More on Patient Engagement

Improving healthcare literacy could save billions, improve outcomes

If all U.S. counties had high health-literacy levels, there would be $25.4 billion in Medicare savings annually.

Jeff Lagasse, Associate Editor

Intuitively, it stands to reason that consumers would do well to maintain a sense of healthcare literacy, especially given the system's complexities. But new findings from UnitedHealth Group research illustrate that increasing health literacy is a key component to driving better health outcomes and improving affordability. All told, it could save billions.

Seniors in particular stand to benefit from increased health literacy, since they use more services, have more chronic conditions and take more medications compared to other age groups. Literacy helps them make informed decisions and enhances their overall healthcare experience, and hospitals and health systems could do more to promote health literacy among this cohort in order to improve care quality and engagement.


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Education, languages spoken, health behaviors and health system characteristics all contribute to variations in health-literacy levels across the U.S., according to the research. In the best performing counties in the country, only 15% to 27% of the population had limited health literacy, compared to 36% to 59% in the lowest performing counties.

High- and low-performing counties were spread out geographically, but there was a concentration of poorer-performing counties in more southern stretches of the country, from Southern California to New Mexico, Texas, Louisiana and Florida. High-performing counties were scattered, seeing spikes in Colorado, the Dakotas, Michigan, New York and much of New England, particularly Massachusetts.

On average, Medicare beneficiaries in counties with the highest health-literacy levels experience better outcomes than those living in counties with low levels. For instance, among beneficiaries, 31% have more flu shots; 26% experience fewer emergency department visits; 18% see fewer emergency department visits; 13% experience lower costs per beneficiary; and 9% had fewer hospital readmissions.

Extrapolating the data, UnitedHealth found that if all counties had high health-literacy levels there would be about 670,000 additional Medicare beneficiaries receiving a flu shot each year, nearly one million fewer Medicare hospital visits per year and $25.4 billion in Medicare savings annually.

There are several ways that the public and private sectors can invest in improving health literacy, the research found, such as ensuring that doctors and clinicians speak with patients clearly and in a manner they can understand. 

It also recommends making consumer-facing communication available in a variety of languages so people can more effectively access it, and provide those materials only after they've proven that they're accurate and actionable.


A 2018 Accenture report found that half of U.S consumers are unable to navigate the complexity of the healthcare system, with this low level of literacy costing the industry an estimated $4.8 billion annually in administrative costs alone. 

The healthcare system is so complex, the report found, that 52% of consumers don't understand how to navigate it appropriately. They struggle to make informed decisions about everything from the health plan types they choose and the premiums they pay to the doctors they see and the procedures they have done.

Overall, just one in six consumers, about 16%, are considered to be experts in navigating the system. One-third have no experience or proficiency with it whatsoever.

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Twitter: @JELagasse
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