Bridging language barriers: Access to primary care for Medicaid Managed Care patients with limited English proficiency in three metropolitan areas

This secret shopper study compares the wait times for scheduling a first-time primary-care appointment among adults enrolled in Medicaid Managed Care who speak English, Spanish, or Mandarin in the Los Angeles, Houston, and New York Metropolitan Statistical Areas. Primary-care practices in Medicaid Managed Care Organization directories were randomized by language. The objective of the secret shoppers was to schedule first-time primary-care appointments, either in person or via telehealth. We found that the average wait times for Spanish and Mandarin speakers were greater than for English speakers by 3.73 and 14 days in Los Angeles and 7.29 and 2.55 days in Houston, respectively. The average wait time among Spanish and Mandarin speakers was 2.22 and 1.76 days less compared with English speakers in New York. We discuss the importance of policies and provide recommendations to address disparities in health access and use among adults with limited English proficiency.