Language Services for Medicaid Health Plans

Summary

Notice of Action and All Plan Letter Compliance

California’s Medicaid health plans follow strict and evolving regulations to facilitate improved access to care. In 2021, the state ruled that All Plan Letters (APL) like notice of action letters needed to be translated to limited English-speaking members. In 2022, this expanded to all member correspondence and publications. This meant that plans needed to proactively provide alternative formats like audio, large print, and braille to members who had requested these formats.

These changes presented a variety of new challenges for health plans, changes that needed to be implemented in a short time frame with little state guidance. Avantpage understood the impact this would have on their language access plans, and acted fast to create tailored solutions for compliance and organizational needs. As a result, health plan members receive communications in their preferred language and in a timely manner, leading to better outcomes.

Scope

Speedy Translations and Complex Alternative Format Services

All Plan Letter regulatory updates such as the Notice of Action, Notice of Resolution, and Alternative Format communications were created to improve equitable care. Department of Healthcare Services (DHCS) provided the deadline for implementation and defined what services needed to be made available to health plan members. However, there was no roadmap and very little guidance to meet these new requirements. Between deadlines, newly chartered territory, and lack of guidance on practices, plans were risking meeting compliance and the needs of their members.

California’s Medicaid Health Plans (Medi-Cal) needed to:

• Translate Notice of Action and Notice of Resolution letters to their plan members
• Ensure these letters adhered to a strict 72-hour delivery timeframe
• Provide alternative format services for all communications to identified plan members
• Meet the deadlines to implementation (March 2022 and July 2022)

Avantpage was uniquely positioned to facilitate culturally-competent language access for these health plans. Even more, we have provided our translation services to over 30% of DHCS-managed Medi-Cal plans, as well as some of the largest health plans in the US. With this level of expertise and direct insight into the practices of many health plans across California, our teams were able to jump in for APL solutions that would fit each of our client’s unique needs.

Solution

Tailored Language Services for Medicaid Health Plans

With NOA/NAR letters and Alternative Format Services (AFS) required by APL regulatory changes, Medicaid health plans of California were presented with the challenge of meeting higher quality language access for members, complex services, looming implementation dates, and little state guidance for practices.

Avantpage leveraged our expertise in Medicaid health plan translations to create and offer each plan a unique approach that would fit the organization’s needs. Furthermore, Avantpage was uniquely placed with the insight into what many plans were choosing to implement for this new regulation. After understanding the updates and the entire scope of needs, our Avantpage team was able to offer the following:

• Leverage current RapidFire translation service to create a workflow that allows for 4-hour turnaround time for NOA and NAR letters
• Included an added variable text strategy to leverage cost savings, consistencies, and faster turnaround
• Created AFS offerings that would bridge the gap to meet language access while offering added cost saving options

Outcome

Tailored Language Services for Medicaid Health Plans

As a result, Medicaid health plans in California set the precedent for health plans across the US to better meet the language access needs of members who are limited English proficient, and/or who need alternative format services for communications. Other health plan organizations may follow suit with these practices as they work towards improved multicultural health care. The National Committee for Quality Association further highlights the benefits of multicultural health care, such as identifying gaps in care, establishing standardization, standing out as a market leader, lowering costs, and ultimately creating more equitable access for all individuals, leading to healthier outcomes.

In the first year of these changes, Avantpage and our California Medicaid Partners have:

• Delivered close to a thousand APL projects
• Completed APL projects during every business day since implementation
• Ensured language access to over 7 million eligible LEP members