The health care Triple Aim — high quality, low cost, and positive experience — only matters to a patient if he or she is able to participate in the system. In other words, there can be no Triple Aim unless the patient actually has access to health care services. On the 50th anniversary of Medicare in 2015, the New England Journal of Medicine cited important survey data on which adults have, and more importantly, do not have, access to care.
For the purposes of the study, “access problems due to costs” included filling prescriptions, receiving required specialist care, undergoing recommended tests or follow-up, and arranging a doctor visit for a medical problem. “Bill problem or medical debt” was defined as not being able to pay bills, being contacted by a collection agency for unpaid medical bills, having to make lifestyle changes because of medical bills, and having to pay off medical debt over time.
These data tell a powerful story about the importance of Medicare, as well as Medicare Advantage, in creating access for patients. Furthermore, if the number of uninsured Americans continues its recent decline, commercial (i.e., individual and employer-sponsored) markets may be the next front in the battle to improve access to care.