States Requiring Medicaid MCOs to Demonstrate Progress on Multicultural Efforts
As they put more emphasis on reducing health disparities, some states are requiring Medicaid managed plans to achieve the National Committee for Quality Assurance’s Multicultural Health Care Distinction.
The NCQA Distinction in Multicultural Health Care (MHC) identifies organizations such as health plans, managed care organizations, and population health organizations, that lead the market in providing culturally and linguistically sensitive services and working to reduce healthcare disparities.
Wisconsin is making several changes to its Medicaid managed care contracts. In addition to requiring managed care organizations to participate in the state health information exchange by June 2021, the Wisconsin Department of Medicaid Services (DMS) is developing an updated state Medicaid health information technology plan to bolster quality improvement strategies for managed care.
Wisconsin health officials recently mandated that the state’s 15 Medicaid HMOs achieve full NCQA Health Plan Accreditation (HPA) by the end of 2023, with more rapid adoption of interim accreditation where possible. Wisconsin joins 28 other states requiring its Medicaid plans to adopt the NCQA HPA as the sole quality standard to meet. The plans will be required to meet the NCQA MHC in the same time frame.
“We feel the NCQA Multicultural Health Care Distinction is an important step in the Department’s ongoing work to improve health equity,” said Wisconsin Medicaid Director Jim Jones in a statement on the NCQA website. “The NCQA Multicultural Health Care Distinction will provide additional oversight of consistent health equity standards across all 15 of Wisconsin Medicaid’s health plans.”
MHC Distinction requires that plans meet or exceed standards in providing culturally and linguistically appropriate services (CLAS) and evaluates how well an organization is:
• Collecting race/ethnicity and language data
• Providing language assistance
• Being culturally responsive
• Improving quality improvement of CLAS
• Reducing healthcare disparities
To address gaps in care and disparities, MHC Distinction requires health plans to first identify and measure systemic disparities, and then work to close the gaps they identified using industry best practices.
Failure to address language needs or to consider racial, ethnic and cultural differences leads to worse health outcomes and higher health care spending, NCQA says. A well-designed program that is attentive to cultural needs and that identifies and reduces racial disparities can save organizations time and money.
“An emphasis on health equity is a natural evolution for healthcare quality measurement,” said Kristine Toppe, NCQA assistant vice president, state affairs, in a statement. “Reducing healthcare disparities and ensuring that everyone has equitable access to high-quality care is quickly becoming a national priority, given what gaps that COVID-19 has laid bare. Our MHC Distinction gives health plans a roadmap to identify and work toward closing those gaps.”
Other states see MHC Distinction as laying the groundwork for their future goals, NCQA said. In March, the State of Nevada mandated that its Medicaid plans meet NCQA HPA, and indicated that using MHC Distinction would be foundational in building a strong cultural competency program.
Covered California, the State of California’s health plan marketplace and the largest in the nation, followed suit in April, requiring adherence to both NCQA HPA and MHC for all its plans on a similarly rapid timeline. In the case of California, officials mandated full MHC compliance by 2022, with an additional two years to achieve NCQA HPA.
