Dutch Rojas, Founder of Bliksem Health, has raised concerns regarding the federal 340B Drug Pricing Program. He claims that large nonprofit health systems are exploiting the program to profit from discounts, leaving independent doctors serving Medicaid patients without benefits. Rojas made this statement on X.
"The 340B drug program was supposed to help poor patients," said Rojas. "Instead, it became a $54B loophole that lets billion-dollar nonprofit health systems use to buy drugs at massive discounts, bill full price, and build marble lobbies with exquisite art and a piano man while independent doctors that treat Medicaid patients get nothing."
The 340B Drug Pricing Program allows safety-net providers to purchase discounted outpatient drugs and reinvest savings into underserved communities. However, it is currently under scrutiny regarding whether its benefits truly reach patients or primarily enhance provider margins. In an October 2025 Senate Health, Education, Labor and Pensions (HELP) hearing, lawmakers from both parties supported reforms aimed at increasing transparency, refining the definition of eligible patients, and imposing limits on contract pharmacies. They emphasized the importance of focusing on community health centers and regional access while ensuring that reforms protect access and deliver measurable patient gains.
According to the Health Resources & Services Administration (HRSA), covered entities purchased approximately $66.3 billion in outpatient drugs under the 340B program for calendar year 2023. This figure represents about a 24% increase compared with 2022. The data indicate that many purchases were concentrated among disproportionate-share hospitals, which accounted for roughly 78% of the total purchase volume in that year.
Analyses of the 340B program suggest that large nonprofit hospital systems operating outpatient departments tend to generate higher margins and revenue differentials from participation compared with independent physician practices. A study found that hospital outpatient 340B drug margins substantially exceeded those in freestanding physician-office settings due to greater bargaining power and integration within hospital systems. This disparity has raised concerns about competitive inequalities and whether smaller practices serving Medicaid populations are disadvantaged.
Rojas is a U.S. healthcare entrepreneur and policy advocate who founded Bliksem Health and previously established Sano Surgery in 2012 and co-founded Everyone Health in 2019. According to a board-appointment announcement by Physician‑Led Healthcare for America, he has a history of founding, scaling, and exiting healthcare companies focused on price transparency, physician-led delivery, and practice autonomy. He has publicly commented on healthcare-pricing reform and physician ownership models.
Bliksem Health is a privately held U.S. healthcare consulting and services company working with physician-led and independent provider organizations to reduce unnecessary costs, generate recurring revenue, and optimize risk management. The company's LinkedIn profile describes its mission as helping healthcare delivery organizations "eliminate unnecessary expenses, generate recurring revenue, and optimize risk management." While details about its founding year and full client base are limited in publicly available sources, the profile indicates it aims to serve physician-owned facilities rather than large integrated systems.
