Multilingual Medicaid (Part 2)… it gets worse

by Translation Guy on February 3, 2010

How will changes to Medicaid provisions affect care for Limited English Proficient (LEP) beneficiaries? Probably not much, despite considerable room for improvement. Click here for Part 1, where an advocacy group tried to reach out for medical help in languages other than English. The chief finding: Its’ not so easy to find someone who speaks your language if your language isn’t English. But even if you do find someone who speaks your language, your problem.

When callers connected to someone speaking their language, they often did not get the information they were seeking. Beneficiaries who connected to someone speaking their language frequently encountered inaccurate interpretation, lack of basic standards of interpretation, long wait times and unhelpful or rude customer service representatives. Sounds a lot like customer support in English! But it gets worse.

Interpreters failed to translate accurately, or in the first person too often. Many interpreters struggled with basic medical and health systems’ terminology. Others violated basic interpreter standards by failing to translate fully or interpret in the first person. A lack of familiarity among CSR’s with protocols for interpreter-facilitated communication also contributed to miscommunication.

Plans relied heavily on third party interpreter services and bilingual representatives were rare. A third party interpreter was used in 85% of the calls that connected to someone speaking the language of the caller. A bilingual CSR was never provided in a language other than Spanish and even Spanish calls were regularly handled by interpreters.

Furthermore, receiving assistance from an interpreter, as opposed to a bilingual customer service representative, increased wait times. On average, callers who were connected to an interpreter waited four minutes and fifty-five seconds before speaking to someone in their language (starting from the time the phone is answered by the plan). This is a significant
wait time for a LEP caller who likely did not understand anything the plan representative said before being placed on hold. Callers who were served by bilingual CSR’s only waited an average of one minute and thirty-three seconds.

Customer service quality was also low. Only 40% of plan customer service representative were rated as “very helpful,” while 16% were described as rude. The customer service quality of interpreters was not much better with only 51% receiving a “very helpful” rating; limited English proficient callers were not able to get written materials in their language. During each of the 201 calls in which the caller was connected to someone speaking their language, the caller asked whether written materials were available in their
language. While plans claimed a number of times to have materials available in non-English languages, no materials in languages other than English or Spanish were ever actually received.

Hardly surprising. Par for the LEP course of treatment. Aside from any people dying due to a lack of translation, what does it all mean, industry wise? Now the advocacy group that sponsored this survey wanted the news to be bad, but still, this report is a real black eye for our profession.  Next time, TranslationGuy reveals the dark secrets behind the deadly lack of translation in the medical profession, and explains why its not his fault.


  1. Zibby Lee says:

    I’ve personally experienced this. Lack of translation quality is affecting the customer experience andmore importantly, MY health!

  2. Frank Jones says:

    I think that improved efficiency (cost up front) will actually reduce time and costs, maybe even reduce the need for so many reps.

  3. Agreed

  4. Che says:

    Nice post!

  5. Daisy says:

    One solution could be to enable the bilingual reps access to a centralized translation memory bank in order to avoid manual TM updates…thoughts?

  6. Thomas B says:

    Why do anything, no one is listening to the complaints unless they are in English, right? 😉

  7. Reanna Storp says:

    You cheeky bastard! :-)

  8. Wendy T says:

    LOL, I love that!

  9. Cura says:

    It’s true, no one is making any noise about this online (I looked around). Way to bring it up to the forefront TranslationGuy!

  10. Gillian says:


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