Overview and Goals
HealthSun Health Plans is committed to serving the diverse cultural and linguistic needs of our members, providers, employees, and the communities we serve. Our Cultural Competency Program supports the delivery of respectful, culturally responsive, and linguistically appropriate health care and services.
Through the program, HealthSun works to:
- Provide health care services to members in a culturally competent manner.
- Recognize and respond to members’ cultural, racial, ethnic, religious, and language needs.
- Support providers in meeting the diverse needs of HealthSun members.
- Identify and provide appropriate language and communication assistance.
- Monitor the provider network to help ensure members have access to care that meets their needs.
- Respond to changes in the cultural and demographic characteristics of the membership.
- Reduce health care disparities and support improved quality and health outcomes.
- Promote culturally appropriate member materials and communications.
- value, affirm, and respect the dignity of each member.
HealthSun recognizes that cultural and language differences can affect communication, access to care, and health outcomes. Understanding and responding to those differences is an important part of providing effective, respectful health care.
Definition of Cultural Competency
Cultural competency is a set of behaviors, attitudes, and policies that work together to enable organizations and health care professionals to interact in cross-cultural situations.
Cultural competency applies to both clinical and non-clinical areas. In clinical care, it supports effective relationships and communication between patients and providers. In non-clinical settings, it includes organizational practices, services, communications, and interactions that may affect a member’s health care experience.
HealthSun Strategies for Cultural Competency
HealthSun supports culturally and linguistically appropriate care through activities that include:
- Assessing member cultural, racial, ethnic, and language needs using available health assessment, population, demographic, and other relevant information.
- Evaluating the provider network to help determine its ability to meet members’ cultural and linguistic needs.
- Responding to member requests for providers who may meet specific cultural, racial, ethnic, or language needs, when available.
- Providing cultural competency information and education to network providers and subcontractors.
- Supporting workforce awareness of cultural competency and the diverse needs of HealthSun members.
- Reviewing member feedback, complaints, grievances, and requests involving cultural or linguistic needs to identify opportunities for improvement.
- Monitoring changes in the membership and provider network and taking appropriate action when opportunities for improvement are identified.
HealthSun also maintains a Provider Directory that can help members identify providers based on available characteristics, including language capabilities.
Language and Communication Support
HealthSun is committed to helping members receive information and services in ways they can understand.
Language and communication support may include:
- Bilingual Member Services support
- Interpreter services at no cost to members, as needed.
- TTY/TDD or other appropriate communication assistance.
- Member materials available in Spanish and, when appropriate, additional languages based on member needs.
- Assistance for members who experience language or communication barriers when accessing health care services.
Members who need language assistance or other communication support may contact HealthSun Member Services for help.
Annual Evaluation and Continuous Improvement
HealthSun evaluates the effectiveness of its Cultural Competency Program annually.
The evaluation considers available member, provider, network, demographic, complaint, grievance, language-service, and other relevant information. Results are used to identify trends, opportunities for improvement, and activities that may help HealthSun continue to meet the cultural and linguistic needs of its members.
HealthSun may also review relevant information throughout the year to respond to meaningful changes in member or provider-network needs.
Oversight of the Cultural Competency Program
HealthSun’s Cultural Competency Program is aligned with the Plan’s Quality Management Program.
The HealthSun Quality Committee provides oversight of the Cultural Competency Program and reviews program activities and evaluation findings. Cultural competency activities and measures are reviewed at least annually to support recommendations for continued program improvement.
The Cultural Competency Program and its evaluation are reviewed and updated annually.
