What the work actually looks like.
Representative engagements across entity types. Client names are withheld pending permission, and figures are illustrative of typical outcomes rather than guarantees of what any individual program will achieve.
At a glance
- 01Engagement types
- 6 shown
- 02Entity types
- 5
- 03Names
- Withheld
- 04Figures
- Illustrative
Entity profile, challenge, approach, results.
Every case study below follows the same structure deliberately — so you can compare engagements on the substance, not the storytelling.
A mock audit that found what HRSA would have found
Situation. A mid-size disproportionate share hospital with 58 contract pharmacy locations had run its 340B program for nine years without an external test. A new pharmacy director inherited it and could not answer basic questions about how the patient definition was being applied.
What we did. A five-week mock audit across all 25 test areas, working with real claims across every service line, the full OPAIS record and every contract pharmacy agreement.
What we found. Ineligible referral claims across three service lines, driven by referral documentation that did not link the encounter to the entity. A Medicaid Exclusion File status set at registration and never revisited after billing practice changed in two states. Fourteen contract pharmacy agreements more than four years old, three referencing a corporate entity that no longer existed.
Outcome. Remediation completed before annual recertification. The referral documentation workflow was rebuilt, which also increased legitimate capture. Oversight documentation now exists per location.
The finding that mattered most was not the largest one. It was the referral documentation gap, because it was both an exposure and a capture loss.
From no program to first 340B purchase in 11 weeks
Situation. A federally qualified health center with nine service delivery sites had never operated a 340B program. Leadership wanted one stood up before the next grant cycle, with no internal 340B expertise to draw on.
What we did. Scope-of-project review to determine which sites could be registered, eligibility evidence assembly, OPAIS registration in the next available window, wholesaler account setup, TPA selection support, policy build and role-specific staff training.
The decision that mattered. Two of the nine sites were not yet within the approved scope of project. Registering them would have created eligibility exposure from day one. We registered seven and built a scope-change plan for the other two.
Outcome. First 340B purchase 11 weeks after engagement start. Policy set, training records and self-audit calendar handed over as part of the program.
Declining to register two sites was the highest-value decision in the engagement, and the one the client had not expected to hear.
The pro forma that reversed a site-of-care decision
Situation. A health system oncology service line was evaluating a move of infusion services from a hospital outpatient department to a new freestanding location. The pro forma showed a clear operational saving and had reached the point of board consideration.
What we found. The model addressed facility cost, staffing and reimbursement, and did not address 340B eligibility at all. On a service line where drug cost dominated, the eligibility change at the proposed site materially outweighed the facility savings.
What we did. Rebuilt the model with chair utilization, payer mix, site-neutral reimbursement and 340B eligibility as one integrated view, then modeled three alternative scenarios including expansion at the existing HOPD.
Outcome. The move was not pursued in its original form. Capacity was expanded at the existing site instead, with a scheduling redesign that addressed the underlying constraint.
The original advisors were not wrong about anything they modeled. They modeled two of the three variables that mattered.
Shorter examples across entity types
ExhibitClient feedback
“We had three vendors tell us what our savings could be. Juris was the only one that started by telling us what our exposure was.”
Representative of typical engagements. Client names are withheld; figures are illustrative rather than guaranteed outcomes.
Next step
Your situation is probably in here somewhere.
Describe it on a 30-minute call and we will tell you which engagement fits — or that none of them do.