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Despite the digital transformation of healthcare communication, physical mail remains one of the most trusted and effective member touchpoints. From enrollment packets to compliance notices, printed mail continues to play a vital role in ensuring equitable access to information. But here’s the challenge: too often, healthcare organizations translate their mailings without localizing them. And when language is treated as an afterthought, key messages can be lost in translation. The result? Missed appointments, compliance risks, and disengaged members. Localization changes that. When healthcare direct mail is culturally adapted, linguistically precise, and contextually relevant, it doesn’t just deliver a message; it builds trust. This article explores why localization is crucial to effective healthcare direct mail, how it drives engagement and compliance, and what best practices providers and payers can follow to reach every member meaningfully. Table of Contents - Why Direct Mail Still Matters in Healthcare - Translation vs. Localization in Member Mailings - The Risks of “Translation Only” in Direct Mail - The Benefits of Localized Direct Mail - Best Practices for Healthcare Direct Mail Localization - End-to-End Fulfillment: Turning Localization into Scalable Action - Making the Case for Localized Direct Mail in Healthcare - Frequently Asked Questions About Healthcare Direct Mail - Localized Direct Mail: A Smarter Approach to Healthcare Outreach Healthcare organizations increasingly rely on digital engagement, yet direct mail remains indispensable, especially for underserved and multilingual populations. It also works. According to the USPS, most healthcare businesses report direct mail response rates between 11% and 15%, and health companies are the most likely of any industry to see response rates above 25%. Even in a digital world, print remains the backbone of compliance-driven communication, making its clarity and cultural resonance more critical than ever. Before diving deeper, it’s essential to distinguish between translation and localization. For example, a nutrition benefits mailer translated word-for-word might mention “low-fat cottage cheese.” But localized for Hispanic members, it might reference familiar alternatives or culturally relevant dietary examples that connect more naturally. Localization bridges linguistic accuracy with cultural empathy, ensuring messages are not just understood, but felt. Healthcare communication is high-stakes. A word misunderstood or a tone misplaced can have real-world consequences: In contrast, localization humanizes compliance, it makes regulatory communication accessible, accurate, and actionable. When healthcare organizations invest in localized mail campaigns, they see measurable results. Localized materials reflect a member’s language, imagery, and values, strengthening connection and loyalty. Studies show culturally adapted interventions increase patient retention by 40%.  Localization ensures that health literacy, tone, and terminology meet members where they are, reducing confusion and rework. Localized mail supports compliance with federal and state regulations for Limited English Proficient (LEP) populations, a group that includes over 26 million people in the U.S. (8%).  Localized campaigns consistently outperform generic ones, boosting open rates, responses, and satisfaction scores, while reducing grievances and costly follow-ups. Identify top LEP languages within your member base using U.S. Census or internal demographic data. See more in Reducing Language Barriers in Healthcare. Use professional translation services and community reviewers who understand local norms, idioms, and sensitivities. Leverage data to personalize mailings, automating language, name, plan, and benefit details without compromising compliance. Reinforce printed mail with digital reminders or accessible QR codes that link to localized resources online. Hybrid communication ensures continuity for all members. Engage small community panels to test clarity and tone before sending to a large audience. Member feedback ensures materials resonate authentically. Localization is only as effective as the system behind it. Even when organizations understand what to communicate, they often face bottlenecks in how to get multilingual mail out the door: accurately, securely, and on time. That’s where end-to-end communication solutions make the difference. A complete fulfillment platform allows healthcare organizations to manage translation, localization, printing, and mailing in one seamless workflow. Instead of coordinating multiple vendors or risking inconsistencies, everything, from content creation to final delivery, is centralized and automated. This approach ensures: With an end-to-end system, healthcare organizations move from reactive translation to proactive, data-driven communication, building member trust while saving time and cost. Real-world examples show the tangible benefits of culturally adaptive print fulfillment: - A health plan achieved full CMS compliance by translating and localizing member letters into multiple languages while maintaining design consistency and turnaround time.
- A state agency reduced turnaround times and increased response rates after centralizing translation, printing, and mailing through a single, compliant partner. Localized fulfillment isn’t just a translation add-on; it’s an operational and strategic advantage that strengthens outreach and equity simultaneously. Printed communication sent by providers, payers, or agencies to inform, educate, or engage members about benefits, renewals, or preventive care. By aligning language, tone, and design to the member’s cultural and linguistic background, it is possible to improve comprehension and action rates. Yes, when produced under secure fulfillment processes that protect PHI/PII and meet HIPAA and CMS standards. Enrollment packets, benefit change notices, appointment reminders, screening invitations, and health education campaigns. By tracking response rates, renewal completions, grievance reduction, and engagement improvements across language segments. Localization isn’t a trend; it’s a requirement for equitable, compliant, and effective member communication. As healthcare organizations face growing linguistic diversity, culturally adapted print fulfillment ensures every member receives information they can trust, understand, and act upon. The future of healthcare engagement is hybrid, print plus digital, personalized, and multilingual. And with the right partner and platform, localized fulfillment can be not just compliant, but transformational. Ready to build more inclusive and effective healthcare communication? Get a Free Quote to start designing your next localized direct mail campaign.

Our planet is home to more than 7,000 different languages. Thanks to a long history of immigration, experts estimate that anywhere from around 300 to over 800 of those languages are spoken in the United States, making it one of the most linguistically diverse countries in the world. And when it comes to the nation’s healthcare system, just over 50 languages are commonly used between patients and their healthcare providers across the nation, according to data from AMN Healthcare. While most of the country’s multilingual individuals do speak English, about 8% of people living in the United States have limited English proficiency (LEP), meaning they’re unable to effectively communicate with their healthcare providers—or anyone else, for that matter—in English. Because of this, healthcare providers need to be adequately prepared to interact with speakers of other languages in their preferred tongue, as miscommunication between patients and their doctors can lead to serious, even life-threatening, errors. In this blog post, we’ll take a broad look at the global linguistic landscape before narrowing in more closely on factors that healthcare providers need to be aware of to provide equitable language access to their patients with LEP. Table of Contents How Many Languages Are There? A Look at the Linguistic Landscape The Distinction Between Language vs. Dialect The Growing List of Endangered Languages The Geography of Language Why the Number of Languages in the World Matters in Healthcare Healthcare Needs to Be Accessible to All Populations Miscommunication Leads to Misdiagnosis  Language Gaps Disrupt Operations Non-Compliance Puts Your Operation at Risk Strategies & Best Practices for Healthcare Providers Needs Assessment and Prioritization Interpretation and Translation Modalities Technology Staff Training and Cultural Competency Policy, Governance, and Sustainability Challenges and Future Outlook Frequently Asked Questions About How Many Languages Are There & Healthcare Literacy Conclusion Estimates vary on just how many languages are spoken across the world, but most experts seem to agree that the number is somewhere in the ballpark of 7,000 languages. However, there are other factors that contribute to the use and extinction of language.  Data from Ethnologue says there are 7,159 languages in use today. However, this kind of data is tricky to pin down cleanly—the distinction between a language and a dialect can be very subtle. What one source classifies as two separate languages might be identified as two dialects of the same language elsewhere.  But what’s the difference between a language and a dialect? What’s more, languages and their speakers are constantly changing—a language today might eventually split into several different languages later on, just like Latin evolved into modern Spanish, French, Italian, and Portuguese (among others).  Likewise, languages regularly vanish from everyday use. A language is endangered when it is at risk of falling out of use because it has very few speakers, especially if younger generations are no longer learning it. According to Ethnologue, 44% of the world’s languages are endangered. On the flip side, just 20 languages (less than 1% of the world’s languages by Ethnologue’s count) are spoken natively by about half the world population. Linguistic diversity isn’t necessarily spread out evenly. Linguistic diversity in the United States is heavily tied to patterns of immigration.  Within the United States, urban centers like New York City, Los Angeles, and Chicago are home to native speakers of hundreds of different languages. And while other regions may not have quite as many different languages represented, it’s not uncommon to hear languages like Navajo, Mandarin, Spanish, or Hmong spoken in various rural and suburban communities. The table below shows data based on U.S. Census Bureau statistics and other sources like the American Community Survey. But what does all of this mean for healthcare providers in the United States? How do language demographics affect patient care?  Linguistic diversity has real, measurable impacts in clinical settings, and every healthcare provider needs to pay close attention to the linguistic landscape of their particular locale. By understanding linguistic patterns in their area, providers can offer better care to patients with LEP, empowering these patients to advocate for themselves. Ultimately, the number of languages in use worldwide underscores the importance of designing systems that can meet patients where they are linguistically. Here’s how: LEP individuals make up a fairly significant portion of the United States population, at about 8%. While that may not seem like a staggering percentage, in reality, that’s nearly 26.9 million people who are limited in their ability to effectively communicate with English-speaking healthcare providers.  And while you may serve a predominantly English-speaking population, all you need is one deaf or hard-of-hearing or LEP patient needing critical care to highlight the importance of accessible communication. Having the right resources in place ensures healthcare providers can deliver quality care to anyone, anywhere, at any time. Nothing good comes from miscommunication and misunderstanding. When patients and providers fail to understand one another, the likelihood of negative health outcomes increases significantly. Miscommunication has been linked to misdiagnosis, medication errors, delayed treatment, and lower adherence to care plans. Research shows that language barriers increase the likelihood of preventable adverse events in clinical settings. Failing to account for language diversity can also create operational challenges. Staff may spend extra time trying to work around communication gaps, which slows workflows and increases stress.  Hospitals and clinics that neglect proper language services also face compliance risks. The United States, Title VI of the Civil Rights Act requires federally funded healthcare providers to offer language access services. Non-compliance can result in legal penalties, reputational damage, and costly corrective action plans. Here are a few strategies for healthcare providers to take the linguistic diversity of their particular locale into account and improve the quality of their care for LEP patients: Not every healthcare provider will have the same exact language access needs. A hospital in Seattle is much more likely to encounter patients who speak Coast Salish than a provider in Oklahoma City is—and that provider in Oklahoma City is equally more likely to encounter patients who speak Cherokee or Choctaw.  Use a data-based approach to determine which languages to prioritize in your language access strategy—you can draw on data from the US Census to see what languages are most commonly spoken around you, and use patient intake surveys to see what languages are most common among your patients. Once you’ve identified the languages that have the highest demand, you can work with a language service provider to identify interpreting and translation solutions that meet your needs.  Find a language service provider that specializes in medical interpreting and translation and offers services in the languages you need most. Your provider will help you identify the specific services you need most, whether it’s in-person interpreting or on-demand remote interpretation via video or phone call. You’ll also want to identify important documents that need translating—things like consent forms and administrative paperwork should be translated promptly. Many providers may be tempted to use tools like artificial intelligence and machine translation to speed up the translation and interpreting processes. However, it’s not recommended to use without expert supervision, particularly in the healthcare system, where communication is often high-stakes and there’s little room for error. Consult with your language service provider about these technologies and be sure there’s always a human in the loop to verify the quality and accuracy of the software’s output. Even the best language services fall short without staff who know how to use them effectively. Training clinicians to work with interpreters, whether in person or remotely, helps ensure accurate communication. Techniques like “teach-back,” where patients repeat instructions in their own words, can confirm understanding and reduce errors. Cultural competency training also equips providers to recognize language bias, avoid assumptions, and build trust across diverse patient populations. Be sure to establish clear institutional guidelines for interpreter use, translation standards, and staff training expectations. Building partnerships with community interpreters or trusted language service providers can expand capacity for rare languages. Regulatory and accreditation requirements provide a framework, but should also be backed by strong governance. By treating language access as a core part of health equity strategy, providers can ensure long-term impact and accountability. The strategies above can certainly be challenging to implement, but a trusted language service provider like Avantpage can help you with much of the legwork of developing and implementing a strong language access plan. Healthcare providers often find that language access measures are costly to implement. And indeed, interpretation and translation services can certainly be expensive. There are some ways to lower costs without significantly reducing the overall quality of your language access services, such as making use of remote interpreting services, rather than in-person interpretation. You can also consider implementing a technology-driven translation process with human linguists carefully reviewing machine translation output for accuracy and cultural sensitivity. Although it can be costly, keep in mind that the cost of not having a strong language access plan is often greater than the cost of the language services themselves. Without these services, healthcare providers run the risk of extremely expensive (not to mention time-consuming and reputation-damaging) legal fees and fines for noncompliance with local and federal regulations. Another common challenge is finding interpreters and translators who support rare or endangered languages. In these cases, your language service provider can help you find the right person for the job. Additionally, community-based organizations can also help connect you with possible interpreters and language experts. As artificial intelligence and machine translation technologies improve, it’s likely that these tools will be used more and more in the healthcare system. However, it’s important to note that these tools still are not at a point where healthcare providers can safely use them without a human reviewer to make sure that translations and interpretations are accurate. This largely depends on local demand. Healthcare providers in a place like New York City, where more than 800 different languages are spoken, will need to be prepared to support more languages than a provider in a small town with less linguistic diversity. This is why organizations should conduct thorough, data-driven needs assessments and plan their language access services around these needs. Among other risks, poor language access can result in regulatory noncompliance, poor health outcomes for patients with LEP, decreased trust, and lowered reputation. Healthcare providers should work closely with a language service provider to identify the tools they need to address gaps in language access. These may include, but are not limited to, remote interpreting software and machine translation technology. Learn about AvantInterpret and AvantSend. A dialect is a specific variety of a language—think North American English versus British English. The borders between a dialect and a language are often hard to identify—for example, Mandarin and Cantonese are not mutually intelligible, but are often classified under the Chinese language (and on the other hand, languages like Arabic and Maltese have an extremely high degree of mutual intelligibility, but are still considered distinct languages). In healthcare, it’s important to identify the specific dialect that an LEP patient speaks to find an interpreter who is best suited to provide services. Providers can measure the impact of language access programs by tracking patient outcomes, satisfaction surveys, and readmission or error rates among LEP patients. Monitoring interpreter utilization, turnaround times for translated materials, and compliance with legal requirements also provide useful insights. Comparing these metrics before and after program implementation helps quantify improvements in safety, equity, and efficiency. With more than 7,000 languages spoken worldwide, considering linguistic diversity is an important factor in planning out language access services in the healthcare system. Providers who invest in strong language access strategies not only reduce clinical risk but also ease operational burdens and strengthen trust with their communities. From staff training to governance and sustainable partnerships, every step toward better communication is a step toward better health outcomes. To recap, here are some key strategies to keep in mind as you plan out your language access services: As languages continue to evolve and populations shift, healthcare systems must adapt accordingly. The future of equitable care depends on recognizing language as a key determinant of health.  If you’re looking to improve your organization’s language access services, contact Avantpage, use one of our online forms to reach out, email us at [email protected], or call (530) 750-2040. We offer interpreting and translation solutions to clinics, hospitals, and health insurance providers, empowering them to provide patients with the highest quality care possible, regardless of the language they speak.

For individuals who are limited English proficient (LEP) or Deaf/hard-of-hearing and need to participate in a court hearing, they have the right to an interpreter in federal, state, and local courts. An interpreter is required to protect one’s basic constitutional rights by providing equal language access. A legal interpreter plays a critical role in the court process, serving as the bridge between non-English-speaking individuals and English-speaking participants. An interpreter must interpret the content without editing, summarizing, deleting, or otherwise modifying the content. They must be impartial and able to serve the judicial process as required. In this blog, we’ll look at some of the legal interpreter qualifications and requirements used in the legal system. Understanding a legal interpreter’s qualifications is crucial for ensuring accurate communication in court, protecting constitutional rights, and avoiding errors that could affect case outcomes. Table of Contents Federal Legal Interpreter Qualifications Federally Certified Legal Interpreter Professionally Qualified Legal Interpreter Language Skilled / Ad Hoc Legal Interpreters State Legal Interpreters Local and National Organizations and Agencies American Sign Language (ASL) Interpreters Communication Access Real-Time Translation (CART) Organizations that Support Interpreters and Translators Legal Implications of Interpreter Qualifications Frequently Asked Questions About Legal Interpreters Avantpage Legal Interpreters: Bridging Language Gaps in the Legal System The federal government recognizes three types of legal interpreters. A federally certified interpreter has passed the Administrative Office certification exam. These exams are only available for Spanish, Navajo, and Haitian Creole interpreters. The local federal court will determine if an interpreter is professionally qualified or has the language skills for other languages. This designation is for all languages except Spanish, Navajo, and Haitian Creole. A professionally qualified interpreter meets the criteria for this designation. The criteria consider areas like tests and assessments, memberships, and other certifications. A language-skilled / ad hoc interpreter demonstrates the ability to interpret court proceedings to the court’s satisfaction, but isn’t a professionally qualified interpreter. While using a language-skilled / ad hoc interpreter is not always appropriate, it may be acceptable in some cases. Each state has its own legal interpreter requirements. As an example, the state of California recognizes two types of interpreters: Review language access programs by state. Local and national organizations, such as the National Association of Judiciary Interpreters and Translators (NAJIT), may provide other labels for legal interpreters, such as “conditionally approved” or “qualified.” These terms can vary a bit, but they essentially mean individuals pre-vetted by organizations, agencies, departments, or otherwise based on references, skills assessments, previous work history, an association with industry organizations, and more. While hundreds of sign languages exist, American Sign Language (ASL) is one of the most common types in the U.S. Currently, there’s a shortage of ASL interpreters, and some certifications can’t be tested for anymore. Nationally recognized certifications include: CART, also known as real-time captioning, is a method of transcribing spoken language and sounds. The transcription is displayed on computers, mobile devices or other screens. Those who are deaf or hard-of-hearing might prefer this method. LEP individuals may also choose this method over interpreting for various reasons. CART requires reading, and it’s often a one-way communication, although some versions can incorporate two-way communication. Specialists who provide CART services can hold certifications from the Association for Court Reporters and Captioners. Organizations that control assessments, codes of ethics, codes of professional conduct, and more to evaluate interpreter involvement include: The qualifications of a legal interpreter are more than just credentials—they can have real legal consequences. Courts rely on interpreters to provide accurate, impartial, and complete interpretations of proceedings, and errors or unqualified interpretations can impact case outcomes, fairness, and even appeals. By ensuring that interpreters meet federal, state, or professional standards, courts and legal professionals can protect the fairness, accuracy, and legality of proceedings, while maintaining confidence in the judicial process. A legal interpreter should have professional certification, strong knowledge of legal terminology, and proven experience in courtroom or legal settings. Unlike general interpreters, legal interpreters are trained to handle precise legal language, ensure accuracy, and maintain neutrality in court or legal proceedings. Certified interpreters help ensure fairness, accuracy, and compliance with legal standards, reducing the risk of appeals, challenges, or misinterpretation. Legal interpreters have a very important job communicating between LEP, deaf or hard-of-hearing individuals. Legal interpreting is a highly specialized form of interpreting that not just anyone can do. As such, courts may require certain qualifications or a judge may inquire about qualifications, and may come up when a court case is challenged due to the interpretation, such as appeals on verdicts called into question due to the provided interpretation. By partnering with Avantpage, you ensure your legal proceedings are supported by highly qualified interpreters who meet federal, state, and professional standards, protecting both the integrity of the case and the rights of all participants. We provide remote and in-person interpretation services for the legal industry. We partner with the Coalition of Concerned Legal Professionals, and we’ve worked with numerous state Superior Courts as well as Judicial Councils. To learn more, contact us with general inquiries, request a free quote, or call us at (530) 750-2040.

It’s important for Medicare plan providers and healthcare organizations to make sure they’re able to communicate effectively with their patients — and that means speaking to them in their language.  Medicare Advantage sponsors are required by the Centers for Medicare and Medicaid Services to translate documents into languages spoken by at least 5% of the members in a plan’s service area. In this way, the CMS requires providers to be mindful of the country’s linguistic diversity. If your organization is looking to translate documents into a new language, or simply want to refresh old translations, you’ll want to work with a translation agency that specializes in Medicare services. A Medicare translation agency will help you identify the documents that need translation and work with you to make sure you’re up to par with the CMS’ requirements. In this blog post, we’ll take a deeper dive into the factors you need to consider when selecting a translation agency to work on important Medicare documents, to give you a better sense of what to look for when you’re looking for a language service provider. Table of Contents Factors to Consider When Choosing a Medicare Translation Agency The Relationship Between Turnaround Time, Quality, and Cost What’s the Order of Importance? Additional Factors to Consider Frequently Asked Questions About Medicare Translation Agencies Find the Best Medicare Translation Partner With so many language service providers available, how do you choose the one that best meets your organization’s unique needs and goals? These factors all come together to influence one another — for example, shorter turnaround time on a project might require you to sacrifice cost or quality, depending on the agency you work with and its approach. Likewise, lower cost might mean lower quality, and so on. Turnaround time, quality, and cost are deeply intertwined factors that you need to consider when selecting an agency, as they can significantly impact the outcome of your translation projects. For instance, if your priority is quick turnaround time, your agency will need to allocate resources in different areas that will more than likely require a bit of a trade-off between quality and cost. The agency will either need to hire additional professionals or leverage advanced technologies to ensure that the translation can be delivered on time. More human professionals will keep the quality high, but it will also drive the cost up; on the flip-side, technology will keep costs low, but will likely lower the overall quality of your translation. On the other hand, prioritizing quality entails implementing additional processes or involving more linguists in the translation process. This can lead to higher costs and potentially longer turnaround times. If minimizing cost is your primary concern, compromises can be made on the number of linguists involved, simplifying processes, or leveraging cost-effective technologies. However, this often comes at the expense of quality and/or turnaround time. It’s important to recognize that prioritizing low cost in healthcare, particularly in Medicare translation, may not always align with delivering high-quality and timely services necessary for equitable care. Because these factors are so deeply connected, it’s important to figure out which ones you want to prioritize — each organization is likely to have different priorities, depending on the kinds of translation projects they need completed. For instance, Medicare or state-managed health plans like Medi-Cal plans tend to place a premium on both turnaround time and quality, in order to comply with health equity regulations. These regulations often mandate timely delivery of culturally and linguistically appropriate services to effectively address health equity gaps. For example, Medi-Cal Notice of Action letters must not only meet stringent quality standards but also have to adhere to tight deadlines, requiring translations within as little as 4 hours to ensure timely delivery to the patient. Similarly, healthcare organizations that conduct health education workshops may prioritize quality over the other three factors to ensure accurate dissemination of information. While cost considerations are also important, maintaining the integrity of the content and ensuring it resonates with diverse audiences may take precedence. In such cases, turnaround time may be less critical, as events are typically planned well in advance, allowing for adequate preparation time. Ultimately, the order of importance for organizations when selecting a Medicare translation agency may vary based on their specific objectives, regulatory requirements, and the nature of the content being translated. Think of these factors as sort of the “Big Three” to consider when determining the right Medicare translation agency for your organization. They’re the main things you’ll want to consider, but they aren’t necessarily the only things to consider — here are just a few additional factors and sub-factors that could play a role in deciding which agency is the best fit: Medicare translation agencies provide professional translation services and interpretation services to help beneficiaries with limited English proficiency (LEP) navigate health insurance and healthcare communications. By bridging language barriers, these agencies ensure all beneficiaries understand their benefits and receive accurate guidance. Agencies typically offer in-person, on-demand, and phone interpretation options. Medical interpreters are trained to handle complex healthcare conversations, supporting both beneficiaries and healthcare providers with accuracy and clarity. Translation agencies provide subject matter experts in medical and insurance terminology, ensuring that healthcare providers communicate effectively with LEP patients. This improves patient understanding, reduces errors, and supports compliance with federal guidelines. As you look for a Medicare translation agency to help your organization meet its language access goals, there are several factors to consider. Three major ones — turnaround time, quality, and cost — stand out the most. Here are some things to consider as you seek out a language service provider to work with: At Avantpage, we’ve worked extensively with Medicare providers and healthcare organizations to meet their healthcare needs. If you’re looking for a top-notch Medicare translation agency, consider reaching out to us today for a free quote, with any general inquiries, or by calling us at (530) 750-2040.

The COVID-19 pandemic has changed many aspects of healthcare. One of those aspects is routine doctor visits. While many health issues still need to be handled in person, others can be done online through telehealth services (also known as telemedicine). Telehealth lets you talk to your healthcare provider live over the phone or video chat, send and receive messages using a secure online system, and use remote monitoring for updates.  But if patients can’t speak English and the provider isn’t bilingual, what happens then? Telehealth services have grown exponentially since the pandemic. A study by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) found that the number of Medicare visits conducted through telehealth appointments increased 63-fold, from 840,000 in 2019 to 52.7 million in 2020. Also, the number of behavioral telehealth appointments increased 32-fold. Telehealth is here to stay.   Telehealth remains an important part of the modern healthcare system, but how can providers navigate the complexities of offering patient care if they cannot understand the patient? Table of Contents Advantages and Disadvantages of Telehealth Services Offering Telehealth Interpretation: Compliant Support for Patients What Are the Different Types of Interpretation? Improve Healthcare Literacy Through Language Along the Patient Journey  Determine the Best Solution for Your Patient's Need(s) Technology Considerations Appointment Types Language Considerations Frequently Asked Questions About Telehealth Interpretation The Importance of Language Access Needs for Telehealth Services  Telehealth offers many advantages, but it also highlights the gaps in language access, digital literacy, and Wifi accessibility, and thus health disparities, that can impact the health of those with limited English proficiency (LEP). While healthcare organizations may not be able to address some technology issues, they can implement language access solutions in telehealth and the patient journey overall.  Telehealth has advantages and disadvantages for healthcare organizations and patients. Advantages include:  Disadvantages include: 
Let’s look at one of these language barriers: digital accessibility for those with language needs. Unfortunately, this barrier can exacerbate disparities in the healthcare system. For example, one primary care clinic that usually had 14% non-English speaking patients noted that the numbers dropped to 7 percent when operating only as telehealth during the pandemic.    Healthcare organizations won’t be able to make internet access more accessible, but they do have options for improving language services. So how can healthcare organizations close equity gaps when addressing barriers in telehealth and digital access?  For healthcare appointments, providers need to meet language access laws. This includes telehealth, which poses some changes to the new landscape such as accessing remote interpreters, digital literacy, technology, and (Personal Health Information) PHI security.  Providing interpretation services, whether they’re through video remote interpretation (VRI) or over-the-phone (OPI), is critical for improving language access. Healthcare providers should have established language agencies with the setup for appointments and last-minute needs. A language service provider (LSP) can help strategize your needs to efficiently meet video appointments and larger volume calls.  Learn about OPI vs. VRI interpretation, and why you may need to provide both types of telehealth interpreting to patients. To improve healthcare literacy through language, consider patient touchpoints with your organization. The patient journey starts with searching for providers, having an initial appointment, and aftercare, including self-administration of care, and all the touchpoints in between. When you think about the patient experience, ask yourself these questions: If you identify areas that need improvement with language, consider strategizing with your LSP. For example, perhaps you should localize your website or create language voice options on your phone system, and your LSP can help you with that. 
One language scenario may not be enough to fulfill your patients’ needs. Given the disadvantages that we described earlier, and as COVID-19 continues to challenge traditional healthcare solutions, healthcare organizations may have to more than one language strategy for given scenarios.  For example, telehealth appointments may not be the best solution in some cases. With VRI, consider the following factors to have a successful meeting: 
Consider other telehealth options where video conferencing technology won’t be as much of a challenge. For example, some LEP patients may be more comfortable over the phone than on video. The AHA 2022 Environmental Landscape showed that of the 27% of Medicare beneficiaries who participated in telehealth visits, 56% were over the phone, 28% were video, and 16% were both.   Of course, some types of topics are better for telehealth than others. Here are some examples.  Lastly, consider language factors, such as requests by the individual for a specific language and method, complexity of the meeting such as multiple participants which can be confusing on video or phone with interpretation, the digital literacy of all participants, limited hearing by participant(s), sign language users (meaning OPI isn’t a possibility), and more.   Clinicians can determine the need for a healthcare interpreter by reviewing patient records in the EHR system, noting the patient’s preferred language, or asking patients directly when scheduling an appointment. On-demand interpreting solutions and medical interpretation services are available to ensure equal access and health equity, so clinicians can plan ahead and provide professional interpreters for both in-person and telehealth visits. Telehealth interpreters will join appointments via secure links hosted on the AvantInterpret on-demand interpreting platform. Professional interpreters are trained to provide real-time interpreting, supporting patients who are hard of hearing, speak a different language, or need ASL services, all while maintaining accuracy in medical terminology. Yes. All professional interpreters engaged through Avantpage’s medical interpretation services adhere to HIPAA standards, maintaining patient confidentiality at all times. Whether interpreting face-to-face, via video interpretation, or in real-time telehealth sessions, interpreters are trained in medical terminology and confidentiality protocols to protect sensitive health information. Absolutely. Our interpreting platform integrates seamlessly with EHR systems, allowing clinicians to schedule appointments, track patient data, and request medical interpreters directly within the platform. This integration supports real-time, on-demand interpreting solutions and helps ensure that patients receive care in their preferred language without workflow disruption. Yes. ASL interpreters are available for telehealth appointments to provide equal access and support health equity for patients who are deaf or hard of hearing. Interpreters join in real-time via video interpretation, ensuring clear communication and seamless integration with clinicians’ telehealth workflows.Learn how to work with a sign language interpreter for better health outcomes for patients. Telehealth services are going to continue to grow. To reduce health disparities in language, healthcare companies can provide interpreters, address language needs along the patient journey, and evaluate the best solutions for their patients. We provide VRI and OPI services for healthcare organizations and other industries. To learn more about how we can help you, get a free quote, contact us with a general inquiry, or call (530) 750-2040. 

The post-pandemic Medicaid unwinding has created one of the largest coverage shifts in recent history. For Medicaid Managed Care Organizations (MCOs), the stakes are high: millions of members risk losing coverage, not because they’re no longer eligible, but because of procedural disenrollment. According to the KFF Medicaid Enrollment and Unwinding Tracker, 70% of Medicaid disenrollments in early 2024 were due to missed paperwork or incomplete renewals, not actual eligibility loss. Many of these members face a common and solvable barrier: language access. When renewal notices, forms, and instructions aren’t available in a member’s preferred language, deadlines are missed, documents are misunderstood, and coverage slips away. The result? Avoidable churn that disrupts care continuity and drives up costs for plans. The good news: this is a fixable problem. The solution: a proactive, multilingual Medicaid redetermination strategy. Table of Contents What Is Medicaid Redetermination? What is a Multilingual Medicaid Redetermination Strategy? Why a Proactive Approach Matters The Core of a Multilingual Redetermination Strategy - Start Early - Deliver Culturally and Linguistically Appropriate Communications - Leverage Multiple Outreach Channels - Train Staff and Partners on Language Access Measure, Learn, and Adjust - Renewal Rates Among LEP Populations - Call Center Volume and Language Line Usage - Reduction in Procedural Terminations - Member Feedback and Retention ROI Marketing Redetermination Effectively Common Pitfalls to Avoid Frequently Asked Questions About Building a Redetermination Strategy The Bottom Line Medicaid redetermination is the process by which the state reviews beneficiary information to ensure they still qualify for Medicaid benefits. This typically involves verifying details such as income, household size, and place of residence. It’s a routine step that helps ensure Medicaid is providing coverage to people who meet the program’s rules. Ensuring that communication is clear and accessible in multiple languages is essential to help all beneficiaries maintain their benefits.  Learn more about LEP patients and what it means to be limited English proficient. A multilingual redetermination strategy is a proactive, structured approach designed to help Medicaid enrollees renew their coverage, regardless of their language proficiency. It’s about more than just translating a few forms. It means ensuring that every touchpoint in the renewal process, communications, support channels, and workflows, is designed to work seamlessly across languages and cultural contexts. With the right approach, members who are eligible won’t fall through the cracks simply because they couldn’t access renewal instructions in a language they understand. Too often, plans address disenrollment reactively; contacting members only after their coverage lapses. At that point, re-engagement becomes an uphill climb, requiring additional outreach, administrative effort, and resources. Members may also have already gone without needed care or medications, compounding health risks. A proactive approach flips the script: For MCOs and health plan marketers, the renewal cycle isn’t just an operational requirement; it’s an opportunity to strengthen relationships and close health equity gaps. Learn more about how improved language access can make healthcare better. A strong multilingual redetermination strategy weaves together language access, cultural relevance, and well-timed outreach. Here are the essential components: Redetermination should begin months before a member’s renewal date. This means: Early contact gives you time to: Translation is only the starting point. True effectiveness comes from cultural adaptation - ensuring messages are understandable, relatable, and trustworthy.Work with healthcare translation experts to ensure every message: Why this matters: Some populations may distrust official-looking documents or may be unfamiliar with how public benefits work. Tailoring the tone and framing can make the difference between a member opening a letter versus ignoring it. Different communities have different communication preferences. A multi-channel approach ensures your message is seen and understood: Tip: Make each communication channel reinforce the others to create a seamless and consolidated experience for members. For example, a mailed renewal reminder can direct members to a multilingual hotline where language resources are centralized and available on demand, providing real-time support without the higher costs of last-minute interpretation. Meanwhile, a follow-up text can link directly to the renewal form, guiding members smoothly through the process. This strategic coordination helps reduce confusion, saves resources, and ensures consistent language access across touchpoints. Even the most perfectly translated materials will fall short if frontline staff don’t know how to connect members to language assistance. Training should cover: Language access consulting can help build a sustainable plan that ensures every frontline staff member, from call center agents to community health workers, not only knows how to support LEP (Limited English Proficient) members effectively, but also understands the process to accurately identify the required language before connecting to an interpreter. Tools like “I Speak” cards or call-routing systems can prevent wasted time and expense from reaching the wrong interpreter. Proper training on using phone systems is also crucial; many staff unintentionally hang up or fail to connect due to a lack of familiarity, which can be uncovered through methods like mystery calls. A multilingual redetermination strategy is only as strong as its measurable impact. Tracking the right indicators ensures that your efforts are driving meaningful retention, improving member experience, and meeting compliance requirements. Pro tip: Segment results by language and region to identify high- and low-performing areas for more targeted follow-up. Pro tip: Use this metric together with renewal rates to gain a fuller understanding. Some members might reach out for help but still fail to complete the process without extra support. Additionally, analyze drop-off points to identify where language barriers may be causing friction for Limited English Proficiency (LEP) members, and conduct quality assurance to uncover gaps in language coverage. Pro tip: Use this metric alongside renewal rates to get a complete picture. Some members may call for help but still not complete the process without additional support. Pro tip: Translate surveys and use trusted messengers to boost response rates from LEP members for more accurate sentiment analysis. When it comes to helping members renew their coverage, especially those with limited English proficiency, the way you market matters. Meet people where they already are. Run targeted ads on social media, place spots on local radio stations, share print flyers, and partner with community media outlets,  all in the languages your members speak. Avoid spreading your resources too thin. Instead, concentrate your outreach efforts on neighborhoods and regions where your target language communities reside and work. This strategic focus ensures that your message reaches those who need it most. To identify these areas, you can utilize the U.S. Census Bureau's interactive mapping tools, which provide detailed demographic data by location. Skip the technical terms and bureaucratic tone. Use clear, friendly language that makes renewal feel simple, urgent, and worthwhile. The goal is to make the process less intimidating and more empowering. By combining these strategies, you can ensure your multilingual redetermination efforts truly connect and help more members keep their coverage. Medicaid redetermination is the process of reviewing a member’s eligibility for coverage. This involves confirming household size and income, among other factors such as residency and disability status. While some states may renew based on this information, beneficiaries may also need to complete a form, provide documentation, or attend an interview.  Medicaid redetermination is crucial because missing deadlines or paperwork can cause members to lose health benefits. Members with limited English proficiency are more likely to miss renewal notices if they’re not in their preferred language. Multilingual materials ensure everyone understands how and when to renew. Clear communication in the right language helps members take timely action, reducing the risk of losing coverage due to misunderstandings or missed deadlines. It should include translated notices, culturally relevant outreach, geo-targeted campaigns, and partnerships with trusted community channels. Yes. Retaining members through better communication reduces churn, improves health outcomes, and strengthens long-term plan revenue. The Medicaid unwinding period is both a challenge and an opportunity. By embedding multilingual and culturally competent communication into your redetermination process, you can: Don’t wait until members disappear from your rolls. Start building your multilingual redetermination strategy today. Ready to take action? Explore our expertise in healthcare translations and language access consulting services. You can also learn more about multilingual outreach strategies or request a free quote to start designing your plan.
By acting early and leading with equity, your organization can turn renewal season from a compliance headache into a member engagement success story.

Simultaneous interpreting has been a keystone of high-stakes multilingual communication since it was first employed at the Nuremberg Trials in 1945. Sometimes called the “trial of six million words” due to the sheer volume of words in the transcripts, the main trial was completed in just 10 months, largely thanks to the interpreters who tested the then-new method of interpreting. Unlike consecutive interpreting, in which the interpreter waits for the speaker to finish speaking before providing an interpretation into the target language, simultaneous interpreting requires the interpreter to listen carefully to the speaker in the source language and provide a target language interpretation at the same time. In turn, it’s much faster-paced than consecutive interpreting, lending itself well to high-stakes, time-sensitive settings like medical emergencies and trials. In this blog post, we’ll take a look at simultaneous interpreting, exploring how it enhances clarity and speed across various fields, including law, healthcare, business, and more. Table of Contents What Is Simultaneous Interpreting? Why Simultaneous Interpreting Is Essential for High-Stakes Communication Benefits of Simultaneous Interpreting Challenges and Best Practices How to Choose a Simultaneous Interpreting Service Future Trends in Simultaneous Interpreting Frequently Asked Questions About Simultaneous Interpreting Conclusion Simultaneous interpreting is a method of interpreting wherein the speaker and the interpreter speak more or less at the same exact time—as the speaker talks in the source language, the interpreter listens carefully and speaks in the target language. There’s typically a small lag between the two parties, as the interpreter usually waits a few short seconds to jump in and begin interpreting, also known as the “ear-voice gap.” Interpreters have to be careful with how long they wait to jump in—too soon and they’re likely to use unnatural structure and vocabulary that mimics the source language. But if they wait too long, they’re liable to forget too much of what was said earlier on. This skill requires a finely tuned working memory, and unlike consecutive interpreting, the interpreter does not know how a given sentence is going to end when they start interpreting. You’ll commonly see simultaneous interpreting in healthcare settings, especially in time-sensitive emergencies, as well as in the courts and other legal settings. Multilingual conferences also commonly employ simultaneous interpreting as well. Due to its challenging nature and the fact that it’s often used in high-stakes settings, simultaneous interpreting requires a lot of practice—it’s not enough to be proficient in two languages. Formal graduate training in interpretation is often required to work as a simultaneous interpreter. When it comes to high-stakes communication like medical emergencies, delays, even small ones, can lead to negative outcomes. Miscommunication in medical emergencies has been shown to increase the risk of harm by 30% or more. By quickly reducing the risk of miscommunication, simultaneous interpreting can help save lives. By eliminating delays in critical moments, simultaneous interpreting allows you to deliver your message much quicker than you could with consecutive interpreting, which effectively doubles the length of any conversation. Whether you’re dealing with a medical emergency or conducting international diplomacy, simultaneous interpreting is generally your best bet for accurate and speedy delivery of interpreting services. Here are a few industries and scenarios where simultaneous interpreting is typically used: Here are a few of the advantages of using simultaneous interpreting in high-stakes settings: Although simultaneous interpreting has many benefits, there are some challenges in its implementation. Because of the high cognitive load of this task, interpreters often experience significant burnout. To reduce the risk of burnout, it’s a good idea to work with a team of two or more interpreters who can switch out with one another, allowing the other team members to take breaks. Interpreters can also reduce the risk of burnout by preparing beforehand. It’s a good idea to provide your interpreter with basic notes or a run-of-show in advance so they can prepare themselves and brush up on the terminology they’ll need to use on the day of. Additionally, interpreters need to have the right technology and preparation for the job. Simultaneous interpreting often requires specialized audio equipment, such as a pair of high-quality headphones and a microphone. Remote simultaneous interpreting usually requires additional technology, such as interpreting software. If you need interpreting services, the best way to get connected with an interpreter is through a language service provider like Avantpage. A language service provider will handle all the heavy lifting of matching you with an interpreter who suits your needs and making sure they have the proper equipment. When shopping around for a language service provider, here are a few things to consider: Demand for interpreters is growing—the U.S. Bureau of Labor Statistics predicts that demand for interpreters will grow by at least 4% by 2032. Remote simultaneous interpreting has been on the rise for quite a while now, with the COVID-19 pandemic leading to a boom in demand for interpreting services delivered remotely, either by video or phone call. While there’s certainly still demand for in-person services, it’s likely that remote services will continue to grow. Likewise, the recent rise of artificial intelligence technology has also made waves in the fields of translation and interpreting. But it’s important to note that human interpreters aren’t going anywhere just yet, as human reviewers still have to review automatically translated documents to verify their accuracy. Likely, there will always be some level of human-in-the-loop oversight in the interpretation process. Simultaneous interpreting is a form of interpreting in which the interpreter speaks at the same time as the target-language speaker. The interpreter does not wait for the speaker to finish their utterance before interpreting; both parties speak at the same time. Simultaneous interpreting is most effective in high-stakes settings that require quick and accurate delivery of information. This includes courtrooms, medical emergencies, diplomatic settings, and multilingual conferences, to name a few settings. Simultaneous interpreting can improve outcomes in high-stakes situations in several ways. First, it reduces delays, allowing each party to maintain a more fluid, natural conversation. Simultaneous interpreting also requires a high level of training and skill. When you work with a vetted simultaneous interpreter, you can rest assured that you’re working with one of the most qualified individuals available. With simultaneous interpreting, the interpreter and speaker both speak at the same time. With consecutive interpreting, the interpreter waits for the speaker to finish speaking before speaking. Consecutive interpreting is a slower process, as the interpreter must take turns with each speaker. When seeking out simultaneous interpreting services, it’s important to find a language service provider you can trust. Ask them about their vetting process for their interpreters, what industries they have experience in, and how their interpreters prepare for a session. The answers to these questions will help you find the right interpreting service for your needs. When you’ve got high-stakes communication needs, simultaneous interpreting is the way to go. From medical emergencies to diplomatic missions, simultaneous interpreting enables people to communicate freely and fluidly without having to take long breaks between speakers. You never know when a time-sensitive emergency is going to come up, which is why organizations must prepare in advance by partnering with a trusted language service provider who can offer on-demand simultaneous interpreting services. 
At Avantpage, we offer in-person and remote simultaneous interpreting services, with on-demand interpreters in more than 150 languages. With AvantInterpret, you can get connected to an accredited, specialized interpreter in as little as 30 seconds to ensure timely communication in high-stakes settings. If you’re looking for simultaneous interpreting services, contact us today at (530) 750-2040 or [email protected]. Or, request a free quote now.

For a democracy to be truly representative, its citizens must have equal access to vote in their elections. This is one of the guiding principles behind the Voting Rights Act of 1965, which prohibits racial discrimination in elections across the United States. Since its adoption in 1965, this key piece of legislation has been expanded to protect the voting rights of other minority groups as well, including the nearly 25.7 million Americans with limited English proficiency (LEP). In particular, Section 203 of the Voting Rights Act outlines key measures to ensure language justice in elections—that is, it empowers eligible voters with limited English proficiency to exercise their civic duty by setting requirements for translating election materials. Multilingual election ballots have since become a mainstay of American elections, as they allow individuals LEP to fully understand what’s at stake in each election, whether it’s a small municipal election or a hotly contested presidential election. In this blog post, we’ll take a look at the legal framework for language justice in elections, sharing proactive, actionable strategies that election offices can use to ensure that LEP voters in their jurisdiction can exercise their right to vote just as easily as a native English speaker might. Table of Contents The Legal Foundations for Election Translation Compliance Pitfalls and Enforcement How to Implement Language Justice in Elections Beyond Compliance: Building Equitable Access for the Future Frequently Asked Questions About Language Justice in Elections Conclusion As discussed earlier, the Voting Rights Act lays out government-related translation regulations that ensure individuals with LEP have equal opportunity to participate in elections. Section 203 of the Voting Rights Act states that jurisdictions with significant populations of language minority citizens must provide them with information in their preferred language.  While Section 203 only covers languages spoken by “persons who are American Indian, Asian American, Alaskan Natives or of Spanish heritage,” it’s good practice to go beyond the bare minimum—while it may not be required to translate election materials into Arabic or Haitian Creole, it helps make elections more fair and accessible, especially in jurisdictions where these languages are widely spoken. That is, anything that’s available in English must also be made available in the language spoken among the LEP population. Additionally, election boards must staff the polls with workers who can provide LEP voters with assistance in their preferred language.  More specifically, the act covers any locality where more than 10,000 people or 5% of the total voting age citizen population meet the following conditions: In 2021, a total of 331 jurisdictions met those criteria and had to provide language assistance to voters with LEP. And that number’s on the rise: just five years prior, only 263 jurisdictions had to do so. To ensure language justice in elections, any jurisdiction that meets these criteria must translate the following materials: They must also have a multilingual team of poll workers who can offer assistance to LEP voters. And the Voting Rights Act isn’t the only piece of legislation that aims to improve accessibility and language justice in elections. The National Voter Registration Act (known colloquially as the “Motor Voter” law) requires states to offer voter registration opportunities at state motor vehicle agencies. If a given jurisdiction is covered by the language minority provisions of the Voting Rights Act, these registration forms must be translated and available in any relevant minority languages.  Likewise, Title VI of the Civil Rights Act prevents discrimination on the grounds of national origin, a category which includes an individual’s linguistic background. There are also several local and state regulations that election boards must be aware of as well. Even with clear legal requirements in place, compliance with election translation laws can be uneven, and in some cases, neglected entirely. When jurisdictions fail to meet their obligations under Section 203 or other language access laws, they not only risk legal consequences but also erode trust among voters who already face barriers to participation. Many complaints have been raised against jurisdictions that do not comply with the requirements of Section 203 of the Voting Rights Act. For example, a 2024 complaint was filed against Pawtucket County, which allegedly did not sufficiently translate election-related materials into Spanish, despite being required to do so under Section 203. Noncompliance can result in costly and time-consuming legal challenges, but more importantly, a lack of language justice in elections is likely to result in elections that are not fully representative of your population. Ultimately, compliance isn’t just about avoiding lawsuits—it’s about delivering on the promise of fair and inclusive democracy for all. If voters have difficulty understanding the voting process or what they’re voting on, they’re likely to skip voting entirely.  By translating election materials into languages spoken widely throughout your community, you can help LEP citizens build trust in the voting process and ensure more representative elections. Here are some strategies to go above and beyond the federal requirements for language access, so your organization can take a proactive approach to language justice in elections: CBOs that work closely with immigrant populations can help you identify weak areas in your language access measures and develop strategies for improvement. The federal government releases a list of areas and languages covered under Section 203 every five years, but it’s important to be proactive. Look into census data and other local demographic information to see if there are any languages not covered under Section 203 that could be worth translating election materials into, even if you don’t technically have to. While this is required under Section 203, it’s important to strategically place bilingual poll workers at the polls. If one poll is located in an area with very few Spanish speakers, it may be a better idea to have Spanish-speaking workers posted at a poll where they’re more likely to come in contact with Spanish-speaking voters. Language service providers can help you assess your translation, interpretation, and localization needs. Don’t try to undertake the task of translation all on your own—a language service provider will connect you with professional translators and editors to ensure top-notch quality. True language justice in elections means meeting voters where they are, both linguistically and culturally. This means translating materials with cultural competence and ensuring that assistance is accessible to voters who speak non-written languages or regional dialects. Partnering with trusted community organizations can amplify outreach and build trust where it's needed most. Looking ahead, election officials are increasingly turning to digital tools, such as multilingual voter portals and mobile-friendly ballot guides. While AI-powered translation tools offer promising efficiencies, they also carry risks, such as producing inaccurate translations that could confuse or mislead voters. As the electorate becomes more linguistically diverse, calls to modernize the Voting Rights Act’s language coverage formulas and establish stronger federal standards for translation and accessibility are growing louder. Language justice in elections means going above and beyond the basic language access requirements of elections and working to ensure that voting-age citizens can participate in elections seamlessly, without having to worry that their LEP will impact their ability to understand the voting process. The Voting Rights Act requires election boards to translate election materials into a variety of different languages. Specifically, Section 203 outlines the requirements for translating election materials into languages other than English. If a jurisdiction has more than 10,000 people or 5% of its population who are voting-age citizens that are members of a single language minority group, have depressed literacy rates, and do not speak English well, they must comply with Section 203. The most recent list of jurisdictions that must comply with Section 203 can be found here. Yes. Any election-related materials that are available in English must also be translated into the language spoken by the covered language minority group. Learn about the election materials that need to be translated. Failure to comply with Section 203 of the Voting Rights Act can result in expensive and time-consuming legal challenges. Additionally, it may harm a jurisdiction’s reputation, further discouraging LEP voters from participating in future elections. Machine translation alone should not be used to translate election materials; at the very least, human translators should review machine translation for potential errors. Machine translation tools often struggle with context and nuance, so it’s important to have a human who’s familiar with English and the target language to review and edit translations and ensure accuracy. According to the 2021 list of jurisdictions covered under Section 203, Spanish is by far the most commonly covered language under the Voting Rights Act. It’s followed by Chinese, Vietnamese, Filipino, and several other Asian and Native American languages. Many election materials have already been translated for you—look to the Election Assistance Commission and your Secretary of State’s office to find them. Additionally, language service providers often provide a wide range of services, from the standard human translation to more cost-effective methods like machine translation post-editing. Consult with multiple different language service providers to determine the option that works best for your office. To ensure elections are fair and accessible to all, election offices should go beyond the bare minimum requirements outlined in Section 203 of the Voting Rights Act. Conducting thorough assessments of your jurisdiction’s language needs is the best way to ensure that citizens from all linguistic backgrounds can participate fully in our democracy.  Though the 2024 elections are now in the rearview mirror, it’s never too soon to look into ways to make upcoming elections more accessible. As our country becomes more linguistically diverse and the population of LEP citizens grows, language equity is becoming a core principle of our democracy.  If you’re looking to promote language justice in elections, consider reaching out to Avantpage. We specialize in translations for election offices across the country, empowering LEP voters to fulfill their civic duty. Fill out this form to get a free quote for election material translation services or contact us at (530) 750-2040 or [email protected].

A few years before Avantpage was founded, our CEO Luis Miguel’s friend had a bit of a health scare.  This friend, a native Spanish speaker with limited English proficiency (LEP), went to the doctor one day to check up on a health concern he’d had. Though he often brought his daughter to doctor’s appointments to interpret for him, he decided not to this time around, in case it was something serious. But when he left the doctor’s office, he wasn’t sure what to make of the experience — he knew he had a growth in his chest, but he had no idea if it was malignant or not. So he asked Luis Miguel to help him out. Luckily, it was just a cyst, and not a tumor, as he had feared. It was this experience, among others, that inspired Luis Miguel to found Avantpage nearly three decades ago. Luis’s friend’s experience was lucky, but not entirely unique — millions of patients across the United States have LEP, making a routine trip to the doctor’s office a fairly complicated excursion. As we celebrate Avantpage’s 27th birthday on Oct. 31, we think it’s worthwhile to understand what it means to be an LEP patient navigating the all-too-complex healthcare system in the United States. In this blog post, we’ll explore the LEP meaning through the experience of LEP patients, while also providing a few key tips for healthcare providers to keep in mind as they attempt to support individuals with LEP. Table of Contents LEP Meaning: What it Means to Be an LEP Patient Why Language Access Matters for LEP Patients Legal Requirements for Supporting LEP Populations Practical Tips for Supporting LEP Patients Common Misconceptions About LEP Patients A Closer Look at Spanish-Speaking Populations Frequently Asked Questions About Supporting LEP Patients Conclusion Limited English Proficient (LEP) individuals are those who do not speak English as their primary language and have a limited ability to read, speak, write, or understand English. According to the U.S. Census Bureau, 25.7 million U.S. residents over the age of 5 were classified as LEP in 2021—that’s nearly 1 in 10 people. In a medical context, this language barrier can lead to: LEP patients frequently face challenges understanding complex medical terminology, interpreting insurance coverage options, and advocating for their own needs, especially when clinicians lack access to professional language assistance services. Healthcare already involves high-stakes decisions, complicated terminology, and critical written instructions. Even for native English speakers, research shows that 88% of adults have inadequate health literacy. Now, imagine navigating those same situations without full English language proficiency. This is where language access, bilingual staff, and culturally competent care make all the difference. Providers that fail to accommodate LEP individuals risk:  Language access isn’t just a “nice-to-have,” it’s federally required when your organization receives federal funds. Here are the key laws and policies: Failing to comply with these policies can result in audits, complaints filed with the Department of Justice (DOJ) or Office for Civil Rights (OCR), and reputational harm. Here’s how healthcare providers can build stronger systems for inclusive care: 1. Identify the most common languages spoken in your service area and create a custom language access plan based on the demographics.
2. Speak with an experienced language access service provider to learn about creating a plan for different languages and healthcare settings, such as language access plans during emergencies for first responders. 1. Avoid relying on bilingual family members or friends.
2. Offer in-person, telephonic, and video remote interpreting services. 1. Teach staff to recognize LEP individuals.
2. Use tools like “I Speak” cards to identify language needs quickly.
3. Ensure language preferences are documented in the medical record. 1. Whenever possible, assign the same interpreter for follow-up visits.
2. Be mindful of gender preferences or cultural norms when matching interpreters. Spanish is the most common non-English language spoken in the U.S., with over 42 million native speakers. Ensuring access for Spanish-speaking LEP patients is often a first step toward broader health equity. Bilingual staff, translated discharge instructions, and community engagement all play a critical role in reaching this large, underserved population. LEP patients are people who have limited ability to read, speak, write, or understand English, and therefore may struggle to navigate healthcare without language assistance. In healthcare, LEP stands for Limited English Proficiency. The LEP definition, as used by the U.S. government, refers to individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English. The LEP meaning in healthcare specifically highlights the communication challenges these individuals face when accessing medical services, making it essential for providers to offer qualified interpreters and translated materials to ensure safe, equitable, and high-quality care. Yes. Under federal laws like Title VI and the ACA, healthcare organizations receiving federal funds must provide qualified interpreters and translation services to ensure meaningful access. Use “I Speak” cards or ask direct questions about language preference. Document this in the patient’s record and act on it at every encounter. Yes. Studies show that errors are significantly more common when untrained bilinguals interpret versus certified medical interpreters. Implement a language access plan, use trained interpreters, offer translated materials, and train staff in cultural competence and health literacy. At Avantpage, we believe every patient deserves clear, compassionate, and informed care, no matter their first language. By implementing thoughtful strategies, training staff, and investing in trusted language access services, healthcare organizations can reduce disparities and deliver high-quality care to all. Need help building or improving your language access plan? Contact us today at (530) 750-2040 or contact us to learn more about our translation, interpreting, and localization services.

California is one of the most linguistically diverse states in the country. As a major destination for immigrants to the United States, California is home to speakers of more than 200 different languages, many of whom have limited English proficiency (LEP). In fact, the state accounts for about a quarter of the nation’s LEP population, with seven million people reporting that they speak English “less than very well.” For healthcare providers in California, that means that interpreter services are absolutely critical. In particular, healthcare providers who work with patients on Medi-Cal, California’s implementation of the federal Medicaid program, must be prepared to provide thorough and extensive Medi-Cal interpreter services to their patients with LEP. In this blog post, we’ll take a look at the nuances of Medi-Cal interpreter services in California. We’ll explain what Medi-Cal is, how Medi-Cal interpreter services can improve health outcomes for your patients with LEP, and how to integrate interpreting services into your workflow. Table of Contents - The Landscape of California's Linguistic Diversity - What Is Medi-Cal? - Legal Requirements for Medi-Cal Interpreter Services - The Benefits of Professional Interpreting - Common Challenges Without and Interpreter - How to Implement Interpreter Services in Your Healthcare Practice - Options for Providing Medi-Cal Interpreter Services - Summary Whether you’re in a cosmopolitan megalopolis like Los Angeles or the rural farmlands of the Central Valley, you’re likely to hear of a wide range of different languages spoken throughout the state. That’s because about 40% of Californians speak a language other than English at home.  The most widely spoken language in the state after English is—as in the rest of the country—Spanish, but there are more than 200 other languages and dialects spoken throughout California, making it one of the most linguistically diverse places in the country. To name just a few, other languages spoken widely throughout the state include: Many speakers of these languages are fluent in both English and their primary language. But not all of them are—as previously mentioned, about seven million people are classified as LEP. That’s around 17% of the state’s population. And although the state as a whole only makes up about 11% of the country’s population, its LEP residents make up a fairly significant portion of the country's entire LEP population: 19%. Additionally, individuals who speak a language other than English at home are particularly over-represented among Californians who depend on the state’s Medicaid program, Medi-Cal. More than 44% of the Medi-Cal beneficiaries speak a language other than English at home. This dynamic means Medi-Cal interpreter services are an absolute must-have for any healthcare provider working with Medi-Cal beneficiaries. Medi-Cal is California’s Medicaid program. Supported by both federal and state taxes, Medi-Cal covers healthcare services for individuals with limited income and resources, allowing them to access high-quality healthcare at low or no cost. Many Medi-Cal beneficiaries are able to receive healthcare without paying a premium, co-pay, or out-of-pocket costs. Since so many Medi-Cal beneficiaries speak a language other than English at home, it’s important for providers to be prepared to offer interpreting services to their patients. The presence of a medical interpreter can make or break a patient’s health outcome, as clear, seamless communication is key to making sure doctors are well-informed of their patients’ symptoms and that patients are able to advocate for themselves and understand their doctors’ instructions. By lowering the risk of miscommunication, research shows that medical interpreting services can help lower the risk of readmission for patients with LEP by 25%. And while many Medi-Cal beneficiaries do speak English, patients who speak another language at home may still prefer to receive healthcare in their primary language. By offering Medi-Cal interpreter services, you can build trust with your patients and ensure that they are comfortable receiving your care. Both federal and state laws require healthcare providers to offer language access services to patients with LEP. Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act mandate that providers receiving federal funding—like those serving Medi-Cal patients—must ensure meaningful access to care through qualified interpreters and translated materials, on the grounds that not doing so would qualify as discrimination against a patient on the basis of their national origin. In California, the Department of Health Care Services (DHCS) expands on these rules. Medi-Cal managed care plans must provide free interpretation, offer timely access to interpreters, translate essential documents like NOA/NAR letters, and more.  Providers who fail to comply with these requirements risk legal penalties, funding loss, and lower patient satisfaction scores. Interpretation services aren’t optional—they’re essential and enforceable. Working with professional interpreters who specialize in medical interpreting will allow your doctors and other caretakers to worry less about communication struggles and focus on what actually matters: taking care of patients. Medi-Cal interpreter services ensure that care teams are able to seamlessly communicate with their patients in whatever language works for them. That means healthcare organizations and patients alike will experience the following benefits of interpreting services: Research shows that patients with LEP are more likely than their English-speaking counterparts to experience a severe medical error. Without an interpreter to help you communicate with your LEP patients, you run the risk of encountering the following obstacles, which could have serious consequences for you and your patients: It should be clear by now that Medi-Cal interpreter services are absolutely critical for any healthcare provider who works with Medi-Cal beneficiaries. Still, you may not be sure where to begin—let’s break it down step-by-step: When contracting Medi-Cal interpreter services, you’ll likely come across a lot of different forms of interpreting. Let’s break down some of the most common modalities for delivering interpreting services: When contracting Medi-Cal interpreter services, the reality is that you will likely need to use some sort of hybrid model—that is, a combination of all three modalities. Because of the complex nature of medical interpreting, your language service provider will work closely with you to identify when and how you’ll use each modality. It’s hard to overstate the importance of high-quality language access measures to providing effective, equitable healthcare to patients. A Medi-Cal interpreter enables healthcare providers to not only meet legal requirements, but also gives LEP patients the same level of care that their English-speaking counterparts receive. If you’re in need of Medi-Cal interpreter services, consider seeking out the services of a trusted language service provider who specializes in healthcare. Ready to improve communication and care for your Medi-Cal patients? Learn more about our professional interpreter services tailored for California healthcare agencies. Fill out this form to get a free quote or contact us at [email protected] or (530) 750-2040.

During Hurricane Irma's press briefing, Manatee County made a serious error by relying on an unqualified interpreter to convey critical information. Instead of providing essential updates, the person signed unrelated words like "pizza" and "bear," causing confusion and frustration within the Deaf community. While some showed understanding toward his intentions, this incident underscores the importance of qualified, certified interpreters in ensuring equitable access to vital information. This example highlights how effective language services are essential in moments of crisis, where accurate communication can directly impact safety and well-being, especially when it comes to crucial procedures like emergency preparedness, or health. Providing American Sign Language (ASL) interpreting services in government settings is not only a legal obligation but also a vital public service responsibility. Offering ASL interpreter services ensures that the Deaf and hard-of-hearing community has equal access to public services, promoting inclusion, transparency, and effective communication. Table of Contents

- The Accessibility Gap in Government Services
- Understanding the Deaf Community and ASL
- Legal Requirements for Government Agencies
- The Benefits of Providing ASL Interpreter Services
- When to Use ASL Interpreter Services
- Implementing ASL Interpreter Services
- Common Misconceptions About ASL Interpreter Services
- Conclusion: Taking Action to Improve Accessibility Despite existing legal protections, many ASL users still face communication barriers in government settings. Even with the Americans with Disabilities Act (ADA) in place, many agencies struggle to meet the needs of deaf individuals effectively, leading to an accessibility gap that can limit deaf residents’ ability to engage with important civic activities like public meetings, legal proceedings, and government services. Unlike threshold languages, which are based on population size, American Sign Language (ASL) access is a civil right and should be ready at a moment's call to all Deaf individuals, regardless of the population size. ASL interpreter services are essential in bridging this gap, ensuring that communication is fully accessible and equitable for all members of the Deaf community. Accessibility in government isn’t just about legal compliance; it’s about public responsibility. Government services must be available to all citizens, regardless of their hearing ability. By offering ASL interpreting services, government agencies can take the necessary steps to fulfill this responsibility. American Sign Language (ASL) is a fully developed, distinct language used by over 500,000 people in the United States. ASL has its own grammar, syntax, and structure, making it a complex language in its own right—one that is fundamentally different from English. Written English and lip-reading often do not provide adequate access for many Deaf individuals, which is why ASL interpreter services are crucial for ensuring that individuals can fully understand and participate in government processes. It’s also important to recognize that ASL is not a one-size-fits-all language. As a relatively newer language, there are variations such as Pidgin Signed English (PSE), Signed Exact English (SEE), and different use cases like tactile interpreting for those who are both deaf and blind/low vision, or even home signs used by tightly-knit families or communities. For agencies, this means understanding that language access needs can vary widely within the Deaf community, and the provision of ASL services should reflect this diversity. Without qualified interpreters who can navigate these variations, government communications risk excluding a significant portion of the population, leading to inequities in services and programs. The Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act mandate that public entities provide “effective communication” for individuals with disabilities, including those who are deaf or hard-of-hearing. These laws require that government agencies not only provide access to services but also ensure that their communications are accessible. "Effective communication goes beyond written text, captions, or relying on family, friends, or unqualified interpreters. It requires trained, vetted professionals who ensure true understanding. For many in the Deaf community, ASL interpreting services are necessary to ensure complete understanding. Failure to meet these requirements can result in negative outcomes for the individual, legal consequences, including complaints, lawsuits, or damage to an agency’s reputation. More importantly, it undermines the trust of the community and the agency’s credibility. Providing ASL interpreter services supports government agencies by making public services truly accessible to all. It promotes inclusion and advances equity for historically marginalized communities. For individuals who are deaf, having access to interpreters at public meetings, hearings, and services means they can fully participate in civic life, leading to more engaged and informed communities. But beyond civic engagement, ASL access is often critical in high-stakes or even life-or-death scenarios. Whether it’s a natural disaster, an environmental hazard, or a public health emergency, deaf individuals must receive timely and accurate information to stay safe and make informed decisions. Ensuring qualified ASL interpreters are available in these moments isn’t just a best practice—it’s a matter of public safety and civil rights. There are many scenarios where ASL interpreter services should be integrated into government settings. Public meetings, town halls, and community hearings are prime examples. These events often involve important discussions that impact local residents, and ensuring that deaf individuals can fully participate is crucial for fostering an inclusive environment. Additionally, ASL interpreters are essential for government services such as the DMV, housing offices, and benefits agencies, where in-person interactions occur. Emergency situations, such as disaster briefings or public health updates, also require immediate access to ASL interpreter services. Providing timely, accurate information during a crisis can be a matter of safety for Deaf individuals. To successfully implement ASL interpreter services, government agencies should start by assessing the demand for these services. Understanding when and where deaf individuals are most likely to require an interpreter will help agencies allocate resources effectively. It’s also crucial to partner with certified, professional ASL interpreter services to ensure that the interpreters are qualified and experienced. Training staff on how to work with interpreters is another important step. Ensuring that public employees know how to coordinate with interpreters and communicate respectfully with individuals who are deaf or hard-of-hearing can make the experience smoother and more effective for everyone involved. This includes understanding what a relay call might sound like when a deaf individual contacts an agency with an interpreter on the line—so they’re not mistakenly hung up on. Simple awareness like this can make a meaningful difference in access and dignity. Additionally, agencies should actively promote the availability of ASL interpreter services to the public. Many individuals who are deaf or hard-of-hearing may not know that these services are available, so clear communication about how to request an interpreter can increase access to services. Video Remote Interpreting (VRI) is also an option for remote communication and should be considered when appropriate, especially for virtual meetings and smaller gatherings. One common misconception is that writing things down or using family members to interpret is sufficient for communication. However, ASL interpreting services go beyond simple translation and require skilled professionals to accurately convey both the meaning and context of the message. Using family members or bilingual staff who are not trained interpreters can result in misunderstandings or legal risks, as their interpretations may not be accurate. Another misconception is that there is no demand for ASL interpreter services. Many Deaf individuals may not ask for services because they assume that these accommodations aren’t available. Agencies should proactively offer ASL interpreting services rather than waiting for requests, ensuring that all members of the community know they have equal access to government services. You may also like...
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Case Study: Bridging the Digital Divide with Embedded Sign Language Videos Providing ASL interpreting services in government settings is essential for fostering an inclusive, transparent, and equitable environment. By implementing these services, government agencies can not only meet their legal obligations but also demonstrate a commitment to accessibility and public service. The benefits of offering ASL interpreter services are far-reaching, improving equity, public trust, compliance, and community engagement. Government agencies have a responsibility to ensure that all citizens—regardless of their hearing ability—can access public services. ASL interpreting services play a crucial role in making this happen. By taking steps today to integrate these services into government communications, agencies can create a more inclusive and equitable future for all residents. Ready to improve accessibility in your agency? Partner with certified ASL interpreter services to create an inclusive, welcoming environment for all members of your community.

For so many of us—whether we’re caring for a child, a foster or adopted loved one, an aging grandparent, a live-in relative, a friend, or a trusted caregiver—getting medical care is rarely a solo experience. It often involves the people around us, and that means communication is a shared responsibility. Patients need to understand their care, of course—but when others are involved, they should be part of the conversation too. No matter what your family looks like, clear communication in healthcare is essential. And for families who speak a language other than English, that often means having access to translation services for families—not just during doctor’s appointments, but throughout the care journey. Imagine a parent bringing their child to a clinic, hospital, or emergency room. They deserve to feel confident they’ll understand the diagnosis, treatment plan, and next steps—and that they’ll be understood in return. But when English isn’t the family’s primary language, that experience can quickly become overwhelming. Miscommunication can lead to missed diagnoses, medication errors, and serious health risks. That’s where translation services for families make all the difference. These services ensure that everyone involved in a patient’s care can understand, ask questions, follow instructions, and make informed decisions. They don’t just support better communication—they build trust, safety, and inclusion. For millions of families across the U.S., this isn’t optional. It’s essential. Table of Contents

- Families Deserve More than Just Words
- What the Law Requires-and Why It Matters
- The Real-World Impact on Families
- Moving Forward: How Providers Can Improve Language Access
- Frequently Asked Questions
- Healthier Families, Stronger Communities Language barriers can make even the most routine medical visits stressful. Parents may struggle to understand what a provider is saying about their child’s condition. Grandparents might not follow after-care instructions after surgery. A caregiver could misinterpret medication dosages or fail to follow discharge instructions correctly.  Without access to translation, families may struggle to make informed decisions. The result is often worse health outcomes and higher costs for both families and providers. But when families can clearly communicate with their care teams, they're more likely to pursue preventive care, follow treatment plans, communicate openly with providers, and make the confident, informed decisions about their health that ultimately improve health outcomes.  You can learn more about how these services work by visiting our page on translation services and healthcare translation solutions.  It’s not just good practice to offer language support—it’s the law. Under Title VI of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act, healthcare organizations that receive federal funding are required to provide meaningful access to individuals who are limited English proficient (LEP).  This includes offering professional translation and interpretation services free of charge. According to HHS Office for Civil Rights, organizations must take reasonable steps to ensure LEP individuals can understand and access the services they need.  Failing to meet these standards can result in legal consequences—and more importantly, puts families at risk of not receiving effective care. For families, the absence of reliable language services creates a domino effect. A single misunderstanding can lead to a missed follow-up, which turns into a preventable emergency room visit. A caregiver who doesn’t understand a discharge plan may unknowingly worsen a loved one’s recovery.  In contrast, translation services for families build trust. They ensure parents can confidently consent to treatment. They help patients adhere to care plans. They give families the voice and agency they need to be active participants in their health—not just passive recipients.  Language access is also about dignity. Every family deserves to understand their own medical journey, regardless of the language they speak. Healthcare providers don’t have to overhaul everything overnight, but there are clear starting points. Working with a professional translation partner can help organizations assess where gaps exist and how to effectively close them. That could mean translating intake forms, providing access to on-demand interpreters during telehealth visits, or making sure discharge instructions are available in a patient’s preferred language.  Digital technologies are playing an increasingly vital role in improving access to healthcare for diverse families. Remote interpreting technology platforms, AI-driven translation tools like machine translation post-editing (MTPE), multilingual client portals, and telemedicine services are all helping bridge the gap—especially for families in rural or underserved areas. These tools aren’t meant to replace human connection, but they serve as valuable extensions, ensuring more inclusive communication and care. At Avantpage, we offer global language services tailored specifically for healthcare providers, enabling them to reach families in meaningful, accurate, and culturally appropriate ways. Our solutions include access to usage data and language data, helping providers understand and track the needs of their patients, making it easier to deliver care that truly resonates. You may also like... Language and Trust: How Communication Shapes Health Outcomes Why a Spanish Medical Interpreter is Essential for Equitable Healthcare Access How to Make Telehealth Services More Accessible for All Patients Any individual with limited English proficiency (LEP) is eligible for translation or interpretation services when receiving care from healthcare organizations that receive federal funding. This includes families whose primary language is not English. These services are required under Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act, which protect patients from discrimination based on language barriers.  No. Translation services for families in healthcare must be provided free of charge to patients with LEP when the organization receives federal funding. This includes in-person interpretation, phone or video interpretation, and translated written materials such as forms, prescriptions, and discharge instructions. According to the HHS Office for Civil Rights, these services must be readily available to ensure meaningful access.  Families should inform the front desk, admissions team, or care providers that they need language support. Hospitals are expected to have protocols in place to provide interpreters on-site, over the phone, or via video. In many cases, translated materials—such as consent forms or discharge instructions—should also be available. If families are unsure, they can ask for “language assistance” or “interpreter services” at any time during their visit.  Translation refers to converting written content (like forms or discharge instructions) from one language to another. Interpretation, on the other hand, is verbal or signed conversation and used during interactions—like doctor visits or telehealth appointments. Both services are critical components of effective language access for families.  While accurate translation is critical, cultural competency helps ensure that healthcare communication is not only understood but also respectful and relevant. Providers can work with professional language service providers who offer culturally informed translations. Training staff on cross-cultural communication and hiring multilingual personnel also strengthens this effort. Together, cultural competency and translation services for families build trust, improve patient satisfaction, and lead to better health outcomes.  Only if they’re trained and qualified as medical interpreters. Healthcare facilities must ensure interpreters meet competency standards in medical terminology, ethics, and confidentiality. While many bilingual staff want to help, relying on untrained personnel can lead to serious miscommunications and liability risks.  Onsite interpreters are best suited for complex, sensitive, or lengthy medical conversations. When in-person support isn’t selected, video remote interpreting (VRI) or over-the-phone interpreting (OPI) can effectively support simple interactions. Ideally, all three options should be accessible, allowing patients with limited English proficiency to choose their preferred method. Providers should consider the patient’s needs, the context of care, and the complexity of the visit when selecting the appropriate modality.  When healthcare is truly accessible—linguistically, culturally, emotionally—families thrive. Children receive timely, appropriate care. Parents feel supported in making medical decisions. Patients can manage chronic conditions with clarity and confidence.  The long-term benefits are powerful: improved health outcomes, lower costs, reduced disparities, and stronger trust between communities and care providers. Simply put, translation services for families aren’t a bonus—they’re the foundation of equitable care. If your organization is ready to make language access a priority, get a free quote and start building a better experience for every family you serve. Contact us to learn how we can be a trusted partner in your language access efforts.