Limited health literacy costs the U.S. healthcare system billions

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Health literacy may impact health via three pathways:

1. The access and utilization of care
2. The patient/provider relationship
3. Self-care

Health literacy is linked to both an individual’s and community’s socioeconomic context. Health literacy is a necessary element for achieving health equity.

We are putting the cart before the horse with our planning if we do not assess for the patient’s health literacy level prior to communicating with a patient and family about the plan of care. Limited health literacy impacts personal, health, and financial outcomes. Low health literacy predicts poor understanding of how to take medications, and we know medication errors are the number one reason for readmissions. Limited health literacy causes misunderstanding of the meaning of prescription warning labels, the inability to schedule follow-up appointments, and the inability to complete health insurance forms. Medicaid enrollees with low literacy incur healthcare costs estimated at $10,688 vs. $2,891 annually for health literate enrollees. The total cost of limited health literacy to the U.S. healthcare system is estimated at $50–73 billion (source).

Healthcare systems are moving forward with models and methods to prevent unnecessary readmissions, and we often miss an obvious barrier to our detailed and complex patient education plans and materials if the patient cannot understand what we are saying, writing, or delivering. Health literacy and cross-cultural communication must be modified to improve the dynamics of the patient and case manager relationship and ultimately improve healthcare disparities.

Editor's note: For more infomation, see Case Management Guide to Population Health: Management Across the Continuum of Care.