Health Equity

ACOs have the potential to address health disparities and promote health equity. Advocates must work to ensure that Medicaid ACOs are designed in a way that is culturally appropriate, responsive to patients’ diverse needs and mindful of the important role upstream factors (such as housing, food security and economic status) play in health outcomes. While health equity is included here as a separate section in order to make this toolkit user-friendly and easily searchable, health equity should be considered and embedded in all aspects of a Medicaid ACO and this list should not be viewed as exhaustive.

Does your state Medicaid ACO program do the following?

  • Include requirements for cultural appropriateness, health literacy and implicit bias training for ACO providers. Furthermore, ACOs should define how they will evaluate these requirements; quality measures could focus on these principles.

  • Provide opportunities to train providers in caring for diverse groups. A training for caring for people living with disabilities could focus on independent living principles; a training for caring for LGBTQ populations could include preventing discrimination based on sexual orientation or gender identity.

    • Health literacy standards include ensuring written materials are accessible and understandable to all ACO members. Written materials should be printed in multiple languages and offered in alternative formats for blind and visually impaired members.

    • Oral interpretation should be available for all members with limited English proficiency, as should assistance for people who are deaf and need American Sign Language.

  • Implement strategies to encourage safety-net provider participation

  • Demonstrate how ACOs will employ a variety of health care providers, such as community health workers and peer specialists, into their care teams. Diverse providers are often attuned to the culture and needs of specific populations, and may be effective at connecting consumers to social services or at teaching healthy habits.

  • ACOs should also provide opportunities for team building and training and ensure all care team members feel empowered and engaged.

  • Develop plans to address health disparities. Collect and stratify data on key demographic and socioeconomic measures in order to appropriately target population health interventions, address and reduce health disparities, and improve how ACOs deliver care.