The Final Mile of Care

Coverage gets people into care. Completion gets people through care.
Healthcare systems across the country are beginning to recognize something important:

Access alone does not guarantee care completion.
For years, much of the healthcare conversation focused on expanding access, increasing eligibility, and improving coverage.
Those efforts matter.

​They helped millions of people enter the healthcare system.
But healthcare leaders are increasingly confronting a second challenge:

What happens after care begins?
Across military and civilian healthcare environments alike, continuity, coordination, affordability, and follow-through are becoming operational concerns in their own right.

Recent developments across the Military Health System reflect this shift.

The Department of Defense is proposing structural changes to military healthcare budgeting amid rising cost pressures and long-term sustainability concerns.

​At the same time, Defense Health Agency leadership has emphasized reducing administrative burden and improving healthcare execution across the Military Health System.

Federal oversight findings continue identifying challenges involving:
• Specialty care scheduling
• Referral coordination
• Follow-through within increasingly complex healthcare environments

These developments matter because healthcare disruption does not always begin with denial of care.

Sometimes it begins later:
• At the pharmacy counter
• During a referral delay
• After another out-of-pocket bill arrives
• Between appointments, authorizations, transportation challenges, and the practical realities of carrying treatment forward over time

Increasingly, the challenge is not simply whether care exists.
It is whether care successfully continues.

The Growing Pressure of Healthcare Costs
Affordability pressure continues rising across the healthcare landscape.

Updated 2026 TRICARE cost schedules show increasing beneficiary cost-sharing responsibilities across multiple areas of care, including retail pharmacy copays that now fall within ranges associated with increased prescription abandonment risk.

Research published through JAMA Network Open found prescription abandonment rates rise significantly as patient out-of-pocket costs increase, particularly within approximately the $30–$75 range.

Additional national reporting continues reinforcing the broader affordability environment:
• Gallup reported that many Americans continue delaying or skipping healthcare because of cost.
• KFF reporting similarly shows many individuals struggling with healthcare affordability even while insured.
• Massachusetts remains one of the most highly insured states in the country, yet reporting from CHIA continues showing ongoing affordability strain and medical debt concerns.
Together, these signals point toward an important distinction:

Coverage does not always guarantee continuity.

Where HCAP Operates
At the frontline level, this is where the Medic Now Foundation's Healthcare Cost Assistance Program (HCAP) operates.

HCAP provides small, targeted financial interventions designed to help military-connected individuals continue progressing through care when out-of-pocket healthcare expenses create disruption risk.

The program does not replace healthcare systems, insurance coverage, or clinical care delivery.
Rather, HCAP functions as a controlled continuity-support mechanism operating within the final stages of care execution.

Through vendor-restricted controls and defined healthcare spending categories, HCAP supports healthcare-related purchases involving:
• Pharmacies and Drug Stores
• Health Facilities and Healthcare Centers
• Dental and Vision Services
• Healthcare-supportive household needs tied directly to care continuation

Current HCAP observations continue suggesting that many affordability-related disruptions occur not at the point of healthcare eligibility.

They increasingly appear during the practical realities of sustaining care over time.

Importantly:
This is not simply a military healthcare issue.
It is increasingly becoming a broader healthcare systems issue.

An Emerging Opportunity for Collaboration
As healthcare environments become more operationally complex, the ability to sustain continuity through the final stages of care may become one of the defining healthcare challenges of the next decade.

That creates an opportunity for collaboration.

The future of healthcare support may require stronger coordination between:
• Healthcare systems
• Public agencies
• Veteran-serving organizations
• Frontline nonprofits
• Continuity-support mechanisms capable of helping patients carry care through to completion

The Medic Now Foundation believes programs like HCAP may represent one example of how this type of frontline support infrastructure can operate alongside larger healthcare systems in practical, measurable, and operationally supportive ways.

Because ultimately:
Healthcare access may begin the process.

But whether care successfully continues and reaches completion may matter just as much.


Sources & References
• Department of Defense Military Health System budget discussions (FY2026)
• Defense Health Agency FY2026 operational priorities
• TRICARE 2026 cost and pharmacy updates
• VA Office of Inspector General specialty care findings
• Gallup healthcare affordability research
• KFF healthcare affordability research
• JAMA Network Open prescription abandonment research
• IQVIA Institute healthcare affordability research
• Massachusetts Center for Health Information and Analysis (CHIA)