Here are five reasons for Benefit Managers and Consultants to consider Translating Open Enrollment Communication materials:
1. Increase Participation Rates
If you have a large LEP workforce (Limted English Proficiency) and your participation rates among this workforce are down, translating open enrollment communication materials might give an incentive to learn more about the benefits of Open Enrollment. Note also that decision making is often a family-wide practice. Even if your workforce is proficient in English, the complexities of the healthcare system and the fact that information has to be shared to other LEP family members could be a reason why your participation rates are down.
2. Help Clarify Healthcare Concepts
Related to the first point, healthcare in the United States is often confusing. Even among English speaking Americans, the healthcare system makes use of confusing terminology that often seems similar, but in fact can have different financial consequences. Terminology such as in-network and out-of-network have clear definitions and require more information about the doctors, hospitals or specialists that you visit. But what about the relation between deductible, out-of-pocket maximums, copay and co-insurance? These are concepts that need to be understood to make informative financial decisions about the plans that are offered. Much of these plan offerings can be simplified using examples, but these examples don’t give you the whole picture. In researching Spanish terminology among plan providers, insurance agencies and government organizations, we found that these organizations do not always use the same terminology for the same English concept, adding to the confusion. Translating materials and providing glossaries will help enrollees become more confident in the decisions they make.
3. Better Healthcare Data
Big Data is the driving force behind the integration of disparate systems that make up employee benefits. There are two factors that could be impacted by translation. One is the participation rate, which was discussed before. This could increase access to employee data and their wellness has become a strategic advantage to overall employee performance and retention. Companies may learn that different workforce populations make different decisions or perhaps similar decisions that could be leveraged. Certainly, if the workforce population is culturally diverse, different health beliefs and healthcare outcomes may also feed into data that could help an organization make better decisions. Having the right data also may inform your healthcare communications to address topics that have previously been uncovered. Participation data may need to be tested against benchmark industry data to see if there is correlation.
The other big data factor is that employees are more in control over their own healthcare data. However, without a true understanding of the individual’s role in the management of their own health and wellness, these individuals may fall behind and avoid using the tools necessary to make better decisions. Whenever we see Open Enrollment or Healthcare Communications that aim to drive behavior towards the adoption of Health and Wellness programs (Read more about Health Disparities), there is a lack of continuity in language support that may have an impact on the efficacy of the program.
4. Better Access to Technology
Part of the problem is a delay in adoption of translation in technology. The lack of professionally translated web platforms or apps could cause a discrepancy in experience when an organization offers enrollment support in one language, but is unable to support many of the programs in the same language. That technology gap is shrinking rapidly through the standardization of localization practices. App developers have more access now to localization automation tools; see for instance Apple’s internationalization best practices with Xcode. Many platforms now are built around XML or XLIFF standards that are used in localization by professional translation firms. Plan providers are now supporting more languages as well as the needs are growing.
Enrollment help can also be made more efficient by adding foreign language support. This support doesn’t have to be expensive. Phone Interpreting Technology can be leveraged to support a call center during Open Enrollment periods and could be used to help individuals sign up to portals, apps or wellness programs. The increasing availability of translated materials around wellness and healthcare should give confidence to organizations to provide healthcare communications in the person’s native language, without the fear of losing consistency in experience when they go through the healthcare system.
5. Be the Authority in Healthcare Communications
A lot of translation support in healthcare has been developed through mandates that have been put into law. Organizations that are offering ACA or Medicare/Medicaid plans have already had to adopt language support for plan participants who make up more than 10% of their population. This threshold is only met in certain states and only in Spanish, but there is also an additional mandate where language access support is offered if requested for the top 15 languages spoken in a particular region. This has made hospitals, doctor offices and supporting healthcare more language diverse by adopting their own language access plan (read about CMS’ guidelines on creating a Language Access Plan).
However, despite the detailed information that CMS puts out, we often do see language access being performed at a lowest bidder level likely due to the mandate that language access must be offered for free. So while language access might be up and more expected, the quality of language support may vary. Just recently, we were working on a CMS Form into the Farsi language and were looking to see if CMS had done related materials in Farsi. The materials that were found online were full of errors and in discussions with our translation team who has worked on CMS documentation, it is often not the quality of the translators, but rather the quality of implementation (formatting, preparation work, glossary work) that lacks detail. In our case, a detailed and adequate scope of work was required to make decisions about references, eliminating formatting discrepancies between systems and proper allocation of proof time for final approval.
By moving the source of information away from disparate efforts in language support across the healthcare system into the domain of your own healthcare communications, your organization will serve as the leading authority when it comes to healthcare decision making. Your organization can take a leading role in making healthcare better for everyone and less reliable on the set of resources that may lead them to behavior that is not in the best interest of the employee or the company.
The goal of Open Enrollment communications is to ensure that your workforce is participating in choosing the right healthcare benefits and in an informed manner. While open enrollment is very much employee driven towards their benefits and success, it is certainly also a strategic component of your hiring and retention practices and controlling of costs. If you as a Benefits Administrator, HR Consultant or Plan Administrator find that your workforce is in need of language support but don’t know whether to justify the costs of translation of open enrollment communications, consider how the metrics to support translating open enrollment communications are driven. First, consider how your workforce is making decisions. Are they speaking other languages at home with their family? What’s the cost of retention versus the possibilities of workers making poor health decisions? Do plan participants fall off when it comes to participation rates when technology is involved? Is there something I can learn more about different participation groups if I can help them access to technology? What are the barriers? These are all metrics that can be bench marked and tracked against performance before and after language support. Because open enrollment is often the first, and sometimes the only place where people make decisions about their health, it’s worth investigating the opportunity cost against supporting your workforce in more than one language.