Why it’s expensive to invest in low-cost interpreting services

With one in five U.S. residents now speaking a language other than English at home and more than 350 languages spoken across the country, health care organizations increasingly rely on language service providers (LSPs) and qualified interpreters to communicate effectively with patients.

But while organizations that receive federal funding are required to provide language services to patients with limited English proficiency (LEP), it’s an area that’s regulated but unfunded — physicians are left footing the bill for these critical services.

That makes language services a natural place for practices to target when looking for places to cut costs. Remote interpreting services, however, are far from a commodity. While it can be tempting to opt for the lowest-price interpreting service, that decision could create liability, compromise service quality and incur higher costs in the long run.

Here’s what you need to know about the true price tag of investing in low-cost interpreting services.

Low-quality interpreting can create liability

Health care providers are required by federal laws, including Title VI of the Civil Rights Act, to provide meaningful access to services for patients with LEP. Failure to comply with these regulations can result in investigations, fines and loss of federal funding.

In addition, miscommunication due to inadequate interpretation can lead to incorrect diagnoses or treatments, which can result in a medical malpractice claim.

Low-quality interpreting can compromise quality of care

Using medical interpreters with specialized education and training has been shown to be highly effective in decreasing readmission rates and improving outcomes for patients with LEP. When language barriers get in the way of effective communication, physicians are often unable to provide a certain standard of care to their patients. Without a professional interpreter, they run the risk of making decisions about medical care based on a misunderstanding or incomplete information from the patient.

In other instances, physicians without access to a medical interpreter turn to a patient’s family members for help. When providers rely on ad hoc interpretation by family members or children, English proficiency can vary widely. These family members may struggle with medical terminology, introduce bias, or even find it hard to share difficult news. Among its stipulations, Section 1557 of the Affordable Care Act prohibits relying on family members or friends as medical interpreters, except in emergency situations where imminent patient harm is at stake and no qualified interpreter is immediately available.

Unfortunately, not all LSPs vet their interpreters to ensure that they are qualified to provide medical interpreting; without testing for skills, there’s no way to know whether interpreters have the required education and training.

The lowest per-minute price may not result in the lowest total cost

Health care leaders are looking to find the right balance between the quality and cost of interpreting services, but not all physicians are aware that the lowest per-minute price can come with unforeseen consequences that include the following:

• Call efficiency: Inexperienced interpreters cost less, but inexperienced interpreters are also less efficient in facilitating conversations. This leads to longer calls, which translate into higher spend and increased risk.
• Additional costs: Many lower-cost LSPs bury costs behind a low-minute rate. When considering the total overall cost, ensure that you are aware of any extras the LSP will charge, including implementation, software license fees, custom call routing, integrations, support materials, training, monthly minimums and third-party dial-outs. You may have to ask about each of these specifically during the purchasing process.
• Internal efficiencies: A budget interpreting resource may care more about its own bottom line than yours. Look for an LSP partner who will support you in running your language program as efficiently as possible, for example, with an electronic health record integration that streamlines access to interpreters.
• Privacy and security: Some lower-cost LSPs outsource their IT and security support, which can expose you to liabilities related to data privacy, security and patient confidentiality. Your LSP should both be compliant with the Health Insurance Portability and Accountability Act and have an in-house security team, including a risk officer on staff.

Find the right partner

Whether you’re looking to begin offering interpreting services or exploring your options with a new LSP, there’s a lot to consider. While there is widespread awareness of the need to ensure meaningful access to interpreters for patients whose preferred language is not English, price is always going to be a big piece of the equation. To ensure that you are able to accurately project what your costs will be, find a company that’s not burying additional costs. You should be able to fairly accurately predict what your expenses will be by giving your LSP your language mix and number of minutes per month or year.

Above all, choose a partner who matches your level of commitment and personal touch. The interpreter on the other end of the line is representing your team to your patient — and potentially to your peers as well. Know what you want to convey about yourself and your brand and ensure that your partner’s interpreters meet the level of quality you aspire to. Ultimately, the right partner will make sure both you and your patients are supported and protected.

Kristin Quinlan joined Certified Languages International (CLI) in 1999, ascending to CEO in 2006. Under her leadership, CLI has become not just a provider of language services but an advocate for the greater good of comprehensive language access.