Is a Lack of Cultural Competency Closing the Doors on Access to Care for Those Most in Need?

Is a Lack of Cultural Competency Closing the Doors on Access to Care for Those Most in Need?

As it pertains to my students undergoing clinical training, one of the social workers who is currently working in an elementary school in a predominantly Hispanic community recently discussed a situation of concern regarding a student’s mother. Because the social worker is bilingual, and from this particular community, she is a trusted resource for many local families of children who attend the school.

Knowing my medical social work background, I think she intentionally mentioned this case to discuss for assistance. She described to me a story of a student’s mother who came to the school asking for help from the counselors. She is a primarily Spanish-speaking woman who has been diagnosed with Stage 3 ovarian cancer. She has been paying cash for her medical appointments, because her husband is approximately $1,000 per month over income for Medicaid; however, he works for a small company as a painter and does not have health insurance.

When discussing the Marketplace coverage, the woman said she believed that she would not be approved for coverage because of her cancer diagnosis. When I asked about the oncology office, the social worker stated that they worked out a cash price for the patient as a 50-percent discount; however, with the expectation of chemotherapy she cannot afford the treatment. 

I could go on about what occurred in this case and the missteps of this office in failing to support her by not assisting her in obtaining health insurance, much less the lack of willingness to help her apply for Social Security disability. I also could go on about the lack of cultural and empathic support from this office, as this woman must now face a difficult prognosis while trying to parent small children. 

I tell this story because ironically, this past week, Kaiser Family Foundation (KFF) news posted their report on Health and Health Care Experiences of Immigrants: The 2023 KFF/LA Times Survey of Immigrants | KFF. The narrative highlights a disappointing story in our healthcare system, wherein we fail to acknowledge and recognize cultural biases and their impact on health equity.

The survey of 3,300 participants found that 29 percent of respondents stated that it is hard to receive respectful and culturally competent care. The study also highlighted that because of the trend in employment with and/or running small businesses among immigrant families, the majority of the population is often over-income for Medicaid, but lacks access to health insurance, likely because of cost. Additionally, the study found a hesitancy of immigrants to seek healthcare services, regardless of citizenship, citing prevalence of immigration-related fears and language barriers being the primary reasons.

The study reviewed the relevant differences that exist among coverage for immigrants in states that have expanded Affordable Care Act (ACA) Medicaid coverage and those who do not. The report even goes into the disparities among this population in seeking assistance for housing, food, healthcare, or other social programs because of the concern and confusion around inconsistent eligibility requirements. 

In the recent publication on the CMS Framework for Health Equity 2022–2032, the Centers for Medicare & Medicaid Services (CMS) provides their top priorities to improve health equity in our country, with priority 3 and 4 most aligning for a recommended increase in culturally tailored services and greater workforce support to reduce disparities. Maybe the report was intended to be vague or high-level, but it missed the direct need to address implicit biases on healthcare delivery or mention a path for greater minority representation among healthcare providers.

As much as healthcare is striving to be the answer to all social complexities, it is relevant to note that my patient story was impacted by the local school counselor who was compassionate enough to try to find answers and connect this woman with the resources she needs.  

Facebook
Twitter
LinkedIn

Tiffany Ferguson, LMSW, CMAC, ACM

Tiffany Ferguson is CEO of Phoenix Medical Management, Inc., the care management company. Tiffany serves on the ACPA Observation Subcommittee. Tiffany is a contributor to RACmonitor, Case Management Monthly, and commentator for Finally Friday. After practicing as a hospital social worker, she went on to serve as Director of Case Management and quickly assumed responsibilities in system level leadership roles for Health and Care Management and c-level responsibility for a large employed medical group. Tiffany received her MSW at UCLA. She is a licensed social worker, ACM, and CMAC certified.

Related Stories

Coders Beware: Newly Updated Overpayment Refund Rule

Coders Beware: Newly Updated Overpayment Refund Rule

The Centers for Medicare & Medicaid Services (CMS) have issued the display copy of the Final Rule interpreting the 60-day Refund Rule for Medicare Parts A/B (Traditional

Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Decoding 2025 OPPS Charge Capture and Coding Complexities: Strategies for Success

Decoding 2025 OPPS Charge Capture and Coding Complexities: Strategies for Success

Prepare your organization for the 2025 OPPS updates with expert insights from Tiffani Bouchard, CCS, CRCR, a Revenue Integrity Professional with over 30 years of experience. This webcast will address critical challenges in charge capture and coding, providing clarity on APC policies, C-APC packaging, exclusions, and payer-specific requirements. Attendees will learn actionable strategies to ensure compliance, optimize reimbursement, and mitigate risks of claim denials. Gain the knowledge needed to implement updates effectively, educate your team, and maintain seamless revenue cycle operations in the face of evolving OPPS complexities.

January 29, 2025
Enhancing Outcomes with CDI-Coding-Quality Collaboration in Acute Care Hospitals

Enhancing Outcomes with CDI-Coding-Quality Collaboration in Acute Care Hospitals

Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.

November 21, 2024
Comprehensive Inpatient Clinical Documentation Integrity: From Foundations to Advanced Strategies

Comprehensive Outpatient Clinical Documentation Integrity: From Foundations to Advanced Strategies

Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.

September 5, 2024

Trending News

Featured Webcasts

Navigating the 2025 Medicare Physician Fee Schedule: Key Changes and Strategies for Success

Navigating the 2025 Medicare Physician Fee Schedule: Key Changes and Strategies for Success

The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.

January 21, 2025
Patient Notifications and Rights: What You Need to Know

Patient Notifications and Rights: What You Need to Know

Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.

December 5, 2024
Navigating the No Surprises Act & Price Transparency: Essential Insights for Compliance

Navigating the No Surprises Act & Price Transparency: Essential Insights for Compliance

Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks.  Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.

November 19, 2024
Post Operative Pain Blocks: Guidelines, Documentation, and Billing to Protect Your Facility

Post Operative Pain Blocks: Guidelines, Documentation, and Billing to Protect Your Facility

Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.

October 24, 2024

Trending News

Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more

Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24