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As a clinical pharmacist, I’ve spent my career helping patients understand their medication and navigate increasingly complex healthcare decisions. One lesson has remained constant throughout every role I’ve held: the best clinical recommendations are only effective when they are truly understood.
Communication is one of the most powerful clinical interventions we have. Yet for millions of Americans with limited English proficiency, language barriers can turn even the simplest medication instructions into confusion, uncertainty and missed opportunities for better health.
This is also deeply personal to me. I’m Vietnamese, and like many families, healthcare decisions often involve multiple generations and family members doing their very best to care for one another. Like many adult children, I also help care for my mother from a distance, which adds another layer of complexity coordinating her healthcare.
I experienced firsthand how easily communication can break down. My elderly mother was prescribed pain medication by a specialist. When my family became concerned because she had become increasingly confused, we discovered there had been a misunderstanding about how her medication should be used. Whether it was the complexity of the instructions, the language barrier or simply the challenges that come with caring for an aging loved one, the result was the same: my mother experienced an avoidable medication-related event that could have had serious consequences.
As both a daughter and a clinical pharmacist, that experience reinforced something I have seen throughout my career: improving health outcomes isn’t simply about translating words. It’s about giving patients and caregivers the understanding, confidence and support they need to safely manage medications, navigate the healthcare system and make informed decisions within the context of their language, culture, health literacy and family support system.
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Clear communication drives action
Many health plans invest heavily in programs designed to improve medication adherence, chronic disease management and preventive care. But those efforts can only succeed if members understand what they are being asked to do.
From a clinical perspective, successful therapy depends on more than writing a prescription. Members and caregivers need to understand:
- Why the medication was prescribed
- What benefits they should expect
- How and when to take it correctly
- What side effects or warning signs require attention
- When follow-up is necessary
- How to navigate the healthcare system if questions arise
When members don’t understand this information, engagement efforts become less effective. They may not follow treatment recommendations, refill prescriptions or schedule follow-up care—not because they don’t want to, but because they don’t fully understand what is expected of them.
How language barriers affect health outcomes
For members with limited English proficiency, language can become one of the biggest barriers to understanding. Healthcare information is often complex, and instructions that seem straightforward to clinicians may not be clear without translation or additional explanation.
The effects can be seen throughout the healthcare journey. Misunderstood medication instructions contribute to nonadherence. Language barriers also increase the risk of medication use and adverse drug events, particularly among older adults managing multiple chronic conditions. Missed appointments create gaps in care. Delayed treatment can lead to worsening health and avoidable emergency department visits. Over time, small communication barriers can have a significant impact on health outcomes.
A thoughtful language access strategy helps remove those barriers. By communicating with members in the language they understand, health plans make it easier for them to follow treatment plans, navigate the healthcare system and take a more active role in their care. Better communication also supports health literacy and health equity by helping members access the information they need to understand their health and the care available to them.
What may appear to be a lack of engagement is often a lack of understanding. Addressing those communication barriers is not only good clinical practice—it is increasingly recognized as a critical component of quality, equity and member outcomes.
Language access is more than compliance
CMS regulations require Medicare Advantage and Part D plans to provide language assistance services and translated notices in the most commonly spoken languages in their service areas, including additional languages that meet CMS population thresholds. These requirements establish an important baseline, but leading organizations recognize that meaningful language access delivers benefits far beyond regulatory compliance. A robust language access strategy can improve:
- Member experience
- Medication adherence
- Chronic condition outcomes
- Quality performance measures
- Member retention and satisfaction
- Health equity initiatives
In other words, language access should be viewed as an investment in outcomes—not merely an operational requirement.
What should a language access plan include?
An effective language access plan should address more than translation alone. It should help members understand and act on important health information throughout their healthcare journey. While every organization has unique needs, several core components can help support engagement and better outcomes:
- Bilingual staff and native speakers
- Native speakers and bilingual staff provide more than translation. They help members feel understood while supporting culturally responsive communication.
- Interpretation services during live interactions
- Members should have access to interpreters during calls, care management interactions and clinical outreach. Timely language support helps ensure members understand important information and can ask questions with confidence.
- AI-enabled translation tools
- AI-enabled translation tools can improve scalability and speed, particularly for written communications. However, AI should augment—not replace—trained interpreters, bilingual staff and clinicians. Clinical conversations often require nuance, empathy and clarification that technology alone cannot reliably provide.
- Multilingual written communications
- Important materials should be available in members’ preferred languages, including:
- Welcome materials
- Medication reminders
- Preventive care outreach
- Educational resources
- Digital communications and text messages
- Consistency across channels helps reinforce understanding.
- Cultural competency
- Language and culture are inseparable. Cultural beliefs influence how patients perceive illness, medications and preventive care, and even who makes healthcare decisions within a family. Effective communication requires understanding not only what language a member speaks, but also the cultural context in which healthcare decisions are made. Culturally responsive care builds trust, strengthens relationships and improves engagement.
- Data and member preferences
- Understanding who members are and how they prefer to engage enables more personalized and effective outreach. Health plans should identify and document:
- Preferred spoken language
- Preferred written language
- Communication channel preferences
Improving understanding to drive health outcomes
After years of working as both a clinical pharmacist and healthcare operations leader, I’ve come to believe that the goal of language access is not simply to convert words from one language to another: The goal is understanding.
Throughout my career as a clinical pharmacist, healthcare operator and daughter helping coordinate care for an aging parent, I’ve seen firsthand how communication can directly influence clinical outcomes. When patients and caregivers truly understand their medications and care plans, adherence improves, medication safety improves and trust grows.
Language access should not be viewed simply as a compliance requirement. It is a clinical quality strategy that helps reduce health disparities, improve medication safety, strengthen member engagement and, ultimately, deliver better outcomes for the populations we serve. By investing in culturally responsive communication and meaningful language access, we empower patients and caregivers to participate more confidently in their care and create healthier communities.
When members and caregivers understand recommendations, they are more likely to take medications appropriately, engage with their healthcare providers and make informed decisions that support their long-term health.
At AdhereHealth, we partner with health plans to deliver personalized, multilingual engagement strategies that help members navigate their care with confidence while improving adherence, quality performance and health equity. Contact us to learn more!
Authored By:
Tram Thai, PharmD, BCACP
Vice President of Clinical Operations, AdhereHealth
