Cleveland Clinic is committed to providing high-quality, compassionate care to all patients.

We have pioneered many medical breakthroughs, including coronary artery bypass surgery, the first deep brain stimulation surgery for stroke recovery and the first near-total face transplant in the United States. Cleveland Clinic is recognized throughout the world for our expertise and care.

Our health system is composed of 23 hospitals and 280 outpatient locations, including our Main Campus in Cleveland and facilities in northeast Ohio; southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, United Arab Emirates; and London, England.

Cleveland Clinic cares for a large population of vulnerable patients.

In Ohio, we are the leading provider of Medicaid services, providing the highest number of outpatient visits as well as days of inpatient care for patients enrolled in Medicaid. Our care extends from our Main Campus to more than 230 community-based locations and hospitals throughout the state, including rural communities.

What Is the 340B Drug Pricing Program?

Created by Congress in 1992, the 340B Drug Pricing Program allows eligible hospitals and other health care organizations that serve low-income patients to buy outpatient drugs from pharmaceutical manufacturers at a discount. This program helps eligible hospitals stretch limited resources so they can provide more comprehensive community services and ensure access to life-saving care.

The 340B program reduces the amount that participating pharmaceutical companies may charge hospitals for eligible medications. It is not funded by tax dollars.

Why is the 340B program important to Cleveland Clinic?

Cleveland Clinic serves as a safety net for highly specialized care, and in some cases, we may be among a few providers —or the only provider— of certain services in the country.

While demand for care is strong, hospitals are experiencing high costs for pharmaceuticals, supplies and contracted workers, which increases expenses. For example, from 2022 to 2023, the amount Cleveland Clinic spent on pharmaceuticals rose 20%.

The 340B program helps us save resources that would have been spent on purchasing medications but now can be used to provide care, at no additional taxpayer expense.

Unlike other industries, hospitals operate on a very slim margin of revenue over expenses. Cleveland Clinic’s small margin is partly because we provide emergency and medically necessary care regardless of a patient’s ability to pay. In some cases, we provide the care for free or at a significant discount. In 2023, we provided $261 million in free or discounted care to more than 110,000 patients.

The reimbursements we receive from Medicare and Medicaid also are much less than the actual cost to provide care for covered patients. Approximately 65% of our patients are covered by these two programs.

In 2023 Cleveland Clinic experienced a $1.4 billion shortfall between the cost of providing care and our reimbursement from Medicare and Medicaid.

In Ohio, our hospitals’ reimbursement from Medicaid is approximately 65% of the cost to treat patients covered by that program. Absent the 340B discounts for qualifying drug purchases, the gap between reimbursement and cost for Medicaid services would be even larger and would undermine the safety net in our communities.

Additionally, in 2023, Cleveland Clinic provided $111 million in uncompensated care to uninsured/under-insured patients, which we wrote off as bad debt. The 340B program helps us continue to provide vital care to all individuals, including the most vulnerable and those with limited means.

The graph below compares our 340B benefit to our cost for uncompensated care.

How does 340B help us serve our communities?

Each community is unique. The 340B program provides flexibility so that hospitals and health systems can use their cost savings in ways that best meet the needs of the individual communities they serve.

In addition to helping Cleveland Clinic support patients who cannot pay for care, the 340B program has allowed us to:

  • Continue investing significantly in our local communities. In 2023, we contributed $1.46 billion in community benefit for our operations in Ohio, Florida and Nevada. This includes activities from health screenings and health plan enrollment assistance to major investments in alleviating childhood hunger and ensuring that homes are free of lead paint. Learn more about our community commitment.
  • Preserve access to pharmacies. In recent years, retail pharmacy closures have affected many communities. Access to a local pharmacy can significantly impact patients’ health —for example, by helping them take medications as prescribed. Cleveland Clinic operates 25 retail pharmacy locations across Northeast Ohio as well as various specialty pharmacies and programs. In 2025, we plan to open a new pharmacy at our South Pointe Hospital, which is in a community that has been particularly affected by pharmacy closures. Learn more about our pharmacy programs.
  • Preserve community access to critical services. In 2023 we provided $21.5 million in subsidized health services, which are clinical services that meet community needs despite creating a financial loss. Examples include pediatric programs, psychiatric/behavioral health programs, obstetrics services, chronic disease management and outpatient clinics.

Additionally, we provide extensive pharmacy-related benefits at minimal to no additional cost to patients or payers, including:

  • Delivery of a hospital patient’s discharge prescription(s) to the patient’s room following discharge orders at no cost. This program saves trips to the pharmacy and reduces barriers to medication adherence post-discharge. In 2023, nearly 45,000 patients received this valuable service.
  • Transition-of-care pharmacists who contact high-risk patients post-discharge to reconcile prescriptions, provide medication counseling, address medication access barriers and recommend adjustments to discharge medications.

In short, the 340B program enables Cleveland Clinic to serve as a safety net for highly specialized care and ensure that our services are available to all who need them, in our local communities and beyond.

Cleveland Clinic provides patients with the highest quality advanced care and is often among the first to offer certain treatments. Below are some of our patients' stories.