Medicaid HCBS beneficiaries may have chance to review state programs
It’s been more than two years since Jose has been able to work due to a progressive respiratory disorder. As his health declines, he’s become increasingly dependent on his daughter not only for home care, but also because she acts as a translator for his doctors during appointments. Unfortunately, when she is unable to be with him, he is treated differently, and some of his providers have all but given up trying to communicate with him, a non-native English speaker, when she’s not there.
While Jose and his daughter are grateful his enrollment in a home- and community-based services program allows him to continue to live in his apartment despite his health challenges, this is not the only instance of healthcare discrimination they’ve faced. And based on what they’ve heard in their small community, they are not alone in their frustration.
A recently proposed regulation from the U.S. Centers for Medicare & Medicaid Services (CMS) includes a provision, that if passed, will give individuals like Jose a way to share their experiences with program administrators. Their feedback can then inform equitable care practices for the programs they are enrolled in.
The proposed rule, “Medicaid Program; Ensuring Access to Medicaid Services,” was written in part to support states in their work to improve outcomes of program participants of a diverse background. CMS is currently reviewing public commentary on this regulation, and the final version has not been released.
The regulation includes a requirement for state Medicaid agencies to create a Beneficiary Advisory Group (BAG) to complement already existing Medicaid Advisory Committees (MACs). Through a BAG, participants can provide feedback related to provided medical services, policy development and how programs are run.
CMS included BAG requirements because program participants are best able to comment on “cultural competency of providers, language accessibility, health equity, and disparities and biases in the Medicaid program,” according to the proposed rule.
Program participants or their family members can be selected as members of a BAG. While there is little guidance on member selection other than that, the CMS said, “We believe that diversely populated MACs and BAGs can provide States with access to a broad range of perspectives, and importantly, beneficiaries’ perspective, which can positively impact the administration of the Medicaid program.”
Creating equitable systems
BAGs are another way CMS is addressing disparities in health and human services offerings as directed by the Framework for Health Equity. The CMS Office of Minority Health established this framework to provide guidance for building health equity into existing or newly established programs, so agencies can ensure the quality delivery of care to historically marginalized populations. This 10-year strategic plan includes five priorities for improving health equity, including:
- expanding the collection, reporting and analysis of data.
- assess causes for program disparities and addressing inequities in policies to close gaps.
- building capacity of organizations to reduce disparities in the delivery of care.
- advancing language access, health literacy and culturally tailored services.
- increasing forms of accessibility to health care services and coverage.
At FEI Systems, we’re keenly aware of the importance of equity in the delivery of health and human services. Our technology solutions are designed to adapt to changes in CMS policies, and we build business rules and program workflows that support health equity initiatives. We’re committed to working with our partners to address issues of disparity and ensure principles of equity are considered in the design, development and operation of our innovative enterprise solutions.