Rx|X Consulting

What Rx|X Consulting does

Rx|X Consulting is a US-based, privately held consulting firm founded in 2010 by Dr. Madeline Wallack and Suzanne Herzog, both former contractors at the HHS Office of Inspector General and HRSA's Office of Pharmacy Affairs. The firm specializes exclusively in the federal 340B Drug Pricing Program, serving 340B covered entities — primarily large, complex hospital systems and Academic Medical Centers (AMCs) — with HRSA and manufacturer audit preparation, Medicaid billing compliance reviews, policy analysis, dispute resolution, and litigation subject matter expertise. The firm states it works with "hundreds of 340B entities," including approximately 100 hospitals, and positions itself on the depth of its founders' regulatory pedigree and direct involvement in shaping HRSA audit processes and the 340B Apexus Certified Expert (ACE) curriculum.

The company's core technology assets are two proprietary, unregistered trademarks: Avanti340B and the 340B/360 framework. Avanti340B is a quarterly-subscription analytics tool that ingests all NDC-level data across a client's accounts and independently reconciles purchases, dispenses, and accumulations against split-billing software output — surfacing compliance and optimization issues that transaction testing alone cannot detect. The 340B/360 framework is an assessment methodology evaluating programs across data, structure, strategy, and mission impact. Both are complemented by the Next Level platform, an invitation-only post-sale client community providing policy briefs, self-auditing protocols, C-suite reports, and dispute resolution support. A new Medicaid Billing Compliance Audit service was launched in 2025.

The business model combines professional services (340B program audits, Medicaid billing reviews, advisory and SME engagements delivered on a quote-based, one-on-one basis by 340B ACE-certified practitioners) with a recurring subscription revenue stream from Avanti340B managed by Rx|X experts. Distribution is sales-led and relationship-driven, relying on thought-leadership content (firm blog, 340Banter podcast appearances, LinkedIn) and the founders' industry reputation to drive inbound inquiries from enterprise healthcare buyers. Pricing is not publicly disclosed; prospective clients contact the firm via email or phone for custom quotes. The firm is founder-owned, self-funded, and operates with a small team (1–10 employees) based in Minneapolis with a Colorado phone presence.

Name

Rx|X Consulting

Legal name

Rx|X Consulting

Website

https://rxxconsulting.com

Company type

Private

Founded year

2010

Operating status

Operating

Headcount range

1–10 employees

Short description

Rx|X Consulting is a US-based niche consulting firm specializing in the federal 340B Drug Pricing Program, serving large hospital systems and Academic Medical Centers with HRSA audit preparation, Medicaid billing compliance, and proprietary analytics via its Avanti340B tool and 340B/360 framework.

Ownership category

akta.pro rank

Product category

340B Healthcare Compliance Consulting

NAICS

Management Consulting Services (54161), Other Management Consulting Services (541618)

SIC

Services-Management Consulting Services (8742), Services-Prepackaged Software (7372)

akta.pro primary industry

340B Program Administration & Contract Pharmacy Services (HLAFALAL)

Keywords

• 340B compliance consulting
• HRSA audit preparation
• Pharmacy program audits
• Medicaid billing compliance
• Healthcare regulatory advisory

Headquarters

HQ city

Minneapolis

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales

Revenue model

1. 340B Compliance Consulting Services: Professional consulting services including comprehensive 340B program audits, HRSA/manufacturer audit preparation, Medicaid billing reviews, policy analysis, and strategic guidance. Services are delivered through one-on-one engagement with certified experts and ongoing client support.
2. Avanti340B Subscription: Quarterly subscription-based access to the proprietary Avanti340B audit tool, managed by Rx|X experts. Provides enhanced program visibility, actionable analytics reports, and ongoing monitoring of procurement and inventory management for 340B drugs.

Pricing tiers

Go-to-market motion1 record

Distribution channels2 records

Marketing channels4 records

Core offering

Rx|X Consulting delivers expert 340B Drug Pricing Program compliance and audit services to healthcare covered entities, with a focus on HRSA and manufacturer audit preparation, Medicaid billing reviews, and program optimization. Service delivery combines one-on-one expert consulting with a proprietary audit tool, Avanti340B, which performs quarterly NDC-level analytics on split billing, purchasing, and accumulators. The firm supplements engagements with its 340B/360 assessment framework and the Next Level exclusive client community for ongoing education, policy briefs, and dispute resolution support.

Product overview

Rx|X Consulting offers a suite of 340B compliance and consulting services anchored by its proprietary audit tool Avanti340B and the 340B/360© framework. The core product portfolio consists of consulting services for 340B program audits, Medicaid billing review, and subject matter expertise, with the Next Level platform providing an exclusive client community hub for ongoing education, webinars, and resources. Avanti340B serves as the key differentiator—a data analytics tool that ingests NDC data to reconcile purchases, dispenses, and accumulations quarterly, while 340B/360© provides a comprehensive program assessment framework. The Next Level platform complements the services by delivering curated content including policy briefs, white papers, and client community webinars. Together, these offerings form an integrated compliance ecosystem for 340B covered entities.

Differentiator

Problem solved

Functional benefit

Brands

• Avanti340B: Proprietary audit tool and inventory reconciliation tool for overseeing data connections and team processes that power procurement and inventory management of 340B drugs. Allows teams to go beyond patient transaction testing and provides insights into split-billing software performance.
• 340B/360©
• Next Level

Products and services

• Avanti340B Proprietary audit and analytics tool that ingests NDC-level data across all accounts to perform quarterly reconciliation of split billing, retail accumulators, purchasing processes, and data connectivity. Used by 340B covered entities to identify compliance issues and optimization opportunities that cannot be detected through traditional transaction testing.
• 340B/360© Program Assessment Proprietary comprehensive assessment service that evaluates how effectively a 340B covered entity's program supports its mission and the communities it serves, using targeted data review, interviews, and on-site collaboration across data, structure, strategy, and impact dimensions.
• 340B Program Audits Comprehensive 340B program audits covering HRSA and manufacturer audit preparation, contract pharmacy reviews, transaction testing, and detailed policy analysis to optimize program efficiency and compliance for 340B covered entities.
• Medicaid Billing Review Risk assessments, Medicaid billing reviews, and financial analyses designed to identify potential compliance issues and prepare 340B covered entities for HRSA audits.
• Medicaid Billing Compliance Audit Focused compliance audit that evaluates AAC billing accuracy, modifier and submission code consistency, alignment with HRSA and state-specific Medicaid rules, and integrity of Medicaid Exclusion File and NPI configurations for 340B covered entities.
• 340B Subject Matter Expertise (SME) Tailored expert advisory support for 340B program design, implementation, dispute resolution, education, and litigation support delivered by Rx|X's certified 340B experts.
• Next Level Client Community Exclusive information hub for Rx|X clients providing policy briefs, best practice self-auditing protocols, education and training, C-suite reports, dispute resolution support, individualized problem solving on 340B policy and technical issues, exclusive white papers and case studies, and client community webinars.

Quantifiable outcome

• 62% reduction in duplicate discounts and diversion findings from 2018 to 2024
• +1 more outcomes

Named customers2 records

Segments2 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature2 records

Partnerships

Four partnerships are on record, tiered core, moderate and minor.

• ApexuscoreStrategic or Co-development Partner · 1 January 2016Rx|X aided Apexus in 2016 with the creation of the 340B Apexus Certified Expert (ACE) curriculum, the leading professional certification for 340B operations. In 2020, Rx|X served as ACE's exclusive consultant helping to create the educational Update Module. Apexus is the exclusive contractor for HRSA's Pharmacy Services Support Center (PSSC) and 340B University educational programs.
• American Pharmacists Association (APhA)moderateStrategic or Co-development PartnerFrom 2011-2013, Rx|X worked with APhA as part of their contract with HRSA to run the Pharmacy Services Support Center (PSSC). The firm conducted research on policy and implementation questions, authored white papers, ran the Covered Entity Peer-to-Peer Program, served as speakers at 340B University, wrote standard response guides for FAQs, and helped develop the HRSA audit process.
• Health Resources and Services Administration (HRSA) Office of Pharmacy AffairsmoderateStrategic or Co-development PartnerRx|X founders served as contractors at HRSA's Office of Pharmacy Affairs providing technical support to 340B covered entities. They gained direct experience with statistics, audits, program evaluation, data collection methods, data analysis, technical writing, and project management while supporting the 340B program.
• Santa Clara v Astra et al (Supreme Court)minorImplementation/ SI/ Consulting PartnerRx|X founders Dr. Madeline Wallack and Suzanne Herzog served as expert witnesses for the Supreme Court case Santa Clara v Astra et al regarding overcharging of 340B entities, contributing expertise on 340B program mechanics and compliance issues.

Scale indicators4 records

Recent moves7 records

Expansion highlights5 records

Broad incumbents

• Huron Consulting Group: Huron is a large healthcare consulting and digital firm serving hospitals and health systems on operational, financial, and regulatory matters — a broad incumbent whose healthcare practice competes for the same AMC consulting wallet.
• Apexus: Apexus is the HRSA-contracted 340B Prime Vendor and operator of 340B University and the ACE certification — a broad incumbent that Rx|X has historically partnered with on the ACE curriculum but which could evolve into a more direct competitor on training and program support.
• BDO USA Healthcare: BDO's healthcare practice provides 340B audit and advisory services to hospitals — a broad incumbent competing for the same AMC compliance engagements with the backing of a national accounting platform.
• Craneware: Craneware provides pharmacy revenue cycle and 340B solutions to U.S. hospitals at scale — a broader incumbent whose product suite includes 340B program management features that overlap with Rx|X's audit and analytics offering.

Others

• 340B Health: 340B Health is the leading advocacy association for 340B hospitals — not a commercial peer, but an ecosystem participant that shapes policy, education, and demand for the consulting services Rx|X provides.

Direct peers

• CaptureRx: CaptureRx offers 340B split-billing and compliance software to covered entities, including contract pharmacy and inventory reconciliation — overlapping directly with the operational problems Rx|X audits and resolves.
• Macro Helix: Macro Helix provides 340B software (split-billing, contract pharmacy, and audit/analytics) and services to hospitals and health systems — a direct competitor in both the consulting and proprietary-tool layers that Rx|X targets with Avanti340B.
• Sentry Data Systems (Commure): Sentry Data Systems delivers 340B management, pharmacy analytics, and compliance solutions to hospitals and FQHCs — directly comparable to Rx|X on the 340B analytics and program-management axis.

Emerging players

• Stratice Healthcare: Stratice Healthcare offers 340B program management and technology to hospitals and health systems — an emerging player with partial overlap to Rx|X in the 340B analytics and compliance operations space.
• Pivotal Partners (340B specialty consulting): Smaller 340B-focused consulting firms serving hospitals on program optimization and audit support — emerging niche players competing for the same AMC compliance engagements as Rx|X.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/rx-x-consulting
• Xx.com/RxX_Consulting

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Rx|X Consulting