Describe the relationship between this fragmentation and the delicate balancing act between access, cost, and quality (referred to as the Triple Aim). Include at least one example of the fragmentation within the U.S. healthcare system; provide at least two of the driving forces for that fragmentation; and discuss the impact that the fragmentation has on access, cost, and quality. Support and validate your comments by ensuring there is sufficient external evidence by including in-text citations from your references.