Healthcare is complex. It’s fragmented, can be expensive, and it has long suffered from a lack of coordination. In fact, costs for patients with uncoordinated care are 75% higher than for matched patients with coordinated care. That’s why care coordination is a helpful model that payers and providers can use to streamline complex medical care, improve customer satisfaction and reduce overall costs- all while enhancing population health for patients and their communities.
Successful care coordination models have defined core principles that can be shared and understood at all levels across a health system, ensuring that member and patient information doesn’t get lost or miscommunicated along the way.
One challenge many healthcare organizations face is navigating language barriers. While engaging members or patients with complex care is difficult, language barriers can make driving positive health outcomes seem impossible to achieve. Incorporating bilingual care coordination into your organization can foster relationships with Limited English proficiency (LEP) members and patients through mutual language and compassionate care and help provide improved access to vulnerable populations.
Healthcare organizations that are designing, developing, or optimizing a bilingual care coordination program should consider the following:
#1: Determine Your Language Gaps
Limited English proficiency (LEP) is not only a barrier to accessing health care in the first place, but it also affects communication with health care providers and ultimately impacts health literacy. Take time to look at your LEP member and patient base communities to determine where your language barriers lie. This can help you identify the linguistic and cultural populations you serve so you can best serve them at all junctures in your healthcare system through language services. If you’re a provider you can find information on this using the Language Access Plan and Language Access Program Audit. If you’re a payer and you’d like to observe your present language obstacles, review your internal cultural competence program or consider prepping for an NCQA Multicultural Health Care Distinction.
#2: Fill the Language Gaps
Now that you have documented your language obstacles, it is important to look at what solutions work best for your members and patients and organization overall. Work with your language services partner and internal stakeholders to discuss ways you can fill your current language gaps.
#3: Provide Continuity of Medical and Non-medical Services in Language
True care coordination doesn’t solely address the medical needs of individuals, but it also addresses non-medical issues that affect health. Organizations should look at the social determinants of health affecting their communities to help create more seamless and encompassing care. Ensuring that these services are in language helps create better overall health outcomes. According to one study, the use of translation tools increased the satisfaction of both medical providers and patients by 92% while also improving the quality of healthcare delivery and patient safety.
#4: Implement Tools for Delivering Bilingual Coordinated Care
To secure functional bilingual care coordination, organizations will need to implement instruments that allow providers to work across healthcare settings and give members and patients access to care that is equitable. Things like Video Remote Interpreting (VRI) based care, Over-the-Phone Interpreting (OPI) based care, translation, localization are some of the essential tools that can help deliver quality bilingual coordinated care across your organization. It is crucial to make sure that your communications are in language, timely, and accurate.
#5: Focus on Improving Transitions of Care
LEP populations experience low health literacy which can lead to poor health outcomes, affect the quality of care and lead to high readmission rates. Members and patients with poor health literacy are 1.3 times more likely to be readmitted than those with higher education about their care, and many of those individuals are part of the LEP community. As we know, the cost of readmissions in the U.S. healthcare system is very high, sitting at about 26 billion dollars annually. This is why improving transitions of care through bilingual resourcing should be a focal point in your care coordination model.
#6: Conduct Health Risk Assessments to Understand More about Your LEP Population
While performing health risk assessments is a core principle in a basic care coordination model, conducting these evaluations can also greatly help your organization understand the health risks that are associated with your LEP populations.
#7: Measure and Optimize to Provide Tailored Bilingual Case Management
One of the most effective ways to improve health outcomes for your LEP population is to measure your performance of bilingual case management. This information can help you better target people in need of bilingual coordinated care, while also tailoring your care even further to the subgroups of your LEP members and patients. These measurements and optimizations help to distinguish your LEP communities and the high-risk groups within.
#8: Regularly engage with Key Stakeholders
In order to address the wide range of LEP patient and member needs, meet with your organization’s stakeholders on a regular basis and create an interdisciplinary care team. Include your language service partner in this process. Through an interdisciplinary care team that includes bilingual care providers, staff can share information about LEP populations and design approaches to solve complex health care problems together.
#9: Continuous Training of Bilingual Staff.
To guarantee effective bilingual coordinated care, bilingual staff should be trained consistently and continuously. An essential part of this training includes cultural competence. This highlights the idea of successfully operating in different cultural contexts and changing practices to connect and communicate with different cultural groups in your care.
#10: Review Yearly CMS Measures for Improvements.
To keep your bilingual care coordination model up to par, monitor the Centers for Medicare & Medicaid Services’ (CMS) annual performance data under Measure C27: Care Coordination. Consider whether the data is available by language and ensure you can monitor the impact of your bilingual care coordination program. Compare your data and measurements to your English-language programs to make a plan that optimizes your bilingual care coordination model for the coming year.
Your LEP members and patients deserve equal access to healthcare and exceptional service. Unlike traditional interpretation, consider using an external bilingual care team to drive improved health outcomes by extending coordinated care models to complex LEP populations. The steps above bring you through the journey towards a comprehensive and reliable bilingual care coordination model.
To learn how you can get started on creating a bilingual care coordination model that works for your organization, get started with our Language Access Program Audit, visit our bilingual care coordination landing page, or contact us to get started on a distinction in NCQA’s Multicultural Health Care.