The 340B program was created in 1992 to enable eligible organizations to provide medications at a discount to help low-income and uninsured patients while providing more comprehensive services. Under the Affordable Care Act (ACA), more facilities, including Critical Access Hospitals (CAHs), became eligible to participate in the program leading to extensive growth in the percentages of hospitals participating. This study will leverage American Hospital Association survey and National Council for Prescription Drug Program data to address the following questions:

1. Did rural hospitals, including CAHs, enrolling in 340B expand their service offerings?
2. Were rural hospitals, including CAHs, that enrolled in 340B more likely to retain important services like obstetrics and cardiac care compared to non-enrolling rural hospitals?
3. What kinds of pharmacies did rural hospitals enrolled in 340B contract with (e.g., independent, large chain, etc.)?