From Coverage to Care: Strengthening and Facilitating Consumer Connections to the Health System

To date, most Affordable Care Act implementation efforts have focused on getting individuals enrolled in health insurance coverage; indeed, millions of Americans, many of whom had never been insured, have since obtained health coverage, either through the health insurance marketplaces or through expanded Medicaid eligibility, if available in their state. Yet reducing the number of uninsured is only part of the law's goal. It also aims to improve population health and lower health care costs. Less attention has been paid to confirming that the newly insured obtain appropriate health care and maintain long-term relationships with their health care providers, which are critical steps to help achieve these latter goals. This article describes lessons learned from conversations with a variety of stakeholders in the health care industry. These conversations covered the gamut of steps consumers must undergo to become fully engaged with their health care, from applying for coverage and selecting a plan to finding a provider, accessing care, and engaging in care over time. In each phase of the process, consumers must take specific actions and overcome new challenges. Stakeholder efforts to help consumers often focus on just one of these phases, at the expense of the bigger picture, and often occur in isolation, with little coordination across stakeholder groups. Thinking more strategically and holistically can help provide the "connective tissue" that can help prevent consumers from becoming disengaged and falling through the system's cracks.