How Language Gaps Across the Member Journey Can Affect CAHPS Scores (and How to Fix It)

When CAHPS scores fall short of expectations, the problem may go deeper than a single poor appointment-booking phone call.

Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures capture members’ experiences with their health plans across areas such as getting needed care, getting appointments quickly, and receiving information or help from customer service. For Medicare Advantage plans, selected CAHPS measures feed into Star Ratings, which affect quality bonus payments and give prospective members a public way to compare plans.

That puts real pressure on healthcare leaders to understand what shapes the member experience. One area deserves a closer look: language access across the full member journey. Because its impact can show up across multiple touchpoints, it’s easy to miss the full pattern. 

Throughout that journey, LEP individuals may rely on translated materials, digital services, automated phone systems, interpreters, and customer service to understand their coverage and get help. When language support varies from one touchpoint to the next, those inconsistencies can shape the experience that members later report through CAHPS.

Read on to identify your gaps across the member journey, assess your program using BIG’s five-level maturity framework, and see what higher maturity looks like in practice.

How Small Language Gaps Can Affect CAHPS Scores

CAHPS asks members about their experiences securing needed care, getting timely appointments, and receiving information or help from their plan. Every interaction a member has across every touchpoint is cumulative: it either adds to their experience or subtracts from it. 

A well-interpreted call can help resolve a problem. But what about the untranslated letter that created the problem in the first place? Or the portal screen the member could not use? Or the English-only phone menu that made it difficult to reach support? 

To see how that friction can build (and to stop it from building), let’s look at the main touchpoints members rely on throughout their experience with the plan.

Member Touchpoints

These touchpoints show where members may experience friction. 

Documents and Member Communications

Enrollment materials, welcome kits, member ID card instructions, explanations of benefits, renewal notices, and appointment reminders all affect how easily members can understand their coverage and use their benefits. Limited-English proficient (LEP) members need those communications in the appropriate language and/or, when needed, an accessible format.

This matters to CAHPS because the Customer Service measure includes questions about whether members received the information or the help they needed and whether plan forms were easy to fill out. The Centers for Medicare & Medicaid Services (CMS) uses those questions to understand how well the plan supports its members.

Digital Experiences

Member portals, apps, online forms, password reset processes, and downloadable documents can either support or hinder members from accomplishing what they set out to do. LEP members need more than a translated landing page. They need to understand the steps required to complete the task at hand.

If a member cannot find benefit information or request help online, that’s more work, more friction, and more frustration before the member ever reaches out to customer service.

Phone Menus and Routing

Interactive voice response (IVR) menus shape the experience before a representative joins the call. Members need to hear how to reach language assistance early and continue receiving that support after transfers.

This channel also carries a direct Star Ratings connection through CMS’s foreign-language interpreter availability measure.

Customer Service and Interpretation

Customer service is often where earlier language gaps finally surface. A member may call because they could not understand a notice, find information online, or figure out what to do next.

At that point, members need more than access to an interpreter. Interpretation should remain available across calls, transfers, and follow-up conversations, while translated forms, instructions, and other written materials should be available when members need to take the next step.     

These calls can also help plans identify recurring problems. Repeated questions about the same materials, benefits, or processes can point to language access issues in other touchpoints. 

How a Mature Language Access Program Supports the Member Journey

The next question is what those touchpoint gaps reveal about the program behind them.

BIG’s five-level language access maturity framework gives quality and member-experience leaders a practical way to assess that program. The framework describes how organizations move from case-by-case support toward an integrated, data-informed program that anticipates language needs, measures performance, and improves over time. 

You can use this matrix to assess written, digital, and spoken support separately before assigning one maturity level to the whole program. For example, a plan may manage interpretation well while translated documents or digital experiences remain less consistent.

More mature programs are better positioned to provide a consistent member experience because teams plan language support across the journey. Members rely less on individual employees finding workarounds, and leaders gain clearer insight into whether language services are working as intended.

Now let’s look at what stronger maturity looks like in daily operations and give healthcare leaders a practical place to begin.

Clear Ownership Across the Program

A mature language access program has a designated owner, whether a person or a team, who coordinates the program across the organization. The program owner helps keep language access consistent across all the journey touchpoints.

They set standards, monitor performance, work with internal teams and language service providers, and follow up when members are not getting the support they need.

Start here: Identify who owns your language access program today. Make sure that role has clear responsibility for program standards, performance, and coordination across the member journey.

Support That Starts Before Members Ask

More mature programs use language data to plan services before a member has to ask for help. At the individual level, that means collecting and maintaining information about members’ preferred languages. At the plan level, aggregate data can help leaders understand which languages members use and where demand for translated materials, interpretation, and other support is likely to be highest.

The next step is to create processes informed by the data you’ve gathered. Defined procedures can help teams apply language preferences to routine communications, prepare commonly needed materials, plan interpreting capacity for the languages members use most often, and respond reliably when members request less common languages.

Start here: Review what language data your plan collects, how current it is, and where teams can use it. Then identify high-volume languages, common member interactions, and the process for less common language requests so you can plan support before demand shows up in any touchpoint     

Consistent Information Across Touchpoints

Members should receive consistent terms and instructions when they move from a notice to a portal, phone menu, interpreter-assisted call, or customer service conversation. A more mature program treats those touchpoints as connected parts of the same experience.

At BIG Language Solutions, LanguageVault®  supports this work by helping teams manage translation requests, review cycles, approvals, versions, user permissions, and secure access to final files. 

Start here: Review materials tied to high-volume member tasks or recurring service questions. Check for consistent terminology across channels, and make sure translated materials maintain the same branding and information hierarchy while adapting layout as needed for each language. 

Technology Used at the Right Scale, With Safeguards

Higher maturity does not mean adding technology for its own sake. It means using the right tools for the right language access tasks, with quality controls, privacy protections, human oversight, and clear escalation paths.

For example, our own LanguageExpress™ translation method was developed specifically for high-volume member communications. It’s a technology-enabled workflow for urgent, large-scale translations in 300+ language combinations, with machine translation, human oversight, secure custom workflows, direct-to-member fulfillment, and alternate format support.

AI interpretation can also support approved, lower-risk spoken exchanges when teams define the languages, settings, privacy requirements, and human escalation rules.

Start here: Classify the tasks and content types that technology, including AI, can support safely. Define the review steps, escalation triggers, and performance checks that apply before you scale the service.

Staff Prepared to Provide In-person Language Support

A more mature program equips member-facing staff to use approved language services and preserve support during transfers. Staff know how to reach interpreters, when to request assistance, and how to handle a failed connection.

Start here: Review your language access training for member-facing staff. Make sure employees know which services are available, how to access them, when to escalate to a qualified interpreter, and how to maintain language support during transfers or follow-up.

Measurement That Connects Operations to Member Experience

Mature programs track how language access performs across the member journey. Leaders need visibility into demand, service quality, and recurring gaps across translation, interpretation, digital content, and accessible formats.

Start here: Choose a small set of program-wide measures, such as requests by language and channel, translation turnaround times, interpreter fulfillment, availability of translated or alternate-format materials, complaints, or repeat contacts. Review trends over time to spot changing needs and persistent barriers.

Compare operational data with member feedback and relevant CAHPS results, without assuming that one language access metric caused a change in CAHPS performance.

Use This Assessment to Strengthen Your Language Access Program

By this point, you should have a clearer view of where language access is working well, where members still encounter friction, and which parts of the program need more structure or consistency.

Choose one priority and focus on the change that will make the biggest difference for members.

For more guidance, download our Language Access for Healthcare Leaders guide. It can help you identify priorities and plan the next stage of your language access program. 

You can also see how we helped one Medicare Advantage organization strengthen multilingual call quality through specialized interpreter preparation, terminology protocols, and service standards aligned with CMS requirements. 

If you would like support strengthening your language access program, contact us to discuss where you are today and what to prioritize next.