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Advice for your practice from parents of children on Medicaid and CHP+

The Colorado Children’s Healthcare Access Program (CCHAP) conducted a parent advisory meeting, in which parents discussed their perceptions and ideas about their experiences with their children’s pediatric office. A variety of minority and ethnic groups were represented and nearly all had children insured by Medicaid or CHP+.

These ideas, from parents, can help your practice better serve minority and families with low income.

The importance of reception staff

The front desk staff is an extremely important part of the experience that families with Medicaid and CHP+ will have in your office. As you already know, reception and scheduling staff serve as first responders and are responsible for handling the situation if parents are upset. They are also the staff members most affected when Medicaid and CHP+ patients experience “glitches in the system”, or if confusion or problems arise with people from other cultures.

The parents in our advisory group recognized how important their interactions with the front office staff are. They thought that it would be helpful for staff to learn a little more about the social and economic issues sometimes faced by low-income families and families from other cultures, and to learn about ways to help parents deal with frustrations.

It is also important for staff know what families with Medicaid and CHP+, minority, or immigrant families may come into the office with an expectation or fear that they will be treated differently. These families may often experience prejudice associated with “being poor” or “being different” elsewhere in their lives, they may expect it when they arrive in your practice too. It will go a long way if front office staff is sensitive to this situation and can make themselves knowledgeable about the problems faced by minorities and by families with Medicaid and CHP+ children. As the families going to private practices become more diverse, the reception, scheduling and business staff will be called upon to handle increasingly difficult and complex problems. So, they will need to develop a high level of sophistication and skill at cross-cultural communication.

The importance of a patient advocate in private practice

Patients and families with special health care or socio-economic needs often require more help in coordinating care, understanding the treatment plan, understanding complicated health issues, completing paperwork, or in arranging various services and appointments.

This can be especially true if parents have limited English proficiency, have experienced frequent Medicaid or CHP+ glitches, have limited literacy / or ability to understand, or have complicated treatment plans or complicated paperwork. It was quite clear in the parent advisory group that they feel this assistance is extremely valuable to them. To maintain the efficiency of your office, it can be very beneficial to have a person who can help families with this higher level of need, and to serve as an advocate and navigator/resource coordinator.

At the end of the visit-two questions that will improve the outcome for the child

There are two things that parents felt that health care providers can do that will dramatically improve parent understanding, compliance and satisfaction, and as a result improve outcomes for the child. Minority and low-income parents told us that they often feel reluctant to ask questions or to admit that they don’t really understand the recommendations they receive. This could be due to limited English proficiency or limited
understanding of terminology or complicated instructions. They said that providers often seem to be in a hurry and the parents feel reluctant to interfere by asking questions. They said it might take a little extra encouragement to enable them to admit that they have questions or do not understand. Their request was for providers at the end of the visit to
ask, “Have I explained everything well enough? (Do you feel you understand this well enough?)” Or, “Do you have any questions?”