ULG Navigator Program
Improves Access and Drives
Engagement in North Carolina

Case Study 49 | Healthcare Navigator


With data driven approach and multi-channel, targeted outreach, the ULG Navigator program improved healthcare literacy, increased care access, and built trust with diverse populations.

Chapter 1


Improving Care Access For Culturally Diverse Communities

The Centers for Medicare & Medicaid Services (CMS) launched a nationwide initiative to increase awareness of the ACA Marketplace and its offerings and improve access to care for underserved, bilingual, and limited English Proficiency (LEP) populations.

United Language Group received a 3-year, $1.3M grant in 2021 as part of the initiative. Among several health systems and community-based non‑profit organizations, ULG was the only private entity chosen as a partner. With more than 30 years of experience in healthcare and the ability to effectively communicate, educate and build trust with diverse populations, ULG was uniquely positioned as a partner with a solution that meets the language and cultural needs of bilingual consumers.


Chapter 2


Consumer-Centric, Culturally-Responsive Approach

ULG developed the ULG Navigator program, a first-ever collaborative effort with CMS to break down language and cultural barriers, guide populations eligible for Medicare and Medicaid through the enrollment process, and improve care access and outcomes.

Comprised of a team of certified and trained bilingual, bicultural navigators with high Spanish and English proficiency, the program provided in-person and complementary telephone services to bilingual and LEP consumers, mostly comprised of Hispanic and Latino populations. The program included 4 key focus areas:

Strategy & Planning

ULG worked together with CMS to determine the program focus and set goals which included enrollments, referrals, benefit utilization, and interactions. ULG then outlined a detailed work plan and timeline for all initiatives Culturally Diverse Communities including:

  • Hiring
  • Training
  • Website
  • Education
  • Outreach

As a multi-year program, ULG also prioritized training and investing in ongoing efforts to evaluate, assess, and support ever-changing cultural, industry, and economic needs.

Target Market Identification

After conducting a population health data analysis, ULG identified the metropolitan Charlotte and Raleigh, North Carolina areas where a high density of bilingual and LEP consumers, including a significant migrant worker population, were located. With a lack of linguistically and culturally‑competent services, these populations historically faced barriers to accessing health insurance and high-quality care.

Supporting Health Literacy

Bilingual Spanish-English navigators as well as multilingual support in 200 preferred languages from on-site and call center interpreters provided education, guidance, and support to improve health literacy.

  • Explained how health insurance works and key terminology.
  • Provided information about how to enroll in the ACA Marketplace plans and
    assistance with the application.
  • Offered access to healthcare and social resources, including a coordinated
    referral network partner.
  • Provided information about medical billing and payments.
  • Conducted educational workshops to promote Marketplace awareness and
    improve healthcare literacy.
  • Helped community members find a providers.

Outreach and Engagement

Strategic partnerships with local organizations enabled ULG to establish and maintain brand awareness, forge trusted relationships in the community, and reach and engage with the target populations.

Partnered with community-based organizations including FQHCs, county
health departments, arts and cultural centers, large health systems, faith-based
organizations and clinics, statewide organizations, the Latin American Coalition,
and Hispanic media organizations.

  • Hosted and attended regular local culturally relevant and enrollment events.
  • Conducted outreach to potential partners and local business owners.
  • Maintained a consistent presence at partner locations and provided translated
    resource materials, addressed inquiries, and scheduled appointments for
  • Launched culturally-relevant, in language marketing efforts and local advertising
    using multi-channel approaches.

Chapter 3


Building Trust, Driving Enrollment

By delivering bilingual, culturally-responsive services, navigators were uniquely positioned to help consumers overcome barriers to enrollment and quickly forge trusted relationships, driving better health outcomes and empowering consumers to make appropriate healthcare decisions in the future.

At A Glance

  • Language and cultural barriers
  • Lack of healthcare literacy
  • Low enrollment in ACA Marketplace
  • Strategic partnerships and local presence to build trust
  • Improved healthcare insurance literacy
  • Outreach and engagement efforts to drive enrollment
  • 81% enrollment in a Marketplace Qualified Health Plan
  • Grew application submissions by 50%
  • Increased consumer interactions by 197%
  • Provided more assistance for the increased need in:
    • Health literacy education
    • General health insurance inquiries
    • Locating Provider
    • Billing and payments questions
    • Advanced premium tax credit
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