Disparities exist between public and private HMOs in access to interpreter services for patients with no or limited English skills, according to an analysis of the 2003 California Health Interview Study by researchers at the University of California-Los Angeles.
More than one million HMO members in California face difficulties in obtaining health services because of language barriers. According to the analysis, public health programs such as Medi-Cal and Healthy Families provided interpreter services for 81% of health plans during business hours, compared with 67% of private plans and 50% of plans associated with Medicare.
The authors found that 25% of patients with limited or no English skills who did not have access to an interpreter experienced difficulties in understanding medication instructions, compared with 2% of patients who were able to work with an interpreter. The analysis also found that patients with limited or no English skills receive less primary, preventive and public health services but visit emergency departments more often and receive fewer services while there, compared with the general population.
The study concludes that data indicate the need for continued monitoring of interpreter services, including the disparity between public and private plans. Researchers suggested that HMOs do more to train providers and staffs and increase the diversity of languages spoken by their employees. Researchers also noted that regulations being developed by the Department of Managed Health Care, which will require private HMOs to offer language translation services, will help clarify what language services limited English speakers should expect from their health plan (Kominski et al., UCLA Health Policy Research Brief, May 2006).