Lee, regarding about challenges in changes processes, as nurse leaders, we need to think outside our own silos, research how others are doing it and maybe change it and apply it to our needs. This is very similar to my topic of reverse innovation, which is getting ideas from the poor and applying it to the more developed economies (DePasse & Lee, 2013).
Your question asked, how can you help your patients seek healthcare options that will meet their needs and stay cost effective? In my area of transplant, we have a separate department that handles insurance, Transplant Patient Access Services (TPAS) representatives. The way that the representatives explain it, there is a separate area to your insurance policy that addresses transplant. Our transplant social workers will locate insurance plans for those patients without funding that need a transplant. Then, the transplant social workers will discuss the insurance plans with the TPAS representatives to ascertain the adequate transplant coverage. Interestingly, many of these plans were from the HealthCare.gov website.
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We have a pharmacy that is connected to the hospital. The have a savings plan that patients can enroll for $10 annually, whereas, generics will be offered at a lowered price and brand is a little higher. With this plan, the items that are sold in the pharmacy are also discounted. Now if you are a transplant patient and are at poverty level, the social workers at our hospital will sign the patient for Medication Assistance Plan (MAP). For certain transplant medications, there is no cost to the patient. MAP along with another inexpensive prescription plan, the patient will have nominal