Improving customer experience with an accessibility culture shift

The Centers for Medicare and Medicaid Services (CMS) are dedicated to advancing health equity, expanding coverage, and improving health outcomes. Equitable information access is critical to meeting its mission outcomes and the needs of citizens with disabilities. Working with Maximus, CMS expanded a required effort to improve accessibility into an organization-wide initiative to drive a broad cultural change, improve customer experience (CX), and support the citizen journey.

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Services provided

  • Program management, including coordination of multiple accessibility
    activities across CMS, other agencies, and their contractors
  • Training, including development, implementation, outreach, and launch of annual
    accessibility awareness program
  • Communications across print, digital, and call center channels to improve access
    to Medicare, Medicaid, Marketplace, and health/drug plan/provider information
  • Research and analysis to expand accessibility for the public

Success achieved

  • Strengthened compliance with Rehabilitation Act sections 501, 504, and 508
  • Reduced barriers to information access and effective communication
  • Achieved up to 98% accessibility awareness training compliance for 6,000+ CMS employees
  • Reduced accessibility complaints against health and drug plans to less than 1%
  • Increased CMS program awareness, customer experience, and overall customer and employee satisfaction
  • Established cross-agency collaboration and accessibility knowledge sharing

Addressing the agency's priority of building a cohesive accessibility program to improve health outcomes


Up to one in four Americans currently lives with some form of disability, and the disability community is the world’s largest minority group. In the U.S., giving them meaningful, equally effective access to government information and services is required by Section 504 of the Rehabilitation Act of 1973. This compels agencies to provide individuals with disabilities an equal opportunity to participate in their programs and benefit from their services.

Equal access can have a critical impact on health outcomes. When disability and vision-impaired advocates raised awareness of this fact, CMS addressed the challenge with substantial changes to improve accessibility.


CMS’s improvement to information access was not simply a box-checking effort, but rather a concerted commitment to becoming a model employer by shifting the culture and conversation around accessibility. The agency implemented Customer Accessibility Resource Staff (CARS), a programmatic approach to providing technology and expertise in program management, accessibility training, and communications with specific tactics to address the agency’s priority of building a cohesive accessibility program. This initiative included:

Accessible delivery of Medicare information to people with disabilities

CARS deployed dedicated staff resources to support equal access to meaningful Medicare information using accessible formats. The team conducted accessibility audits for and, leading to steps to ensure compliance with Americans with Disabilities Act (ADA) standards. Specifically, the team took a holistic view of communications to enhance the customer experience by strengthening use of all engagement channels – call centers, printed materials, digital, social media, and in-person assistance.

Improved stakeholder awareness, internal training and communications effectiveness

Maximus worked with CMS to develop an integrated, accessibility compliance training program for all 6,000 agency employees. The CARS team also integrated accessibility considerations into each new communications project from the start. Outreach and education activities were coupled with accessibility-specific branding. Culturally sensitive graphics, icons, and messaging were implemented to improve effectiveness and build trust with the disability community.

The team leveraged key innovation and expertise to help the agency make better technology investments that support accessibility goals. Implementation of agile processes enabled agency staff to quickly identify, assess, and triage any immediate accessibility issues. Maximus helped the agency stay informed about emerging technologies that enhance customer experience.

Expanded stakeholder outreach with the disability community

Recognizing the need to build bridges with the disability community, the CARS team established connections with CMS navigators – personnel who provide one-on-one benefits enrollment assistance. The CARS team provided the navigators with training to help them better address the needs of disabled citizens. The team also attended nationwide disability events, learning from citizens’ experiences and driving awareness of CMS programs and disability resources.


CARS has led to measurable impact as well as an overall shift toward an accessibility culture at CMS. The agency has achieved compliance for its annual accessibility training, seen significant decreases in information access complaints, and established collaborations with other Department of Health and Human Services agencies for sharing of information and best practices. For its achievements, the agency received a 2023 Service to the Citizen Award.