Including Language Access into Medicaid ACO Design

Area of Science:

• Health Services Research
• Health Policy
• Health Equity

Background:

• Quality health care necessitates effective communication, particularly in a patient's preferred language.
• Federal laws mandate health care and language access services for deaf and Limited English Proficient (LEP) patients, yet access remains a challenge.
• Medicaid Accountable Care Organization (ACO) initiatives aim to improve healthcare quality and reduce costs through alternative payment models.

Purpose of the Study:

• To examine how Medicaid ACO initiatives can be structured to support and reward language access services.
• To explore the potential financial risks and benefits for ACOs regarding language access.
• To identify payment strategies that encourage ACOs to serve deaf and LEP patient populations.

Main Methods:

• Review of public documents from Medicaid ACO initiatives in six states.
• Analysis of existing payment structures within ACO models.
• Exploration of potential payment tools to incentivize language access.

Main Results:

• Some Medicaid ACO initiatives include provisions for language access, but payment for these services is often insufficient.
• Current payment models may inadvertently penalize ACOs for providing linguistically accessible care.
• A combination of payment tools is likely necessary to effectively encourage both access and quality language services.

Conclusions:

• Medicaid ACO initiatives present an opportunity to enhance language access in healthcare.
• Payment reform is crucial to ensure ACOs are financially supported in providing services to diverse linguistic populations.
• Integrating comprehensive language access strategies into ACO payment models can improve health equity.