title: Including Language Access into Medicaid ACO Design.
abstract: Quality health care relies upon communication in a patient's preferred language. Language access in health care occurs when individuals are: (1) Welcomed by providers regardless of language ability; and (2) Offered quality language services as part of their care. Federal law generally requires access to health care and quality language services for deaf and Limited English Proficient (LEP) patients in health care settings, but these patients still find it hard to access health care and quality language services.Meanwhile, several states are implementing Medicaid Accountable Care Organization (ACO) initiatives to reduce health care costs and improve health care quality. Alternative payment methods used in these initiatives can give Accountable Care Organizations more flexibility to design linguistically accessible care, but they can also put ACOs at increased financial risk for the cost of care. If these new payment methods do not account for differences in patient language needs, ACO initiatives could have the unintended consequence of rewarding ACOs who do not reach out to deaf and LEP communities or offer quality language services.We reviewed public documents related to Medicaid ACO initiatives in six states. Some of these documents address language access. More could be done, however, to pay for language access efforts. This article describes Medicaid ACO initiatives and explores how different payment tools could be leveraged to reward ACOs for increased access to care and quality language services. We find that a combination of payment tools might be helpful to encourage both access and quality.
authors: Rachel Gershon, J.D., M.P.H., is a health policy attorney and associate at the University of Massachusetts Medical School's Center for Health Law and Economics. Lisa Morris, M.S.T.D., is the Director of Cross Cultural Initiatives at the University of Massachusetts Medical School's MassAHEC Network. Warren Ferguson, M.D., is the Vice Chair and Professor at the University of Massachusetts Medical School's Department of Family Medicine & Community Health.
authors: Rachel
authors: R
authors: Gershon
authors: Rachel Gershon, J.D., M.P.H., is a health policy attorney and associate at the University of Massachusetts Medical School's Center for Health Law and Economics. Lisa Morris, M.S.T.D., is the Director of Cross Cultural Initiatives at the University of Massachusetts Medical School's MassAHEC Network. Warren Ferguson, M.D., is the Vice Chair and Professor at the University of Massachusetts Medical School's Department of Family Medicine & Community Health.
authors: Lisa
authors: L
authors: Morris
authors: Rachel Gershon, J.D., M.P.H., is a health policy attorney and associate at the University of Massachusetts Medical School's Center for Health Law and Economics. Lisa Morris, M.S.T.D., is the Director of Cross Cultural Initiatives at the University of Massachusetts Medical School's MassAHEC Network. Warren Ferguson, M.D., is the Vice Chair and Professor at the University of Massachusetts Medical School's Department of Family Medicine & Community Health.
authors: Warren
authors: W
authors: Ferguson
mesh_terms: D022126:Access to Information; D060866:Accountable Care Organizations; D006801:Humans; D007802:Language; D008484:Medicaid; D006278:Medicare; D011787:Quality of Health Care; D014481:United States