Online Program

Speaking of language access: Interpreter requests and availability -- impact on patients' ratings of healthcare quality in a complex provider network, within a large and diverse Medicaid health plan, 2011

Wednesday, November 6, 2013 : 9:10 a.m. - 9:30 a.m.

S. Rae Starr, MPhil, MOrgBehav, HealthCare Outcomes & Analysis, L.A. Care Health Plan, Los Angeles, CA
Heidi Thompson, MA, Health Education, Cultural and Linguistic Services Department, L.A. Care Health Plan, Los Angeles, CA
Culturally and linguistically appropriate services require access to professional medical interpreter services at the point of service. Funding such services depends on making the case to administrators for resources. Healthcare organizations are increasingly rated in published measures of the quality of services. Demonstrating how interpreter access impacts those patient ratings, helps make the case for resourcing language access. The study analyzes the association between interpreter access and patients' ratings of healthcare quality. The briefing reports on interpreter access and service ratings in 2011 at a large urban Medicaid health plan serving a diverse population through an unusually large and complex provider network. Patients in 38 provider groups were surveyed as part of a pay-for-performance (P4P) program. Patients were asked how often they needed medical interpreters; how often they requested interpretation; and how often they got interpreter services. The briefing reports the percent of patients needing, seeking, and getting interpreters; relative access between language groups; and access for adult vs pediatric patients -- to guide design of interventions to promote interpreter access. The study also tests the association between interpreter access and patients' ratings of the quality of health care. The research connects interpreter access to performance ratings that demonstrate the value of interpreter services in terms of ratings that healthcare administrators care about. This presentation reports a best practice in measuring and analyzing interpreter access and its impacts, using surveys already done by healthcare systems for other purposes.

Learning Areas:

Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Discuss best practices in measuring and analyzing interpreter access, using surveys done already for other purposes. Describe the role of interpreter access in permitting communication between patients and providers and their staffs. Discuss the proportion of patients reporting need for and medical interpreter in a large urban Medicaid population. Compare interpreter access among language groups, and Medicaid cohorts (adult vs pediatric). Discuss the willingness of Medicaid members to request interpreters when needed, and potential barriers to such requests. Describe potential barriers (and solutions) for members and providers to request and set up interpreter access. Demonstrate the impact of interpreter access on patients' ratings of the quality of care and services. Discuss methods for making the findings actionable within a medical group, clinic, health plan, or agency.

Keyword(s): Interpreters, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Served seven years as Senior Biostatistician at the largest public health plan in the United States serving Medicaid and CHIP populations in an ethnically diverse urban county in the southwest United States. Managed CAHPS and related surveys from 2006 to 2013. Incorporated questions on interpreter access and cultural competence, and designed related analyses to improve the quality of services and care. Consulted on design and validation of measures of professional interpreter knowledge, skills, and abilities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.