May 19, 2006

Language barrier puts Californians in HMOs at risk

A new policy brief from the UCLA Center for Health Policy Research shows that more than 1 million adult HMO members in California with limited English proficiency are at risk for problems accessing health care services and receiving quality treatment. The study, commissioned by the California Office of the Patient Advocate, illustrates the substantial need for language services in commercial plans, Medi-Cal and Healthy Families.

The findings also highlight the importance of recent statutory changes that will require the California Department of Managed Health Care to oversee and regulate language services in licensed HMOs.

“The language barrier impacts every level in the healthcare process, from communicating with your doctor to reading a prescription bottle to understanding important forms,” said Gerald F. Kominski, associate director of the UCLA Center for Health Policy Research and lead author of the study.

In their review of data from the 2003 California Health Interview Survey - the most comprehensive survey of the state’s residents on health issues - the brief’s authors found that 3.4 million adult HMO enrollees in California speak a language other than English at home, and of these, almost 30 percent report not being able to speak English well or not at all.

The policy brief is available for viewing at http://www.healthpolicy.ucla.edu/.

Previous studies have shown that the absence of language services restricts access and decreases the quality of health care for non-English-speaking individuals. In fact, more than

300,000 commercial HMO members in California with limited English proficiency had trouble understanding their own doctors, and 5 percent of these were not able to find anyone to translate for them.

Although the public Medi-Cal and Healthy Families plans have a higher percentage of members with limited English proficiency than commercial plans (21.4 percent compared to 9.2 percent), commercial plans have far more of these members (800,000 compared to 151,000). In addition, Medi-Cal and Healthy Families plans have done a better job of providing language services to their limited-English-proficient populations, while commercial HMOs have not.

“Interpreter and translation services are critical elements in the relationship between an HMO and its non-English-speaking members,” said Ed Mendoza, acting director of the California Office of the Patient Advocate, an independent state agency that advocates for HMO consumers. “Without good communication, it is difficult to deliver high-quality care.”

The California Health Interview Survey - the state’s largest health survey and one of the largest in the United States - is a unique source of information about how HMOs are serving their clients. Since it was first conducted in 2001, the California Health Interview Survey has been an essential tool for policy-makers, researchers and health advocates at every level needing a detailed snapshot of the complex health needs of California’s diverse population.

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