Q&A: Health literacy interventions by case managers

May 16, 2018
Medicare Web

Q. What questions can case managers ask to determine health literacy?

A. Case managers may also use one of two single-item questions in the case management assessment to determine a patient’s health literacy level through screening. Both questions were developed as a result of extensive research and tools of much greater length. The case manager can use these questions prior to every assessment or every meaningful encounter. The first question is: How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy?

  1. Never
  2. Rarely
  3. Sometimes
  4. Often
  5. Always

Scores greater than 2 are considered positive. This means if the patient scores 3–5 (or Sometimes to Always), he or she may have low literacy levels and need to receive all verbal and written material presented in simple terms. The second screening question that may be used is: How confident are you filling out medical forms by yourself?

  1. Extremely
  2. Quite a bit
  3. Somewhat
  4. A little bit
  5. Not at all

A “somewhat” response is the optimal cutoff point to identify patients with limited or marginal health literacy skills

For more information, see Case Management Guide to Population Health: Management Across the Continuum of Care.

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