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[ Recorded presentation ] Recorded presentation

Lessons learned: Linguistic services as a measure of quality in HMOs

Cori D. Reifman, MPH, California Office of the Patient Advocate, 320 W. 4th Street, Suite 880, Los Angeles, CA 90013, 213-576-1320, creifman@dmhc.ca.gov and Leobardo Estrada, PhD, School of Public Policy and Social Research, University of California, Los Angeles, Department of Urban Planning, Los Angeles, CA 90095.

The California Office of the Patient Advocate (OPA) was created in 1999 as part of one of the most comprehensive HMO reform initiatives in the country. OPA is required to produce an annual HMO Report Card for California HMO enrollees. The first annual HMO Report Card in 2001 was the first in the nation to also include data on linguistic services. As part of the Year 3 Report Card project, OPA surveyed the largest commercial and Medicaid health plans to assess the provision of linguistic services and whether plans provide: oral interpreter services, sign-language interpreter services, assessment of interpreters, non-English printed materials, translated provider directories, cultural-competency training, and monitoring of grievances/complaints related to language services. These health plans represent over 90 percent of the 18 million HMO enrollees in the state. California’s delegated model and the different types of coverage (commercial, Medicare, Medi-Cal and Healthy Families) posed unique challenges in both obtaining the data from health plans and presenting the information to consumers in a useful format on the 2003 Report Card. Lessons learned from Year 2 and 3 will be presented including, collaboration with expert stakeholders to receive input on linguistic services as well as plan operations, input by consumers via focus group testing and online surveys, and how these impacted revisions to the survey and the 2003 Report Card. Lastly, an overview of a new and innovative part of the project incorporating the development of a rating scale to compare health plans on linguistic services will be presented.

Learning Objectives:

Related Web page: www.opa.ca.gov

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

[ Recorded presentation ] Recorded presentation

Medicaid and Managed Care: Reaching and Serving Those In Need

The 132nd Annual Meeting (November 6-10, 2004) of APHA