UCLA CENTER FOR HEALTH POLICY RESEARCH
Vietnamese, Russian, Korean, Tagalog, Khmer,Armenian, Arabic, and/or Hmong.
DMHCbegan monitoring health plan compliance in January 2009, when all HMOs were requiredto have ully implemented language accesspolicies and procedures.The law is particularly important in the currenthealth policy environment as LEP populationswill make up a signicant portion o the newlyinsured ater implementation o the AordableCare Act, including via the state’s healthbenets exchange, Covered Caliornia. A recentUC Berkeley and UCLA analysis estimated that29% to 36% o non-elderly adults who take-upsubsidized coverage in Covered Caliornia willbe LEP.
In this study, we examine the LEP HMOenrollee population and attempt to measurecommunication barriers and early progresssince the Knox-Keene amendment wentinto eect. A limiting actor is that datarom 2009 may reer to language barriersthat existed as early as September 2007 andas late as April 2010 since respondents are
This publication containsdata rom the CaliorniaHealth Interview Survey(CHIS), the nation’s largeststate health survey.Conducted by the UCLACenter or Health PolicyResearch, CHIS data givea detailed picture o thehealth and health careneeds o Caliornia’s largeand diverse population.Learn more at:
LEPCaliornianswill make up a signifcant portion o thenewly insured under healthcare reorm.
Determined by the demographic makeupo a health plan’s membership, these arelanguages or which plans must providetranslated vital documents, includingapplications, consent orms, letters abouteligibility or participation criteria, andnotices advising changes in benets andavailability o ree language assistance.
Knox-Keene Health Care Services Act
Caliornia law established in 1975 thatregulates managed care plans. The law hasbeen amended multiple times since itsinception, including in 2003 to addresslanguage access issues as a result o SenateBill 853.
Limited English Profciency (LEP)
Individuals who reported speaking Englishnot well or not at all.
A method o payment in which health careproviders are paid per service rendered.In Caliornia, most ee-or-service care isdelivered to Medicare beneciaries andMedicaid enrollees living in rural areas.
Preerred Provider Organization (PPO)
A health insurance plan that encouragesmembers to seek care through contractedproviders by requiring patients to pay alarger share or services delivered outsideo its contracted network o providers. Forexample, a patient can see an in-networkprovider and pay 20% o the provider’s ee,or see an out-o-network provider and pay40% o that provider’s ee.
Health Maintenance Organization (HMO)
A health plan that requires members toseek care in a contracted network. HMOstypically use primary care physicians andother protocols to authorize specialty careand medical procedures. Care deliveredout-o-network is not covered except inemergency situations.