U.S. Primary Care Practice Capabilities Linked to Language Services for Patients with Limited English Proficiency

Area of Science:

• Health Services Research
• Health Equity
• Primary Care Medicine

Background:

• Patients with limited English proficiency (LEP) face significant communication barriers in healthcare settings.
• Federal policies mandate language services, yet national data on their availability in primary care is scarce.

Purpose of the Study:

• To identify characteristics of primary care physician practices associated with the consistent availability of language services for LEP patients.
• To understand factors influencing the routine provision of language services in adult primary care.

Main Methods:

• Utilized nationally representative survey data (National Survey of Healthcare Organizations and Systems) linked with IQVIA OneKey and American Community Survey.
• Employed multivariable logistic regression to analyze associations between practice attributes and language service availability.
• Defined "always" providing professional language services as the primary measure of availability.

Main Results:

• Fifty-four percent of U.S. primary care practices consistently provide language services.
• Practices in Accountable Care Organizations (ACOs), owned by healthcare systems/hospitals, or with Federally Qualified Health Center (FQHC) status were more likely to offer services.
• Practices with higher Medicaid revenue showed increased likelihood, while those with higher commercial insurance revenue were less likely to provide language services.

Conclusions:

• A significant portion of primary care practices fail to consistently offer mandated language services to LEP patients.
• Practice ownership (system-affiliated vs. independent) and FQHC status are key factors in language service availability.
• Policy interventions supporting ACO participation and favorable Medicaid payer mix can enhance routine language service provision.