Health coverage is often treated as the finish line. If someone is insured, whether enrolled in a Medicaid plan, a Medicare Advantage product, an exchange plan, or employer-sponsored coverage, the assumption is that access to care naturally follows. In reality, coverage is only the beginning.
Across Medicaid, Medicare, the individual exchange, and even employer-sponsored plans, health systems and payers are seeing the same pattern repeat itself. Members technically have access to care, yet they delay, avoid, or never engage with it. Preventive services go unused, chronic conditions remain unmanaged, and emergency departments fill the gaps that primary care never had the chance to address.
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