Scaling with Confidence: How Mercy Medical Center Leveraged Automation to Optimize 340B Savings and 100% Audit Coverage

Introduction

Mercy Medical Center is a nonprofit, university-affiliated teaching hospital serving patients across Baltimore and the surrounding region. Nationally recognized for excellence in orthopedics, oncology, and surgical care, Mercy Medical Center is a trusted destination for complex care. As a Disproportionate Share Hospital, Mercy Medical Center cares for a high proportion of low-income and underinsured patients, making its 340B program a critical funding source for charitable care and community health initiatives. The program spans in-house, contract, and mixed-use pharmacy operations.

In an increasingly complex 340B landscape, Mercy Medical Center's leadership maintains a clear, guiding principle. As Greg Smith, Chief Pharmacy Officer, explains:

"Every decision we make has the patient and compliance at the forefront."

This is why Plenful’s automated compliance workflows have become a critical part of Mercy Medical Center’s 340B infrastructure.

‍

Key Results

• 100% automated audit coverage across all 340B eligible claims
• 33x audit capacity increase
• Recaptured 340B savings from more than 6,000 claims previously marked as ineligible, via Plenful's missed opportunities solution
• Improved executive visibility through centralized reporting dashboards to track key performance indicators and team productivity metrics

‍

The Challenge

Growing Complexity, Limited Bandwidth

The 340B Drug Pricing Program allows eligible safety-net hospitals to purchase outpatient medications at reduced prices and reinvest those savings into patient care. For organizations like Mercy Medical Center, the 340B program is a critical funding mechanism that requires rigorous compliance.

For Mercy Medical Center, managing 340B means overseeing claims across multiple pharmacy types, multiple third-party administrators (TPAs), and 30+ clinic locations, all within an increasingly dynamic regulatory environment. 

Prior to Plenful, the Mercy Medical Center team relied on manual spot audits to monitor compliance - a widely adopted approach across the industry. As the 340B program’s complexity and scale increased, this method could not grow in proportion with the increasing volume of claims, making it more challenging to feel confident about program compliance. 

This was particularly challenging in workflows involving provider attribution and location logic. Providers frequently operated across both eligible and non-eligible sites, requiring consistent location-matching logic to ensure claims were adjudicated correctly. Identifying misclassified claims at scale, across a high volume of encounters, was very difficult through manual review alone.

As claim volume increased, achieving full audit coverage manually required more dedicated full-time staffing. In today’s climate, recruitment of qualified candidates is challenging, and it would be too costly to employ the number of full-time employees required. Plenful offered a different path.

‍

The Solution

Building a Stronger Compliance Posture With 100% Audit Coverage

Mercy Medical Center implemented Plenful’s 340B Audit & Optimization suite to automate compliance auditing and recapture high-value claims across its entire 340B program. By replacing manual sampling with continuous audit coverage, the team gained visibility into 100% of 340B eligible claims, eliminating blind spots and strengthening compliance rigor. 

Plenful’s platform was particularly critical in addressing Mercy Medical Center’s provider location challenge. Using highly configurable rule-based logic, Plenful’s platform identifies patterns tied to provider location mismatches and flags high-risk claims into a centralized task management queue. This represents a fundamental shift from time-intensive manual searching to system-driven prioritization that automates nearly 100% of the manual work.

As Shane Gabriszeski, who serves as the 340B Compliance Officer at Mercy Medical Center, explains it:

“The peace of mind that Plenful brings - knowing that there’s a set of eyes on 100% of our claims - has really changed the way 340B functions at Mercy Medical Center.”

For Mercy Medical Center’s 340B governance committee, which includes physician leadership, finance, and risk and corporate compliance, that shift has translated into greater organizational confidence.

Greg describes the shift:

“Our corporate, risk, and finance leadership are much more confident in our processes since we’ve brought Plenful along. The executive dashboard gives us clear visibility into our program performance and makes it easier to communicate with leadership and stay on top of our compliance and operational KPIs.”

Using Automation to Identify Missed Opportunities at Scale, Returning Critical Savings to the Organization

Beyond compliance, Plenful’s Missed Opportunities solution enables Mercy Medical Center to identify and recapture additional 340B savings incorrectly assigned as ineligible by TPAs. Automation made these insights possible by processing millions of rows of encounter, dispensing, and location data - work that would have been impossible to do manually and with Mercy Medical Center’s growing volume of claims.

Since the partnership launched in 2025, Mercy Medical Center has recaptured savings from more than 6,000 claims flagged by Plenful that were incorrectly marked as ineligible by TPAs. These savings would have otherwise gone missing under a manual-only model. 

Enabling Teams to Focus on High-Value Work

For Shane and the Mercy Medical Center team, Plenful hasn’t replaced work - it has redirected it. Now, the time previously consumed by manual and repetitive tasks is channeled toward strategic, high-leverage activity: reviewing high-value flagged claims, uncovering critical 340B savings, and advancing program strategy.

Plenful’s 360 Executive Dashboard extends this visibility to Mercy Medical Center’s leadership, providing a centralized view of program performance, audit activity, and savings. For Greg and the governance committee, it serves as a single source of truth - bringing together fragmented data into clear, actionable insights.

‍

Looking Ahead

A Foundation Built to Scale

Mercy Medical Center’s 340B program plays a critical role in funding care for Baltimore’s underserved communities. Plenful provides the operational infrastructure to support that mission - ensuring the program operates with rigor, visibility, and efficiency.

For Thomas Kim, Director of Performance Improvement, the impact is clear:

“Plenful helps me sleep at night, knowing our 340B program is compliant.”

Looking ahead, Plenful and Mercy Medical Center are expanding their partnership to stand up Plenful’s Rebate Management Solution. As the 340B landscape continues to evolve, this next phase will enable Mercy Medical Center to stay ahead of regulatory changes while maintaining the same high standard of compliance and patient care.

‍