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How the termination count was made

Source. HRSA's 340B OPAIS covered-entity daily public file, downloaded October 27, 2026 (94,766 registration records). HRSA records a termination date and a termination reason on every terminated registration; the reason codes are HRSA's own (HRSA termination code definitions).

What is counted. Hospital registrations of type DSH, RRC or SCH that are parent records (no parent 340B ID; child sites are excluded so a hospital with twenty outpatient sites counts once) whose termination reason is exactly DSH percentage below statutory minimum. Each hospital counts once per effective year, by CMS Certification Number (CCN), or by 340B ID where the record carries no CCN. A hospital terminated under this reason in two different years appears in both years; 11 hospitals do, across all years since 2017.

What is not counted. Registrations terminated for any other reason, including Change of covered entity type (often a move from the DSH category to the rural referral center or sole community category, where the test is 8% instead of 11.75%), Loss of qualifying hospital status, closures and conversions. Hospitals that filed a cost report under the line but kept their registration are not counted; being under the line in public data is not the same as HRSA terminating the registration.

Re-entry. A termination is a dated event. Some hospitals later file a cost report over the line and re-register. The "Active again" column says whether the same CCN has an active hospital registration in the October 27 file. It does not say when it came back or how long it was out.

Modeled savings. The last column is not a verified loss. It is the same estimate every Numerator page shows: drug cost on the hospital's latest public Medicare cost report (Worksheet A, pharmacy and drug lines), times the outpatient share of drug charges (Worksheet C), times an assumed 60% bought at 340B prices, times an assumed 50% price gap between 340B and GPO or WAC pricing. It is the annual savings associated with the hospital's 340B status at the scale of its own cost report, not what it has realized or lost since termination. Where the cost report's drug lines do not yield a usable figure (a negative or zero drug cost), the cell says n/a and the hospital is left out of any total. Two hospitals, 150090 and 450165, were removed in both 2025 and 2026 and appear in both years' tables; across 2024 to 2026 that is 186 removals of 184 hospitals.

Counts by effective year. 2017: 16 · 2018: 22 · 2019: 18 · 2020: 13 · 2021: 8 · 2022: 11 · 2023: 16 · 2024: 34 · 2025: 67 · 2026: 85 · 2027: 1. 2026 is a partial year (effective dates through October 1, 2026); it is not annualized.

Files. The underlying list is published with this page: dsh-terminations.json.

2027: 1 hospital, scheduled

HRSA records a termination when it is decided, with the effective date it will take; this one is in the October 27, 2026 file with an effective date of January 1, 2027, so the hospital is still registered today and counted here under 2027, not 2026. Modeled annual 340B savings at the time of termination, summed across the 1 with a usable cost report: $10.6M.

2026 (through October 1 effective dates): 85 hospitals

Active hospital registration today under the same CCN: 11 of 85. Modeled annual 340B savings at the time of termination, summed across the 81 with a usable cost report: $261.4M.

2025: 67 hospitals

Active hospital registration today under the same CCN: 16 of 67. Modeled annual 340B savings at the time of termination, summed across the 65 with a usable cost report: $259.5M.

2024: 34 hospitals

Active hospital registration today under the same CCN: 6 of 34. Modeled annual 340B savings at the time of termination, summed across the 33 with a usable cost report: $126.0M.

2023: 16 hospitals

Active hospital registration today under the same CCN: 2 of 16. Modeled annual 340B savings at the time of termination, summed across the 16 with a usable cost report: $34.9M.

2022: 11 hospitals

Active hospital registration today under the same CCN: 1 of 11. Modeled annual 340B savings at the time of termination, summed across the 10 with a usable cost report: $19.8M.

2021: 8 hospitals

Active hospital registration today under the same CCN: 3 of 8. Modeled annual 340B savings at the time of termination, summed across the 8 with a usable cost report: $12.0M.

2020: 13 hospitals

Active hospital registration today under the same CCN: 3 of 13. Modeled annual 340B savings at the time of termination, summed across the 1 with a usable cost report: $1.1M.

2019: 18 hospitals

Active hospital registration today under the same CCN: 4 of 18. Modeled annual 340B savings at the time of termination, summed across the 2 with a usable cost report: $4.8M.

2018: 22 hospitals

Active hospital registration today under the same CCN: 6 of 22. Modeled annual 340B savings at the time of termination, summed across the 0 with a usable cost report: $0K.

2017: 16 hospitals

Active hospital registration today under the same CCN: 2 of 16. Modeled annual 340B savings at the time of termination, summed across the 0 with a usable cost report: $0K.

Numerator Health, Inc. · founders@numeratorhealth.com · Corrections welcome; if a hospital on this list is listed in error, write to us and we will check the record and amend the page.