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Enhancing Cultural Competency in Health Care Services

Explore the integration of health literacy, cultural competence, and language access services in healthcare evaluation programs to improve quality care and mitigate disparities. Understand how accreditation programs address CLAS standards and disparities, focusing on the multifaceted approach to diverse membership needs.

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Enhancing Cultural Competency in Health Care Services

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  1. Integrating Health Literacy, Cultural Competency and Language Access Services October 19, 2015Jessica Briefer French, Senior Research Scientist

  2. NCQA Mission To improve the quality of health care. Vision To transform health care through quality measurement, transparency, and accountability.

  3. Relevant NCQA Evaluation Programs • Accreditation programs for health plans and other entities (n=1522) • Multicultural Healthcare Distinction (n=16) • Healthcare Effectiveness Data & Information Set (HEDIS) (n=1,171) • Recognition programs for Patient-Centered Medical Home (n=11,296) and specialty Practice (n=101)

  4. Health Plan Accreditation vs. Multicultural Healthcare Distinction Health Plan Accreditation MHC Distinction Focus on CLAS and Disparities Standards address CLAS and disparities Health literacy not addressed • Standards in many categories • Fewer CLAS standards • Health literacy addressed throughout (requirements to provide information in understandable language)

  5. Strategic Focus Differs Health Plan Accreditation MHC Distinction Program description for improving CLAS includes objectives for serving a culturally diverse membership, a process to involve members of the diverse community, a list of measureable goals for improving CLAS. Program description specifies objectives for serving a culturally diverse membership (and 8 other objectives)

  6. Cultural Competence of the Network Health Plan Accreditation MHC Distinction Enhancing network responsiveness is comparable. Assessment & Availability of Information also requires collection and publication of information about practitioner languages and language services Network cultural and linguistic competence requires assessment of cultural, racial and linguistic needs of members and adjustment of the availability of practitioners.

  7. Language Services Health Plan Accreditation MHC Distinction Requires: Translation of vital docs Provision of competent interpreter or bilingual services Supporting practitioners in providing language services Notice of the availability of language services Requires: • Provision of language services for complaints and appeals processes and member services • Provision of information on how to obtain language assistance

  8. Focus on Improvement Health Plan Accreditation MHC Distinction Requires: Assessment of the use of, and experience with language services Improvement of CLAS Evaluation of the effectiveness of interventions to improve CLAS Requires: • Improvement, but not focused on CLAS

  9. Data Collection for CLAS Health Plan Accreditation MHC Distinction Requires: Collection of data on race/ethnicity Collection of data on language needs Reporting HEDIS Diversity of Membership measures Requires: • Reporting of selected HEDIS measures

  10. HEDIS • Language Diversity of Membership • An unduplicated count and percentage of members enrolled at any time during the measurement year by spoken language preferred for health care and preferred language for written materials. • Race/Ethnicity Diversity of Membership • An unduplicated count and percentage of members enrolled any time during the measurement year, by race and ethnicity.

  11. 2014 HEDIS Diversity of Membership Measures:Race, Ethnicity, Language Needs Availability of health plan data on race, ethnicity and language needs varied by type of plan, but remained largely incomplete

  12. Patient-Centered Medical Home Recognition Practices must: • Understand and meet the cultural and linguistic needs of its patients/families by: • Assessing the diversity of its population • Assessing the language needs of its population • Providing interpretation or bilingual services to meet the language needs of its population • Providing printed materials in the languages of its population • Use an electronic system to record patient informationas structured data on … race, ethnicity, preferred language • Collect and regularly update health assessment including assessment of health literacy.

  13. Recognized Practice Results

  14. Discussion • Standards and measures of CLAS and health literacy are available • Purchaser and regulatory incentives make a difference • Alignment with Meaningful Use incentives helps • Covered California is considering requiring Multicultural Healthcare Distinction • More leverage and incentives are needed • Combat delivery system reform fatigue • Align and focus efforts on priority areas

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