory knowledge, cutting-edge technology, and hands-on support to ensure your referral capture program not only maximizes savings but also upholds the highest standards of compliance and care. Learn how our customizable solutions and compliance expertise can transform your 340B program. Contact Cooper Strategy today to discuss a referral capture strategy tailored to your organization’s needs.

Contact us to learn how we can maximize your 340B Referral Capture strategy» cooperstrategy.com

What is 340B Referral Capture?

340B referral capture refers to the practice of identifying and documenting outpatient prescription claims that result from a patient referral by a 340B-covered entity’s provider to an external specialist or clinic. In simpler terms, when one of your patients is referred to an outside specialist who then prescribes medication, your organization can potentially “capture” that prescription under your 340B program – provided the patient meets all 340B eligibility criteria and the care relationship is properly documented. This allows the prescription to be filled at 340B discounted prices even though the prescriber is outside your entity.

For example, imagine a patient from your health center is referred to an external cardiologist. The cardiologist evaluates the patient and prescribes a medication for a chronic condition. If your health center maintains an established relationship with that patient and documents the referral and care appropriately, that prescription can be filled through your 340B contract pharmacy at the discounted price – yielding significant savings. Referral capture extends the reach of your 340B benefits beyond direct in-house visits, ensuring patients get affordable medications throughout their care journey while your organization gains additional resources to reinvest in care.

Why 340B Referral Capture Matters

Maximizing Program Benefits: Referral capture allows covered entities to capture prescriptions that would otherwise be missed, thereby increasing 340B savings and revenue. Many covered entities find that a substantial portion of their 340B opportunity comes from referrals – in fact, up to 25–35% of a typical 340B contract pharmacy’s potential volume lies in referral prescriptions. By implementing a robust referral capture program, health centers can significantly boost their savings. One industry analysis found each captured referral prescription can generate an average of $400 in additional savings for the covered entity. These reclaimed dollars directly bolster your capacity to fund patient services and expand programs.

Holistic Patient Care: Patients often receive care from multiple providers. Referral capture helps tie together the patient’s care continuum, so no matter where a patient goes – specialist visits, urgent care, etc. – your organization remains in the loop. By documenting external visits and prescriptions, you ensure better continuity of care and medication management. Providers at your clinic gain visibility into treatments patients receive elsewhere, which helps prevent duplication, catch potential drug interactions, and inform follow-up care. In short, referral capture supports more coordinated, patient-centered care instead of fragmented care silos.

Financial Sustainability for Safety-Net Providers: Every prescription captured is additional revenue (via 340B savings) that can be reinvested into services for underserved populations. For many FQHCs and rural hospitals, margins are thin – referral capture can be the difference that keeps a pharmacy program financially viable. By extending 340B discounts to eligible referrals, covered entities increase their savings and stretch their 340B dollars further, supporting expansion of clinical programs, staffing, and patient outreach. Especially after the COVID-19 pandemic, optimizing revenue through referral capture has proven crucial – centers leveraging referral capture have reported double-digit percentage increases in total 340B revenue. These funds go right back into patient care, aligning with the 340B program’s mission.

Compliance and Risk Mitigation: Why haven’t all covered entities embraced referral capture already? The answer lies in compliance complexity. The Health Resources and Services Administration (HRSA) has not explicitly detailed referral capture in its guidelines, apart from the requirement that a 340B patient must have an ongoing relationship with the covered entity and that the entity is responsible for the patient’s care. This ambiguity means many organizations fear the audit risks of doing referral capture incorrectly. However, with the right processes, referral capture can be done fully compliantly, turning a potential risk into a reward. A well-run referral capture program actually reduces audit risk by ensuring complete documentation of the patient’s care continuum. It demonstrates that your covered entity is monitoring referred care and upholding responsibility for patient outcomes. In fact, some organizations that initially hesitated have found that compliant referral capture not only boosts revenue but also improves their overall documentation practices, leaving them better prepared for HRSA or manufacturer audits than before.

Bottom line: 340B referral capture is important because it expands the impact of the 340B program – more savings, more comprehensive patient care, and stronger financial footing – as long as it’s done right. That’s where Cooper Strategy’s expertise becomes invaluable.

Challenges in 340B Referral Capture for Covered Entities

Implementing referral capture is rewarding, but it comes with unique challenges that must be navigated carefully. Healthcare organizations often encounter:

• Documentation Gaps: Referral scenarios often involve external providers and disparate systems. Critical details – like referral records, specialist visit notes, or prescription documentation – can slip through the cracks when multiple EHR systems or providers are involved. If the documentation linking the referral to the prescription is incomplete, that prescription might not qualify for 340B or could be flagged in an audit. These gaps are common when health centers rely on manual processes or ad-hoc communication to chase down consult notes.
• Data Sharing Hurdles: Technical and privacy barriers can impede seamless data exchange between your covered entity and external partners. For example, the specialist’s clinic might not automatically share visit notes or e-prescriptions back to you. Integrating different EHR systems or getting access to health information exchange (HIE) data is complex. Legal considerations (HIPAA) and technical incompatibilities can make it challenging to obtain the documentation needed for referral capture. Without a reliable data sharing mechanism, referral capture becomes a labor-intensive process of phone calls and faxes – or it fails altogether.
• Regulatory Ambiguity: As noted, HRSA’s patient definition guidelines leave a gray area around referrals. Covered entities struggle with questions like: How to define “continuity of care” for a referral? What documentation is enough to prove the patient remained under our care? Different entities may interpret the guidance differently, creating variability and uncertainty. This ambiguity can make compliance officers nervous about capturing referral prescriptions at all, for fear of unintentionally violating program rules.
• Variable Interpretation and Policies: Even among covered entities that attempt referral capture, internal policies can vary widely. Some may be too conservative (missing legitimate opportunities), while others may be too loose (inviting compliance risk). Achieving the right balance in policy – and keeping it updated as rules evolve – is a challenge without expert guidance.
• Audit Vulnerability: Perhaps the biggest concern is the risk of adverse audit findings. Incomplete or inconsistent referral records are a red flag in HRSA audits. There have been instances where covered entities had to repay manufacturers for prescriptions deemed ineligible due to insufficient documentation of the referral relationship. The prospect of program penalties or disqualification is daunting. For organizations already operating with thin margins, an audit payback can wipe out the very savings the 340B program provides.

These challenges explain why some covered entities have hesitated to pursue referral capture aggressively. However, each challenge can be overcome with the right strategies and tools. Cooper Strategy specializes in turning these challenges into strengths, helping you implement referral capture in a way that is efficient, compliant, and audit-ready from day one.

(Worried about documentation or compliance hurdles in your referral capture process? Contact Cooper Strategy for a free consultation to learn how we help address these challenges head-on – reach out now at our Contact Us page!)

Cooper Strategy’s Custom 340B Referral Capture Solutions

Cooper Strategy brings unparalleled expertise and a comprehensive toolkit to help covered entities design, implement, and refine their 340B referral capture programs. We understand that one size does not fit all – every health center or hospital has unique workflows, patient populations, and partnerships. That’s why we tailor our services to your needs while ensuring industry best practices are embedded at every step. Our approach is grounded in compliance, technology, and a patient-first ethos, setting us apart as a leader in referral capture support. Here’s how Cooper Strategy helps you succeed:

• Customized Program Design: We collaborate closely with your team to develop referral capture policies and procedures that fit your organization’s workflow and clinical relationships. Cooper Strategy does not force a cookie-cutter template on you – instead, we analyze your current referral patterns, EHR capabilities, and staffing to build a program that works in your context. From defining what constitutes an eligible “340B referral” in your setting, to outlining step-by-step procedures for documentation, we ensure you have a clear, written roadmap. The result is a program that is both maximally effective and comfortable for your providers and staff to follow. When your referral capture process is clearly defined and tailored to you, it’s much easier to execute and defend in an audit.
• Workflow Integration & Training: Successful referral capture needs to happen without disrupting clinical workflows. Our experts help integrate referral capture into your everyday systems – especially your EHR. We design and implement solutions like EHR templates, checklists, and automated prompts that guide your providers and referral coordinators to capture all needed information at the point of care. For example, we can introduce a pop-up checklist when a provider makes an external referral, reminding them to include key details or flagging the patient as 340B-eligible. These in-system nudges standardize documentation and close the loop on referrals that would otherwise be forgotten. Alongside technology integration, Cooper Strategy provides comprehensive staff training. We conduct onboarding sessions and regular quarterly trainings for clinicians, pharmacists, and administrators so everyone understands the how and why of the referral capture process. By teaching best practices (like how to document an outside consult note, or how to verify 340B patient eligibility), we create organization-wide alignment. Your staff will know exactly what to do, and more importantly, they’ll understand how referral capture ultimately helps your patients – not just your bottom line.
• Data Integration & Secure Information Exchange: One of the hardest parts of referral capture is getting the data from external providers and pharmacies. Cooper Strategy addresses this by setting up secure, HIPAA-compliant data interfaces with your key partners. We are one of the few firms that can help your organization connect with all major pharmacies and third-party administrators (TPAs) nationwide. Through our proprietary platform, we enable two-way data sharing between your EHR, contract pharmacies (e.g. Walgreens, CVS, Walmart, regional chains), and even Health Information Exchange (HIE) networks. This means your 340B program can automatically receive information like prescription fill data, specialist visit records, and more. Our technology incorporates significantly more provider and patient data than any other referral capture solution, giving you a complete picture of each referral case. Crucially, all data exchange is done with robust privacy and security controls. We implement strict data governance and encryption standards so that patient information remains protected at every step. By knitting together these data sources, Cooper Strategy eliminates the blind spots in your referral capture program – no more chasing paper trails or missing documentation. Instead, you get a seamless flow of information that supports both compliance and continuity of care.
• Continuous Compliance Monitoring & Audit Readiness: When it comes to 340B, staying audit-ready is just as important as capturing revenue. Cooper Strategy helps you build a referral capture program that can withstand the closest scrutiny. We start by ensuring your policies and documentation meet HRSA’s expectations for 340B compliance, interpreting any gray areas in a defensible way. But we don’t stop there – we embed compliance checks into the ongoing operations. For instance, we deploy AI-powered dashboards and self-auditing tools that continuously monitor your referral claims. These tools will flag any referral prescriptions that might be missing documentation or don’t align with your defined policy, before they become a problem. Think of it as a real-time compliance auditor looking over your shoulder to catch errors early. Additionally, Cooper Strategy conducts periodic mock audits and documentation reviews for our clients. We’ll walk through your referral files just as a HRSA auditor would, so you can be confident everything is in order. If there’s ever a HRSA or manufacturer audit of your 340B program, Cooper Strategy stands by your side – we offer direct support during audits, including preparing the necessary evidence packets, addressing auditor questions, and guiding you through the process. Our team has over 50 years of combined audit experience and a perfect track record of zero adverse findings across all covered entity types. With Cooper’s compliance-first approach, you can pursue referral capture opportunities knowing that your program is airtight and defensible.
• Advanced Analytics & AI Technology: Cooper Strategy leverages the latest healthcare analytics, artificial intelligence (AI), and machine learning to supercharge your referral capture results. Our upgraded platform uses AI to analyze vast amounts of data and identify referral opportunities that others miss. For example, our algorithms can scan “ineligible” pharmacy claims to find instances where a referral prescription was incorrectly filtered out, then help reclassify it as eligible – recovering savings that would have been lost. We also employ sophisticated matching algorithms to connect the dots between referral records and prescription fills across systems. This reduces manual work and improves accuracy. AI-driven trend dashboards give you insights into your referral patterns: which clinics or providers are generating the most referral prescriptions, where documentation tends to lag, and how capture rates are improving over time. These analytics help your leadership make data-driven decisions – for instance, to focus training on certain departments or to adjust referral workflows for better outcomes. By continuously learning from your data, our platform optimizes performance over time. The bottom line is more eligible prescriptions captured, faster, with technology doing the heavy lifting. And unlike some one-size-fits-all software, our solution is configured to respect your specific referral policies and business rules, so the AI’s recommendations are always aligned with your compliance parameters.
• Patient-Centered and Ethical Approach: At Cooper Strategy, we never lose sight of the patient. We understand that the 340B program’s ultimate goal is to improve care for vulnerable populations. Our referral capture strategies are designed to enhance patient care, not just boost numbers. What does that mean in practice? It means we ensure referrals are always made for the right clinical reasons, and that capturing a referral prescription is a byproduct of good care coordination – never a driver for inappropriate referrals. We help you implement patient consent and communication processes so that patients are informed about how their information is used and how they can benefit (for instance, lower medication costs or better follow-up from their primary provider). Cooper Strategy also introduces the concept of a comprehensive patient care summary for referred patients. We aggregate data from various sources (specialist notes, pharmacy fills, lab results) into a single care summary document that can be uploaded to your EHR. This summary gives your providers a 360° view of the patient’s journey outside your walls – improving clinical decisions and enabling true continuity of care. By integrating these care summaries, we turn a compliance artifact into a clinical asset: your team can avoid duplicative tests, catch medication issues, and better support the patient’s needs. The result is improved patient outcomes and satisfaction, as documented in one client case where enhanced referral tracking led to higher patient satisfaction due to better care coordination. Cooper Strategy’s ethos is compliance and profit never come at the expense of patient well-being. Instead, we show you how a well-run referral capture program can empower patients – giving them more affordable access to medications and a more coordinated healthcare experience, truly fulfilling the 340B program’s mission.

In summary, Cooper Strategy offers an end-to-end referral capture solution: from initial strategy and policy design, through technology implementation and staff training, to ongoing monitoring and support. We don’t just hand you a software tool or a generic policy and walk away – we partner with you every step of the journey to ensure sustained success. Our services are fully customizable: whether you need a turnkey referral capture program built from scratch, or targeted help to fix gaps in your current process, we will meet you where you are. With Cooper’s blend of expert consulting and powerful technology, you’ll transform referral capture from a daunting challenge into a streamlined, revenue-generating, and compliance-confident operation.

(Ready to strengthen your referral capture process with a partner that offers custom solutions and proven expertise? Contact Cooper Strategy to schedule a consultation and see how we can optimize your 340B program – reach out here ➜ cooperstrategy.com/contact-us/.)

Best Practices for Effective 340B Referral Capture

Drawing on our extensive experience and industry standards, Cooper Strategy incorporates best practices into every referral capture program. Here are some key best practices we advocate to ensure both high performance and compliance:

• Leverage Integrated Health Records: Use a robust Electronic Health Record (EHR) system (or interoperable systems) to track patient encounters, referrals, and prescriptions across all providers. Integration is crucial – your EHR should capture referral orders and ideally receive notes or data from external specialists. If multiple EHRs are in play (e.g., hospital vs. clinic systems), establish interfaces or use HIE networks to share data. Integrated records form the backbone of compliant referral capture by clearly tying referral visits to subsequent prescriptions.
• Comprehensive Staff Training: Ensure all stakeholders are educated on referral capture protocols and 340B rules. This includes providers who make referrals, care coordinators, pharmacy staff, and billing/claims personnel. Everyone should understand the importance of documenting referrals and the specific steps they must follow. Regular training (initial and refresher sessions) helps prevent knowledge gaps – especially when there are regulatory updates or staff turnover. A culture of compliance starts with knowledgeable staff.
• Clear Policies and Procedures: Develop written policies that define how your organization handles referral prescriptions under 340B. This should cover patient eligibility criteria (aligning with HRSA’s definition), documentation requirements for referrals, timelines for obtaining consult notes, and roles/responsibilities. Having crystal-clear procedures removes ambiguity for your team and provides a defensible framework in case of an audit. Update these policies as needed when guidance evolves, and ensure staff acknowledge and follow them.
• Collaboration with Referral Partners: Work closely with external providers and clinics to facilitate referral capture. Establish communication channels or agreements with your common referral partners (e.g., specialist groups or hospitals you refer patients to). Educate them about your need for documentation (they may not know about 340B). Some covered entities include language in referral agreements or MoUs to ensure timely sharing of consult notes and prescriptions. Building goodwill and smooth processes with your partners will greatly improve your success rate in capturing referrals.
• Routine Self-Auditing and Monitoring: Don’t wait for HRSA to find issues. Conduct regular internal audits of your referral capture claims. For example, each quarter, sample a set of captured referral prescriptions and verify that documentation (referral order, external visit note, prescription details) is complete and meets your policy. Monitor key metrics like referral capture rate, documentation turnaround time, and any prescriptions excluded for non-compliance. By self-auditing, you can catch and fix issues proactively. This practice not only prevents audit findings but often uncovers process improvements to capture even more eligible prescriptions.

Implementing these best practices creates a strong foundation for your referral capture program. Cooper Strategy ensures that all of the above are baked into our support model – from day one, we help you set up the systems, training, and policies that make these best practices a sustainable part of your operations.

Cooper Strategy vs. Other 340B Referral Capture Providers

Several companies offer solutions for 340B referral capture, but Cooper Strategy stands out for its blend of personalized service, compliance focus, and industry partnerships. Here’s a quick look at how we compare with other providers in the market:

• Nuvem (Advanced Referral Program): Nuvem offers an Advanced Referral Program with dedicated referral coordinators and a software portal for claims tracking. They highlight automation, real-time data analysis, and even monthly auditing of referral claims for compliance. It’s a solid full-service approach. Cooper Strategy similarly provides full-service support – we act as an extension of your team – but with greater emphasis on tailored strategy and on-site collaboration. Our experts don’t just follow your existing policies; we help you refine them and navigate nuanced regulatory interpretations. We also differentiate by our exclusive data partnerships – for example, our direct access to Walgreens data (one of only two companies with this access) gives us an edge in capturing referral prescriptions that others might miss. Moreover, Cooper’s use of AI and advanced analytics means our technology can incorporate more data points than any other solution, which translates to higher identification of eligible claims. While Nuvem’s coordinators mine the data you provide, Cooper’s platform brings in additional data streams (EHR, HIE, pharmacy feeds) proactively, yielding a more comprehensive capture net. Both services value compliance, but Cooper’s audit support is more hands-on, including mock audits and direct audit representation – services many competitors don’t offer.
• Pillr Health (Referral Capture): Pillr markets a “white-glove” referral capture service, handling everything from obtaining consult notes to uploading them into your EHR. Their pitch is “referral capture without lifting a finger,” using a combination of a modern dashboard and a support team. This is quite similar to Cooper Strategy’s high-touch service – in fact, we also take on the heavy lifting by retrieving documentation and integrating it into your records, all through intuitive tools and dashboards that keep you in the loop. The key difference is that Cooper Strategy couples that service with deep compliance expertise and program optimization. Pillr emphasizes ease and UI, whereas Cooper ensures that every workflow we implement is compliance by design. Our team not only inserts notes into your EHR, but also works with your providers to refine how those notes are used to improve care. Additionally, Cooper Strategy’s solutions are scalable and geared for long-term self-sufficiency – we empower your internal team with knowledge and tools to manage referral capture effectively, rather than creating a dependency on us. For organizations with limited staff resources, both Pillr and Cooper offer relief, but Cooper Strategy delivers that relief without sacrificing customization or oversight. We make sure you have full visibility and control over your program’s direction, and we tailor our support as your program matures.
• Equiscript (EQ Connect Referral): Equiscript takes a unique approach, acting as both a 340B pharmacy services provider and a referral capture facilitator. Their EQ Connect Referral solution leverages proprietary integrations with EHRs and HIEs to automatically pull in external clinical notes, boasting an over 50% referral capture rate (vs. an industry average of 20–25%). Equiscript’s strength is in its data integration – they claim 99% access to patients’ outside records, providing rich data for both 340B and value-based care initiatives. Cooper Strategy aligns with Equiscript on the importance of data: we too prioritize broad data access and integration. In fact, our platform provides access to more 340B data than any other firm, and we ensure connectivity to major retail and specialty pharmacies similar to Equiscript’s “top two chains” access. The difference lies in our vendor-neutral, flexible approach. Equiscript often positions itself as a one-stop solution (they can serve as TPA and pharmacy partner, consolidating vendors). Cooper Strategy, on the other hand, is independent and solely focused on optimizing your program rather than providing pharmacy dispensing services – we work with your chosen TPAs and pharmacy partners rather than replacing them. This means when you work with Cooper, you retain complete freedom in how you operate your pharmacies and contracts. Our role is to make those operations better. Additionally, Cooper’s focus on policy and compliance coaching differentiates us: while Equiscript provides great tech and data, Cooper ensures that your internal policies, procedures, and staff understanding keep pace with that technology. We essentially future-proof your program by combining high-tech solutions with high-touch consulting.

In summary, Cooper Strategy stands out by delivering a comprehensive, customized service that balances cutting-edge technology with deep regulatory expertise and personal support. We benchmark ourselves against these competitors and consistently aim to offer superior compliance support, more adaptable solutions, and truly end-to-end partnership. The result for our clients is higher capture rates, greater audit confidence, and a program that is tuned to their unique needs rather than a generic template.

(Curious how Cooper Strategy’s referral capture solution can outperform your current approach or another vendor’s offering? Contact us for a no-obligation consultation and we’ll provide a personalized assessment – get in touch here ➜ cooperstrategy.com/contact-us/.)

Success Story: FQHC Achieves 50% Increase in Referral Capture and $1M+ in New Savings

Background: A large Federally Qualified Health Center (FQHC) approached Cooper Strategy with a referral capture problem. They served thousands of patients and had an existing 340B program, but referral prescriptions were slipping through the cracks. The health center had fragmented documentation across multiple specialties and struggled to get consult notes from outside providers. As a result, their referral capture rate was low – meaning many eligible prescriptions were not being captured under 340B. Compliance concerns were also mounting; during internal reviews, they found inconsistencies in how referrals were documented, which could pose audit risks.

Solution: Cooper Strategy partnered with this FQHC to implement a comprehensive overhaul of their referral capture process. We standardized referral documentation by introducing new EHR templates that every clinic location adopted for external referrals. We provided intensive staff training so that every provider and referral coordinator understood the updated procedures and the importance of capturing referral data. Our team also set up secure data interfaces with key contract pharmacies and the regional HIE. This allowed automatic import of prescription fill data and some external provider notes directly into the health center’s systems. Additionally, we deployed a real-time compliance dashboard that management could use to track referral prescriptions, documentation status, and any issues needing attention. Cooper Strategy’s experts worked side by side with the FQHC’s staff for several months, providing guidance, answering questions, and fine-tuning the workflow to fit their environment.

Results: Within one year of our intervention, the FQHC saw dramatic improvements. Their referral capture rate increased by over 50%, meaning they were capturing more than half of all eligible referral prescriptions (a huge jump from their baseline). In financial terms, this translated to well over $1 million in additional 340B savings in the first year alone. Those funds were redirected to patient services, including expanding their medication assistance program and hiring two care coordinators. Compliance metrics improved as well: the health center went from numerous referral-related documentation gaps to having a clean record in a subsequent audit, with zero findings related to referrals. They reported greater peace of mind knowing the referral processes were solid. Moreover, providers noted that with the new process, patient care improved – they had more information at hand about what happened at specialist visits, enabling better follow-up. Patient satisfaction scores even rose, as patients experienced smoother coordination between their primary care home and outside specialists. This success story illustrates how a tailored referral capture program, implemented with Cooper Strategy’s guidance, can yield significant financial returns and elevate the quality of care.

(Interested in more examples or want to explore how these results could translate to your organization? Reach out to us – we’re happy to share additional case studies and discuss opportunities specific to your setting.)

The Future of 340B Referral Capture – Staying Ahead

The healthcare landscape is continuously evolving, and referral capture strategies must adapt in tandem. Looking ahead, we anticipate several trends that will shape the future of 340B referral capture – and we’re ensuring our clients stay ahead of the curve:

• Advanced Analytics and AI Integration: The use of analytics and machine learning in referral capture will only grow. Future systems will analyze vast datasets (from EHRs, claims, social determinants of health, etc.) to identify patterns and predict which patients are likely to generate referral prescriptions. This could enable more proactive management – for example, flagging patients who might qualify for 340B if referred to certain specialists, allowing organizations to coordinate care in ways that maximize benefits for patient and program alike. Cooper Strategy is already investing in AI-driven tools that can comb through 100+ pages of medical records and distill key information for referral documentation. As these technologies mature, referral capture will become smarter, more automated, and even more accurate in distinguishing eligible vs. ineligible claims.
• Greater Interoperability: Interoperability standards (such as FHIR APIs mandated by federal rules) are making it easier for different healthcare IT systems to talk to each other. In the near future, obtaining a consultant’s notes or pharmacy fill data might be as simple as an automatic pull via standardized APIs. This will greatly reduce the manual effort in closing referral loops. Cooper Strategy is positioning clients to leverage these developments – for instance, by connecting to state or national HIEs and using our partnerships with major pharmacy chains to streamline data flow. Imagine a world where the moment an outside specialist writes a prescription, your system is notified and all necessary documentation is fetched in real-time. That level of connectivity is on the horizon and will make referral capture more seamless than ever.
• Regulatory Clarity (or Changes): There is ongoing advocacy in the 340B community to get more explicit guidance on referral capture. We may see HRSA or legislators provide clearer definitions of what constitutes a 340B-eligible referral prescription and what documentation is required. Any such changes will require covered entities to adjust quickly. On the flip side, there’s also the possibility of manufacturers or policymakers imposing new restrictions or audit requirements around referrals, given the growing financial impact of these claims. Cooper Strategy keeps a finger on the pulse of policy – our team monitors HRSA updates, court cases, and 340B coalitions – so we can advise you immediately when changes occur. Our agile approach ensures that if, say, new documentation standards are introduced, we can update your policies and systems fast to remain compliant. In a field known for ambiguity, we provide clarity and guidance grounded in the latest information.
• Enhanced Audit Preparedness: As referral capture becomes more widespread, expect audits to scrutinize it more. Covered entities of the future will need to demonstrate not just that they captured referrals, but that they did so in a way that improved patient care (aligning with 340B’s intent). We foresee audit protocols evolving to examine referral programs in detail. Cooper Strategy is already practicing next-level audit preparedness by compiling thorough documentation packets for every referral prescription – including proof of referral, patient eligibility, provider relationships, and care continuity. By ingraining such rigor now, our clients are essentially future-proofing themselves against whatever audit standards come down the line.
• Focus on Patient Outcomes and Value: Lastly, the future will see an even greater merging of 340B strategy with value-based care initiatives. Since referral capture inherently deals with patients seeing multiple providers, it overlaps with care coordination efforts prized in value-based models. We anticipate that covered entities will leverage referral capture data (such as our comprehensive care summaries) to drive quality improvements – e.g., ensuring follow-ups happen, tracking medication adherence post-referral, and identifying care gaps. Cooper Strategy is excited about this convergence: we are expanding our services to not only capture referral prescriptions, but also to help clients use that information to improve outcomes (such as reducing readmissions or meeting quality metrics). In the future, a successful referral capture program will be measured not only by savings generated but by how it contributed to healthier patients – and we are fully aligned with that vision.

Staying ahead in referral capture requires insight, agility, and innovation. Cooper Strategy prides itself on embodying these traits. We continually update our methods and technology so that our clients are always at the forefront of 340B best practices. When you partner with us, you’re not just getting a solution for today – you’re getting a strategic ally who will keep you prepared for tomorrow’s challenges and opportunities in the 340B landscape.

Why Choose Cooper Strategy for 340B Referral Capture?

Choosing the right partner for 340B referral capture can make all the difference between a program that thrives and one that struggles. Cooper Strategy offers a unique value proposition built on expertise, experience, authoritativeness, and trustworthiness:

• Unmatched 340B Expertise: We bring over 18 years of 340B program experience and have served 289+ covered entities across the country. Our team includes 340B Apexus Certified Experts (ACE), seasoned pharmacists, and compliance specialists who live and breathe 340B. This depth of expertise means we understand the nuances of 340B like few others, from federal guidance to day-to-day operational tactics. When you work with Cooper, you gain a brain trust that can answer your toughest questions and preempt issues before they arise.
• Proven Results and Measurable ROI: Cooper Strategy has a strong track record of delivering tangible results. We have helped clients generate over $90 million in additional 340B savings, and many see significant boosts in capture rates and revenue within the first year of our engagement. For example, with our intervention, large health centers have reclaimed millions in revenue that was previously leaking through referral prescriptions. We focus on metrics that matter – shared savings generated, prescription capture percentage, audit outcomes, and patient impact – and we provide transparent reporting so you can see the progress. Our commitment is to produce measurable improvements in both financial performance and compliance standing for your program.
• Compliance & Trust – No Compromises: In the world of 340B, trust is earned through a spotless compliance record. Cooper Strategy has never had a client audit result in payback or program removal due to referral capture issues. Our philosophy is compliance-first, always. We incorporate dual layers of checks (AI and human review) on every referral claim, and we stand by our clients during audits, as evidenced by our 100% success rate in HRSA audits. When you partner with us, you can trust that compliance will be rigorously maintained, allowing you to maximize savings without fear. We also operate with full transparency – you’ll always know what we’re doing and why, and we’ll document every step, which builds trust with your internal stakeholders and external auditors alike.
• Innovative Technology, Customized to You: At Cooper Strategy, technology is a means to an end – and that end is your success. We don’t sell one-size-fits-all software; we deliver a state-of-the-art platform configured to your environment. Our tools harness artificial intelligence and big data to widen your capture capabilities (bringing in significantly more provider/patient data than others), but we tailor the configuration to align with your policies and workflow. Furthermore, our exclusive partnership for Walgreens referral data (covering ~⅓ of U.S. prescriptions) gives us an edge that no competitor can offer. We are one of only two companies in the nation with this level of data access – meaning, if you’re not working with us, you’re likely missing a huge chunk of referral opportunities that “competitors cannot touch”. By choosing Cooper, you gain an innovative advantage that is simply not available elsewhere.
• Client-Centric and Flexible Service: Our clients will tell you that working with Cooper Strategy feels like an extension of their own team. We pride ourselves on responsiveness, personalized support, and going the extra mile. Whether you are a community health center or a large DSH hospital, we adapt to your scale and needs. Need us to train a small group of clinic staff or present to your board about 340B referral strategy? We will. Have a unique situation or a challenging referral scenario? We’ll work through it with you case-by-case. This high-touch approach sets us apart from vendors that only provide a software login or a generic playbook. Cooper Strategy remains by your side through every challenge and milestone, from initial setup to seeing those first captured prescriptions roll in, to the day you pass a HRSA audit with flying colors. Your goals become our goals.

In essence, Cooper Strategy offers the ideal blend of expertise, technology, and hands-on support to elevate your 340B referral capture program. Our experience ensures you avoid common pitfalls; our authoritativeness in 340B means our advice is trusted and proven; our technology and partnerships give you an edge; and our track record of trustworthiness lets you engage our services with confidence. We don’t just promise results – we have the experience and evidence to back it up.

Ready to take your 340B referral capture to the next level? Let’s work together to create a compliant, high-performing program that benefits both your patients and your bottom line.

👉 Contact Cooper Strategy today to schedule a personalized consultation or to learn more about our 340B Referral Capture Services. Discover how our team can help you capture every opportunity and ensure no eligible prescription – or patient – falls through the cracks. Maximize your 340B impact with a partner who delivers excellence at every step. (Visit our Contact Us page to get started.)