*Purpose: Medication access is an essential element to post transplant medication adherence. Access to medications can often be hindered by high copays, insurance premiums, changes in insurance and loss of insurance. A multidisciplinary team of transplant and specialty pharmacists, financial coordinators, transplant coordinators, case managers and the surgical director took part in a 4 month health system process improvement leadership development program at our institution. The purpose of the process improvement project was to develop a Financial Aid Tool Kit that would serve as a resource for staff and patients dealing with medication access problems (MAPs).

*Methods: Data on the origin and solution for various MAPs were collected over a 2 week period to identify the current workflow and identify the most common MAPs.

*Results: During this period of time there were only 6 MAPs. Three cases were loss of coverage, one case was a delay due to a Medicare B vs D determination, one case was a delay due to missing ICD 10 code and the final case was a delay due to delivery from a mail order pharmacy. Data collection will continue to more clearly determine the most prevalent MAPs in our transplant population. A root cause analysis of the various factors felt to lead to MAPs is presented in Figure 1.

*Conclusions: Outcomes presented will include a streamlined process for handling MAPs, an updated process for documentation of insurance information at the time of transplant and updates to the educational materials provided to patients. Components of the Financial Aid Tool Kit will be reviewed and will include resources which will be geared towards both providers and patients such as educational materials on Medicare coverage, state specific extra help programs, transplant specific grants to provide supplemental funds and patient assistance programs. A directory of online resources including coupons and vouchers will also be developed.

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