California Health Information Partnership and Services Organization
The rising number of mono and multi-lingual speakers in California has created significant communication barriers in healthcare settings, resulting in challenges for providers and worse health outcomes for patients. Effective communication between a clinician and patient is critical for safety and quality of care. It is through conversations that clinicians process patient information to determine appropriate diagnosis and treatment plans. When patients and clinicians cannot understand each other, the risk of misdiagnosis, under-diagnosis, duplicative testing and inappropriate prescribing increases. Additionally, patients that experience language barriers are less likely to seek care, build trusting relationships with providers, or adhere to treatment programs.
Anthem Blue Cross (Anthem) also understands the administrative burdens, health risks, and increased health care costs healthcare providers face when encountering patient language barriers. To help provider partners address these challenges and improve health equity for multi-cultural patients, Anthem launched a transformative initiative to help health centers access on-demand, live video and audio interpretation services. This effort has been extended to healthcare providers across California for their entire patient populations.
To make this initiative a success, Anthem Blue Cross has been able to address and overcome a significant billing and claims reimbursement challenge. Historically, healthcare providers have been responsible for working directly with interpretation service venders to manage all billing and claims reimbursement for on-demand video interpretation services. This responsibility carries added financial and administrative burdens for healthcare providers, and presents challenges when it comes to scaling the technology within complex multi-payer health care delivery systems. To overcome these barriers, Anthem Blue Cross partnered with an industry-leading interpretation services vendor to develop a first-to-market solution that is compatible with health insurance reimbursement models.
During initial development phases, the interpretation vendor established a process to collect and store patient health insurance information at the time of service. Significant operational changes were made that enabled the interpretation vendor to use the collected information to bill Anthem Blue Cross directly for interpretation services provided for Anthem’s Medi-Cal members. In future phases, the interpretation vendor will develop the ability to lookup patients’ insurance eligibility status ahead of initiating services, which further helps to streamline the insurance billing process. Additionally, Anthem leveraged its large purchasing power to negotiate and pass through significantly discounted rates from the interpretation services vendor to partnering healthcare providers for services to non-Anthem members and the uninsured.
Anthem is the first health plan to participate in this multi-payer solution, which is already reducing costs and administrative burdens for many health centers. Anthem’s solution is deployed through mobile kiosks that are provided for health centers’ exam rooms. The kiosks include top-of-the-line, Wi-Fi enabled tablets that allow treating clinicians to access and engage certified interpreters immediately, without having to pre-schedule in-person interpreter appointments or wait on hold with health plan call centers.
The kiosks allow healthcare providers to access more than 240 languages, including American Sign Language. These live interpretation services are as effective as engaging onsite interpreters, but are more timely, efficient and cost-effective. The tablets are also pre-configured for telehealth visits using multiple video conferencing platforms. This added value is especially important during the current COViD-19 health crisis. Additionally, the kiosks can be used to access patient and health plan portals, look up patient health insurance information, and access available community resources.
Anthem has already deployed over 200 of these kiosks inside 80 clinics in less than 6 months, and has made a significant investment to procure, configure and embed hundreds more in health centers across the state. This effort is helping health centers establish stronger relationships with multi and mono-lingual speaking patients and strengthening health homes.