Bon Secours Richmond Community Hospital, which has one of the highest profit margins of any VA hospital, made $276 million from exploiting the 340B program

The Institute for Health Policy Accountability (IHPA), an independent authority on key drivers of decision-making in the health care space, today released a new report displaying how major nonprofit hospital systems in Virginia, that profit off the federal 340B Drug Pricing Program, are also enriching executives, bolstering cash flow, and expanding operations.

IHPA’s latest state-focused report comes as Democrats in the Virginia State Senate look to strengthen the 340B program, two years after former Governor Glenn Youngkin vetoed SB119, legislation that would have expanded the 340B program in Virginia. 

The Virginia analysis examines several major hospital systems, including Inova Healthcare Services, Sentara Hospitals, Riverside Healthcare Association, Centra Health, Mary Washington Healthcare, Bon Secours Mercy Health Inc., and Virginia Hospital Center Arlington Health System.

Key findings from the report include:

Massive revenues

• Bon Secours Mercy Health: Over $11.5 billion in 2024 revenue.
• Inova Healthcare Services: more than $6.4 billion in revenue in 2024.
• Sentara Hospitals: nearly $4.5 billion in revenue in 2024.
• Riverside Healthcare Association: more than $2.5 billion in revenue in 2024.
• Centra Health, Mary Washington Healthcare, and Virginia Hospital Center each reported hundreds of millions to over $1 billion in annual revenue.

Fraud and improper billing practices

• Bon Secours Richmond Community Hospital, which has one of the highest profit margins of any VA hospital, made $276 million from exploiting the 340B program.
• Inova settled with the DOJ in November 2024, agreeing to pay over $2.3 million to settle claims that it submitted false claims to Medicaid.
• In October 2016, Centra Health settled with HHS for over $137,000 after allegations that they submitted claims to Medicare at a higher rate than was proper.

Aggressive billing and wage garnishment against patients

• Inova was accused of “overcharging uninsured patients and then using ‘aggressive and humiliating’ techniques to collect” in 2004.
• Mary Washington Healthcare aggressively sues patients for unpaid medical bills that could be “ruinous” for those on the receiving end.

Mistreatment of healthcare workers

• Hospital systems, including Sentara and Riverside, face lawsuits alleging unpaid wages, forced work during unpaid meal breaks, retaliation against employees, and failure to accommodate workers with documented medical conditions.

Inflated executive compensation

• Inova paid 18 employees million-dollar-plus salaries in 2024, with the President and CEO making over $6.5 million.
• Sentara spends over $11 million on executive compensation, including over $1 million each in 2024 to three employees.
• Nearly 2% (or $40 million) of Riverside’s expenses go to executive compensation, including nine employees making over a million dollars in salary in 2024 alone.  

Read the full report here.

BACKGROUND ON 340B: 

• The 340B Drug Pricing Program was enacted by Congress in 1992 and meant to lower prescription drug costs for nonprofit hospitals that serve low-income and vulnerable communities. Instead, research shows the program has been exploited by major nonprofit health systems that generate billions in annual revenue.
• This report follows a Senate HELP Committee hearing in October 2025, where Republican Senators voiced their frustrations with nonprofit hospitals abusing the program.
• According to a CBO analysis late last year, nonprofit hospitals across the U.S. have exploited the 340B Drug Pricing Program, resulting in significant waste, fraud, and abuse. The report found that the program “encourages behaviors that increase federal spending and raise prices for American taxpayers.”

The Institute for Health Policy Accountability is an independent authority on key drivers of decision making in the health care space. IHPA provides fact-based research and analysis across the public policy landscape, adding a central and currently missing voice to the conversation.

###