I was looking into the impact of the new Medicare provisions on medical translation, what with the new MIPPA provisions coming online in 2010.
In Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331) legislative lip-service is given to translation of the application form into at least 10 languages, but that’s about the extent of it. Evidence and experience suggests that its much worse in practice, which will hardly come as a surprise. So long as translation costs money, people are going to want to avoid paying for someone else’s translation unless someone makes them. Patients who don’t speak English need patience, since they don’t have the kind of pull it takes to demand linguistic access.
The California Medicare Part D Language Access Coalition published “Please Hold”, subtitled “Medicare Plans Leave Limited English Proficient Beneficiaries Waiting for Access.” They had a bunch of callers playing LEP Medicade recipients.
Medicaid plan call centers continue to fail to serve significant numbers of beneficiaries. In 2008 plan sponsors are able to serve Limited English Proficient (LEP) beneficiaries 69% of the time (up from 55% in 2006). Non-Spanish speaking LEP beneficiaries are connected to someone speaking their language, after weighting, 57% of the time (up from 37% in 2006).
The majority of survey calls that did not connect to someone speaking the language of the caller ended without even an attempt. Nearly 70% of the calls that connected to a live speaker ended without an attempt to connect in the caller’s language. The remaining 30% ended after an unsuccessful attempt.
Struggles connecting were not confined to particular languages. No language, not even Spanish, saw more than 80% of calls successfully connected to someone who spoke the language of the caller.
Refusal by a plan customer service representative (CSR) to provide service in any language other than English was the most common reason for a failed call. In other cases, the call failed after the plan representative failed to correctly identify the language of the caller or when an attempt to connect with an interpreter was unsuccessful. Even when callers connected to someone speaking their language, they often did not get the information they were seeking. Par for the LEP patient course, so far and there’s more… next time.