As we enter the new year, there are a handful of important regulatory changes to keep in mind about Medicare and Medicaid. With these changes, the demand for language services like translation and localization is sure to rise in the field of healthcare.

On a national level, the Centers for Medicare and Medicaid Services (CMS) is updating the requirements for the kinds of documents and information that agencies have to translate or communicate to patients in non-English languages.

In the state of California, another change is taking place to focus on enhancing care management.

As of this month, all low-income residents of California between the ages of 26 and 49 will be eligible for the California Medical Assistance Program, also known as Medi-Cal, regardless of their immigration status. Previously, undocumented immigrants in this age group — despite making up a significant portion of the state’s population of undocumented immigrants — were ineligible for Medi-Cal, even though undocumented children, young adults, and adults over the age of 50 were able to receive it.

This means roughly 1.5 million people could now be eligible for Medi-Cal — it also means that healthcare providers in California need to be more prepared than ever to offer high-quality language access services. The majority of unauthorized immigrants in the United States have limited English proficiency (LEP), meaning that providers must be ready to serve them in their language.

In this blog post, we’ll take a look at the recent changes to government health insurance programs — with a particular emphasis on the changes to Medi-Cal here in California. We’ll also explain how healthcare providers can ensure their services are accessible to individuals with LEP.

2024 Policy Changes: A Review

As of January 1, a handful policy changes have taken place for government health insurance plans, two of which will have an impact on the demand for language services in the healthcare sector.

On a nationwide level, the CMS introduced a policy change that more explicitly requires Medicare Advantage (MA) and Part D programs to provide more accessible standardized communications in non-English languages. More specifically, plan providers must keep translations of required materials in any language spoken by 5% or more of the population of a plan’s service area. These materials must also be available in an accessible format such as braille, large print, or audio upon request. This change will require MA providers to seek out language and accessibility services in order to accommodate the new translation requirement, meant to enhance care for patients with LEP.

Healthcare providers in California are also likely to see increased demand for translation, localization, and interpretation, as a huge swath of the state’s undocumented immigrant population has just become eligible for the state’s Medicaid program, Medi-Cal. While low-income unauthorized immigrants below the age of 26 and above the age of 50 have been eligible to receive insurance through Medi-Cal for a while now, those from 26 to 49 have not. This means that a huge population of unauthorized immigrants will now be eligible to receive free or low-cost health insurance, making healthcare far more affordable for them.

However, it’s important to keep in mind that many of these immigrants have LEP, meaning that hospitals, clinics, and health plan communications need to be ready to offer interpreting and translation to these new patients.  It also means that Medi-Cal providers need to be proactive about communicating plan eligibility to people with LEP, as many of these individuals may not be aware that they’re suddenly eligible to receive health insurance through Medi-Cal.

Although more people will be eligible for these services, it’s important to note that trust and outreach will be a major barrier in actually providing healthcare to newly eligible immigrants. Providers must use a diverse range of platforms — from print marketing campaigns to social media posts in multiple languages — to ensure that prospective patients are getting the information they need about Medi-Cal.

Enhancing Care through Health Plans in California

With the number of people eligible for Medi-Cal increasing significantly, California-based providers need to be ready for an increased demand for healthcare services. Expect to see more patients accessing your services in non-English languages, and adapt accordingly — that might mean translating more materials, working with a language service provider to contract more interpreters, even hiring more multilingual staff, or a combination of ways.

Here’s how some Avantpage clients are working to adjust to the new policy changes and ensure that they’re able to meet the needs of linguistically diverse communities, enhancing care overall.

Anticipate an Increased Demand for Services

As the landscape of healthcare access undergoes significant changes in California, healthcare providers must prepare for an increased demand for language services.

Conducting an inventory of available language resources, including translation materials, multilingual staff, and interpretation services, will help providers identify potential gaps. By understanding the linguistic diversity of their patient population, healthcare organizations can strategically allocate resources to address the specific needs that arise from the expanded eligibility criteria.

Monitor Q1 Trends in Usage

The first quarter of the year is a critical period for healthcare providers to closely monitor usage trends and adapt their language services accordingly. By analyzing data related to language preferences, service utilization, and patient demographics during this initial phase of policy changes, providers can gain valuable insights into the evolving needs of their patient population.

For institutions with historical data on language service utilization, comparing Q1 trends with previous periods can offer a baseline for understanding the impact of policy changes. If you don’t have much data to compare Q1 with, think of this period as a sort of benchmark you can use to align your resources with emerging patterns. It’s also a good idea to get patient feedback on your language services to see where you might need to improve.

Understand Your Options for Reducing Cost while enhancing care

Understanding various options for cost reduction can help organizations optimize their language service delivery without compromising quality.

Traditional translation memory systems can be leveraged to streamline the translation process and enhance cost savings. By reusing previously translated content, providers can reduce the time and resources required for repetitive translations. Open communication with your language service provider is crucial during this phase. Providers should engage with their account managers to explore innovative solutions, whether it involves adopting new technologies, optimizing savings, or finding alternative cost-efficient approaches.


With policy changes taking place this year, there’s a lot for healthcare providers to do — but making these changes means you’ll be better suited to serve communities that have historically been underserved by the medical establishment.

If you’re a California-based healthcare provider, here are some recommendations as we begin the new year:

  • Anticipate an increased demand in services and keep track of whether or not non-English-language services are in heightened demand.
  • Compare trends in data from this first quarter of the year with historical data to help understand how the policy changes have affected your organization.
  • Work with your language service provider to determine ways that you can reduce cost without sacrificing the quality of your language access services.

At Avantpage, we’ve helped innumerable healthcare providers serve patients with LEP. If you’re looking for help navigating increased demand for language services, Avantpage is here for you: We offer translation, interpreting, and localization services. Contact us today at (530) 750-2040 or [email protected] to learn more.