In recent years, accessibility and language inclusivity have changed from nice ideas to important rules. These regulations have become integral to CMS requirements, and members highly demand them. Health plans must now provide member communications in many formats and languages. This includes Braille, audio, 508-compliant PDFs, and on-demand translations in multiple languages.
This presents a tremendous logistical challenge and adds significant operational burdens that can drag down the bottom line. But these challenges are pushing forward intelligent automation. This technology can simplify complex logistics. It helps ensure better compliance and improves workflow efficiency.
This blog will discuss important CMS updates. The required formats will break down. We will explore the logistical and operational challenges that health plans face. Finally, we will show how to make these processes easier with automated workflows.
Why this matters: The imperative of member-centric accessibility
The landscape for member communications has fundamentally shifted. CMS requires that if a member asks for communication in a certain format or language, the health plan must provide it. No exceptions exist.
This change comes from deeper shifts in what members expect. Members want more accessibility and personalized experiences that meet their needs. In many ways, the CMS mandates simply hardwire these member demands into law.
Accessibility has changed from a “nice to have” option to a key part of fair access to care. It helps build trust with members. The impact affects many important member communications. This includes ANOCs, EOCs, Welcome Kits, Formularies, and general member letters.
Health plans must now explicitly offer:
- Materials come in different formats. These include Braille, audio files (often on a digital file or CD), and large print (usually 18pt font).
- You must translate vital documents into threshold languages based on your member population and CMS standards.
- Non-discrimination taglines: These must be on all important documents in up to 15 languages. They show that language help and extra aids are available.
- Section 508 compliance for digital materials: All digital communications, like posted PDFs, must follow certain accessibility standards. These include WCAG 2.0 Level AA and PDF/UA compliance. This ensures that screen readers can read them.
CMS audits are happening more often and are stricter. Some health plans are facing real penalties. Now is the time to make sure your health plan is compliant. It should also be able to grow and meet these new requirements efficiently and effectively.
Understanding alternate formats and translations
As regulations change, it is important for plans to understand what “alternate format” means. They also need to know the types of “translations” needed to support a diverse group of members. Navigating this full spectrum is essential for comprehensive compliance and effective member engagement.
Alternate Formats include:
- Braille: Specifically designed for visually impaired members.
- Large print: Characterized by a minimum of 18pt font to aid readability for those with low vision.
- Audio: Typically delivered as a digital file or on a CD, providing an auditory option for members.
- 508-compliant PDFs are digital documents designed to be easy to access. They work well with assistive technologies like screen readers. These documents follow standards like WCAG 2.0 Level AA and PDF/UA.
Translations include:
- Your member population and CMS guidelines determine threshold languages. Translate documents into these languages when a certain percentage of the service area speaks them.
- Vital documents: Members must request the translation of these critical communications, such as enrollment materials and benefit summaries.
- Non-discrimination taglines: These notices tell members about language help and support tools. They must be on all important materials in the 15 most common Limited English Proficiency (LEP) languages.
Challenges health plans can face: Navigating a complex mandate
The practical implementation of these CMS requirements poses significant operational challenges for health plans. Most critically, many organizations today rely on fragmented or manual processes to manage member communications and preferences.
The limits of this manual approach lead to significant inefficiencies and compliance risks. This happens as health plans try to follow the complex CMS accessibility rules.
- Manual production is time-consuming. The traditional method for creating alternate formats and translations needs a lot of manual work. This leads to delays and higher costs.
- Managing member preferences is hard without a central system. It is tough to track each member’s choices. This makes it difficult to apply their preferences consistently. This includes their language and format in different departments and communication methods. This task can get complicated and lead to mistakes.
- Tracking and reporting for CMS audits: To show that we follow the new rules, we need strong tracking and reporting tools. Many old systems do not have these tools.
- Disjointed vendor relationships: Relying on separate vendors for print, translation, and accessibility services can create inefficiencies, communication breakdowns, and increased logistical overhead. This often means partners are exceptionally efficient in one delivery method, like conventional English print. They depend on third-party relationships for occasional needs. However, this setup does not scale well with the likely volume and variety of alternate format requests.
The solution: Automate workflows for compliance and efficiency
Leading health plans are using automated workflows instead of dealing with new mandates through manual processes. This strategic shift allows organizations to meet compliance requirements both reliably and efficiently while simultaneously enhancing the member experience.
Key capabilities of automated solutions:
- Sync with member preference databases: A central preference management system is important. It serves as one source for all member language and format preferences. This ensures consistency in all communications.
- Automatically trigger the right formats: After capturing and storing preferences, the system can create and send communications. It can deliver them in Braille, large print, audio, or translated formats. This reduces the need for manual work and errors.
- Make sure you follow 508-compliance and are ready for CMS audits: Automated workflows can include accessibility checks. This ensures all digital materials meet Section 508 standards from the start. They also provide tracking and reporting for easy audit responses.
- Join translations, digital, and print production: Working with a complete solution provider like Toppan Merrill helps combine these processes. This makes production and delivery easier.
Key outcomes of automated fulfillment workflows
The unique capabilities provided through automated fulfillment workflows deliver significant advantages.
- Faster delivery to members: Reduces turnaround times for alternate format and translated materials, ensuring members receive critical information promptly.
- Lower costs: Automating repetitive tasks and consolidating vendors leads to substantial operational efficiencies and cost savings.
- Fewer errors: Minimizes the potential for human error inherent in manual processes, enhancing accuracy and compliance.
- Stronger compliance posture: Proactively addresses CMS requirements, reducing the risk of penalties and audit exposure.
- Improved member experience for underserved populations: Delivers on the promise of accessibility and inclusivity, fostering greater member satisfaction, loyalty, and trust.
A strategic imperative: Investing in accessibility to improve member trust
This strategic shift towards automated, member-centric workflows goes far beyond simply ticking boxes for CMS compliance. It represents a powerful opportunity for health plans to genuinely enhance the member experience, fostering deeper trust and loyalty. When members receive important health information, they feel that someone values their needs. Providing this information in their preferred language and format demonstrates a commitment to their well-being.
This level of personalized care is crucial for building stronger relationships, particularly with underserved populations who have historically faced barriers to healthcare communication. By addressing these needs, health plans can meet rules and create a more inclusive healthcare environment. This can lead to better engagement with care plans. It can also improve health outcomes.
Ultimately, it helps create a fairer healthcare system. In this system, everyone sees, hears, and supports each other.
Investing in these automated solutions is a smart choice for compliance. Also, a strategic step involves providing accessible, high-quality care for all members. This helps build a health plan’s reputation as a true partner in wellbeing.
How Toppan Merrill can help
Let Toppan Merrill help you lower risk, boost efficiency, and provide a better, more inclusive member experience. You can do this without extra operational stress.
Toppan Merrill Control Center is a secure, centralized platform. It automates fulfillment using real-time member data. It tracks every request from intake to delivery. The platform also offers strong reporting for audit readiness.
