Our 340B Story

About UCSF Medical Center

UCSF Medical Center is a public academic medical center serving the greater San Francisco Bay Area, Northern California, Central Valley and beyond. We deliver the highest quality care across a wide range of specialties, procedures and conditions.

We're proud to serve all members of our community regardless of the severity of their illness, their income level or their area of residence. UCSF is among the largest Medicaid providers in Northern California as well as San Francisco's largest provider of hospital care for Medicaid patients. More than 24% of our total patient services are provided to Medicaid patients, a number that has grown statewide due to California's Medicaid expansion under the Affordable Care Act. In fiscal year 2024, UCSF Medical Center provided more than $1 billion in uncompensated care to Medicare and Medicaid patients.

As a primarily self-supporting institution, UCSF Medical Center relies heavily on savings generated from participating in the 340B Drug Pricing Program to offset financial losses incurred in caring for underinsured and uninsured patients and providing additional services to help care for the most vulnerable in our community.

The value of the 340B program at UCSF

UCSF uses savings from the 340B Drug Pricing Program to provide comprehensive care for low-income, uninsured and underinsured patients across San Francisco. These investments directly support key community and health care priorities, including access to care, behavioral health and economic security.

Access to care

• Roving Community Health Initiative: In response to inequities illuminated during the COVID-19 pandemic, the initiative was formed to improve access to care for marginalized communities in the Tenderloin district of San Francisco. It operates regular pop-up clinics in collaboration with community partners, with on-site services complemented by mobile teams that bring care directly to people in the community and a primary focus on unhoused and marginally housed individuals.
• Citywide: This service, which comprises various programs, connects psychiatric patients experiencing homelessness with urgently needed medical and dental care. Through regular pop-up dental clinics, the program builds trust and pathways to more comprehensive care at UCSF or local clinics. It also serves as a training ground for future providers committed to caring for this population.
• Care at Home: This program offers home-based primary and palliative care for homebound adults 65 and older. Care at Home recently expanded access by actively enrolling new patients weekly from high-need neighborhoods.

We also improve access to care by:

• Providing access for Medicaid and uninsured patients to specialty programs that perform lifesaving treatments. These include organ transplants, complex cancer care, immunological care (including bone marrow transplants), neurological and neurosurgical care, cardiovascular care and cardiothoracic surgery.
• Sponsoring educational outreach events to Bay Area seniors to review the Part D plans that will be most cost-effective for each senior and to maximize their existing drug benefits
• Subsidizing pharmacists providing HIV management to a largely Medicaid population
• Employing patient assistance coordinators whose sole responsibility is removing financial barriers and coordinating funding for our patients.

Behavioral health

• Citywide Case Management: This program is the largest provider of intensive case management (ICM) for people with serious mental illness in San Francisco, serving nearly 2,000 clients. Citywide includes five ICM programs that treat adults with complex psychiatric and substance use disorders in an outpatient setting. Recovery-focused services — such as employment support, peer mentorship and substance use treatment — help reduce hospitalizations, incarceration and homelessness.
• Autism Clinic: UCSF is expanding care for people with neurodevelopmental disorders, including autism spectrum disorder (ASD). This multidisciplinary program promotes well-being through early intervention, innovative treatment models and leading-edge research tailored to people with neurodiversity.
• Health and Human Rights Initiative: Provides trauma-informed psychiatric evaluations for refugee children and families seeking asylum, while also training UCSF students, residents and faculty in the intersection of mental health, human rights and culturally informed care.

Economic security

• Food Equity and Food Justice Program: Delivers a comprehensive suite of food access services, including produce prescriptions, home-delivered groceries, teaching kitchens and culinary medicine programs. These initiatives support nutrition security for patients in ambulatory and student-run community clinics.
• Family House: Provides free, supportive housing to families whose children are receiving treatment at UCSF Benioff Children's Hospital San Francisco. This safe, healing environment relieves the financial and emotional burden of temporary relocation during critical pediatric care.
• Patient Supportive Transportation: Ensures that patients facing financial or logistical barriers can reach their appointments by covering costs for rideshare, wheelchair-accessible vans and non-emergency medical transportation. This prevents missed treatments and improves health outcomes for low-income and medically complex individuals.

Impact of scaling back

UCSF Health remains steadfast in its mission to care, heal, teach and discover. Even as reimbursement rates have declined, we have preserved essential services by relying on 340B savings to sustain care for our most vulnerable patients.

Current restrictions on 340B pricing at contract pharmacies are already affecting patients who depend on our community benefit programs. Many patients can no longer access the affordable, life-sustaining medications required to manage complex conditions, which jeopardizes medication adherence, outcomes and overall health.

Continued restrictions on the 340B program threaten UCSF's ability to sustain essential services that support San Francisco's core health priorities in access to care, behavioral health and economic security, which impacts thousands of patients each year. To protect these vital programs, we urge lawmakers to safeguard and strengthen the 340B program so that UCSF and other safety-net providers can continue delivering critical care to the patients and communities who need it most.