Making the Business Case For Culturally and Linguistically Appropriate Services in Health Care

In 2000, based on Title VI of the Civil Rights Act, and Presidential Executive Order 13166, the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) published the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care. These standards have become the clearest, most thorough statement of policy regarding CLAS and they guide health care organizations in addressing the cultural and language needs of the patients they serve.

In 2005, the Alliance of Community Health Plans (ACHP) Foundation, with funding from the Whitehouse Station, NJ-based Merck Company Foundation (the philanthropic arm of pharmaceutical company Merck & Co., Inc.), began a project to develop and make available information about CLAS projects that produced a business benefit. The goal of the project was to support health care organizations that are pursuing CLAS in health care with additional information for planning and decision-making about implementation of CLAS in their organizations.  

On May 1, 2007, the Foundation released the final report and 13 case studies on which the report is based for the project Making the Business Case for Culturally and Linguistically Appropriate Services in Health Care. The findings included in the final report are based on information developed about business benefits achieved by different kinds of health care organizations that implemented projects addressing one or more of the national CLAS standards published by OMH in 2000.

The organizations whose work provides the basis for our final report have achieved different kinds of business benefits from their work to provide equitable and culturally competent health care to patients. Those highlighted in the final report include:

• Increased market share among limited English proficient patients. Health care organizations implementing CLAS standards have achieved increases in enrollment and patient services among the insured. Cultural competency attracts business.
  

• Substantial reductions in outsourced language interpretation services and subsequent savings in related costs. Many health care organizations that address the threshold issue of language services have found very efficient ways to make better use of their own bilingual staff or volunteers, thereby reducing substantial costs of outsourcing interpretation services. 
  

• Increased patient and provider satisfaction. A number of health care organizations indicate that projects designed to implement any of the CLAS standards have improved patient and provider satisfaction with the health care process.
  

• More efficient use of staff time by reducing communication delays between patients and providers. Simply by addressing language issues, providers, provider office staff and patients enjoy reduced delays and a more efficient health care interaction.
  

• Cost-savings resulting from shorter hospital stays and more prompt and efficient patient discharges. Efficient and culturally competent solutions to providing discharge instructions and education in a language other than English have resulted in improvements in hospital-wide discharge practices and have yielded significant savings.