Overcoming Cultural Barriers in a Hispanic Medicaid Population

In May 2015, Eliza Corporation, a Danvers, Mass.-based, healthcare engagement company, launched diabetes management and well-child, preventive care programs among Hispanic members in coordination with 18 other programs for one Medicaid managed care organization.

Eliza identified and reached out to Medicaid members age 18 and over with a diabetes diagnosis, who met HEDIS qualifications for inclusion in the Comprehensive Diabetes Care measure and had a care gap in 2015 based on claims history. The diabetes management program was comprised of several timed and tailored IVR calls, emails, and text message interactions, encouraging recommended diabetes screenings. Members could decide whether to receive messages in English or Spanish.

The goal of a Hispanic approach is to do more than simply translate the English content; thus, key components of each diabetes outreach were tailored specifically for a Hispanic population, focusing on culturally relevant barriers to care, including cost, transportation, and language.
Culturally specific messaging strategies, such as email subject lines, were used in key engagement points. For example, the English version of an email subject line might say, “Keep up to date and feel your best.” Eliza´s culturally adapted Spanish message was, “Do you know how you can make your family happy?”

Eliza also identified and reached out to the parents/guardians of Medicaid members ages three to six and adolescents who qualified for inclusion in the HEDIS well-child visits and had a 2015 gap in care based on claims history. Similar to the outreach for diabetes, the well-child program was comprised of several timed and tailored IVR calls, emails and text message interactions encouraging parents/guardians to take their children to visits.

Parents/guardians could choose to receive outreach in English or Spanish. While it’s not uncommon for parents to have a protective instinct when it comes to their children’s medical care, it is especially prevalent in a Hispanic community. This may contribute to challenges developing relationships with healthcare professionals. It’s a trust issue, and it needs to be acknowledged and addressed when creating a dialogue.


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