Appendix F

Language Concordant Health Coaches Fishbowl Summary

In this program, language concordant health coaches (i.e., those who speak the patient’s preferred language) team with residents to improve the self-management skills and quality of care of patients who have limited English proficiency and health literacy. Coaches, who work in tandem with a resident, conduct a pre-visit meeting, assist during the medical visit, conduct a post-visit meeting, and follow up with the patient 1 to 2 weeks after the visit to offer additional support. The program has led to improvements in the treatment process and clinical outcomes of patients with diabetes, including improved blood pressure and cholesterol levels.

Key Players

Fishbowl Presenter:

  • Hali Hammer is the Medical Director for the Family Health Center at San Francisco General Hospital.


  • Madeleine Konig, AHA, and Shannon Fair, Westat

Reactor Panel:

  • Foster Gesten is the Medical Director for the Office of Health Insurance Programs in the New York State Department of Health [Perspective: State Medicaid Organizations and Policy Expert]
  • Diane Justice, Senior Program Director, National Academy for State Health Policy, focuses her work on long-term and chronic care issues facing states. [Perspective: State Programs Expert]
  • Gregory Pawlson is the Executive Director of Quality Innovation for the Blue Cross Blue Shield Association (BCBSA) [Perspective: Innovation Expert and Payer]
  • Herbert Smitherman is Assistant Dean of Community and Urban Health, and Assistant Professor of Internal Medicine at Karmanos Cancer Institute, Wayne State University School of Medicine. He is also President and CEO of Health Centers Detroit Medical Group, a Federally Qualified Health Center Look Alike in the city of Detroit. [Perspective: Federally Qualified Health Center (FQHC) and Community Health Expert]

Innovation Presentation

The presentation with accompanying audio is available at

Innovation Profile

A full description of the innovation appears in the AHRQ Health Care Innovations Exchange at

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