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Immigrant Health, Value-Based Care, and Emergency Medicaid Reform

The politicization of immigration has highlighted the unique challenges many immigrants face to accessing stable, high-quality health care, particularly those who have lower incomes or are  undocumented. Barriers related to language, stigma, and difficulty navigating the health system aside, immigrants in the United States have more limited access to commercial health insurance through employers and to public insurance through Medicaid and the Children’s Health Insurance Program (CHIP).

Lack of regular health coverage and uncertain access to care creates an environment favoring catastrophic and hospital-based care over ambulatory and primary care, at a time when health systems and policy makers hope to shift in the reverse direction and reduce unnecessary emergency department visits and hospitalizations. Indeed, value-based care is among the few remaining bipartisan health care initiatives, and Alex Azar, JD, Secretary of the Department of Health and Human Services, recently identified “value-based transformation” as one of his 4 overarching priorities.

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