Nationally, healthcare analyst Paul Keckley reports 88% of Americans are functionally health illiterate, costing the healthcare system at least $250 billion every year. Nearly 9 out of 10 people struggle to understand the health information they need to make good decisions about their own care. The result is missed diagnoses, medications taken incorrectly, unnecessary hospital readmissions, and outcomes that fall far short of what healthcare organizations work hard to deliver.
In the Fox Valley in northeast Wisconsin where I live, the picture is sobering. Fox Valley Literacy's State of Literacy Report found that 47% of survey participants struggle to understand healthcare information: prescriptions, physician instructions, and insurance forms. Across Wisconsin, more than 1.5 million adults qualify for literacy services, and more than half read below a sixth-grade level. These are our neighbors, and they are our patients.
Health Literacy is a Patient Safety Challenge
For healthcare leaders, this is not someone else's problem to solve. It surfaces during every care transition, every discharge instruction, and every patient outcome we track. A patient who cannot understand what their doctor told them, or what their insurance covers, is already at a disadvantage before treatment begins.
Health Literacy is a System Design Issue
Through a Value Capture lens, this is also a system design issue. Effective care depends on strong connections between those providing information and those receiving it. If the patient does not understand the instruction, the connection has not actually been made. In too many healthcare encounters, we assume the handoff happened because the information was given when the real test was to see whether it was understood.
The Opportunity for Healthcare Leaders
So, what needs to happen? Keckley points to four areas: better training for the healthcare workforce, health literacy built into education at every level, hospital accountability tied to Medicare eligibility, and technology designed to help patients navigate the system rather than making the system run cheaper. None of them are simple, but all of them are necessary.
Organizations committed to zero harm need to take an honest look at the conditions that make harm more likely. Low health literacy is one of the most significant — and most overlooked — of those conditions. It creates predictable risk when healthcare systems do not reliably check whether patients and families understand the information they need to act safely.
The data is in front of us. Healthcare leaders now have an opportunity to close a gap that accounts for a significant share of the outcomes they are working so hard to prevent. Once we recognize low health literacy and missed understanding as root causes, the path forward becomes clearer: strengthen the systems for connection, build in reliable checks for understanding, and design care so patients and families can act safely on the information they receive.
To dig deeper, read Paul Keckley's full analysis at paulkeckley.com and explore the Fox Valley Literacy State of Literacy Report at foxvalleylit.org.