This Groundbreaking Program Proves the Value of Health Literacy

Healthwise Communications Team

For years, organizations have observed a link between health literacy and health care costs. But attempts to prove exactly how much money could be saved have eluded researchers—until now.


An exciting new study published in the Journal of Medical Internet Research shows that when people read patient education material and communicate their understanding back to the doctor, they are 32% less likely to be hospitalized and 14% less likely to visit the emergency room.1 This groundbreaking research also observed net savings of $675 per person each year. Overall health care costs declined by 11%.

The MedEncentive Mutual Accountability and Information Therapy (MAIT) Program is “a web-based system designed to improve health and lower costs by aligning patient-doctor incentives.”1 It pays doctors to assign and distribute health education, and it pays patients and members to complete the assignments. That might sound counterintuitive to saving money, but the amounts paid per episode were far less than costs traditionally associated with unnecessary readmissions, ER visits, and poor self-management. In other words, the roughly $15 that MAIT paid per episode saved thousands of dollars per patient over the course of the five-year study.

The results go beyond mere cost-cutting measures, however, showing the link between health literacy, patient outcomes, and healthcare costs. According to the U.S. Department of Health and Human Services, nearly 9 out of 10 adults in America lack the skills needed to manage their health and prevent disease, contributing to billions of dollars in preventable spending each year, and the primary responsibility for remedying these numbers lies with the healthcare system.2 But while that may seem like a daunting task, the MAIT study provides a ray of hope for healthcare professionals trying to make a difference.

Health literacy: The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.3

One key to the program’s success was the fact that patients were encouraged to report their progress back to their doctors, something a surprising number of participants rated as very important to their motivation. More than 9 out of 10 patients said they liked showing their providers that they were reading the patient education and self-managing their health as instructed. This proves that healthcare providers do have opportunities to influence patients’ health literacy and health behaviors.

Here are just some of the comments from patients during the program:

“Thank you for this program. It helps me a lot to know the cause, symptoms, prevention, medicine, etc., of my illness. I appreciate that my employer has this kind of medical program for their employees.”

“I love the program. It is educational and beneficial. The financial incentive helps our family greatly as we use it for copays and supplies.”

“Good reminder. It’s hard to remember everything discussed at the appointment. This gives me a refresher to read on my own time.”

Doctors also found the program to be helpful on their end.

“It keeps me on my toes to talk to patients about diet and exercise.”

“This is one of the best and most expedient ways of reinforcing discussions we have with our patients in the office setting.”

“There’s a good selection of articles, and they’re easy to prescribe. Keep up the good work.”

That ease of use probably contributed more to the program’s high adoption and retention rates than any other factor. Because healthcare staff—who are already pressed for time—could prescribe the patient education in a matter of seconds, they were more likely to do so. And because the content used simple language and engaging designs, patients found it easier to read and understand.

When surveyed, the patients rated the program’s helpfulness at 4.4 out of 5. When asked on a scale of 1 to 5 how closely they had followed their doctors’ recommendations during the program, the response was an impressive 4.7. That’s 94%!

What could your organization achieve if 94% of your patients or members were this engaged with their care?

1Greene JC, et al. (2019). Reduced hospitalizations, emergency room visits, and costs associated with a web-based health literacy, aligned-incentive intervention: Mixed methods study. Journal of Medical Internet Research, 21(10): e14772.
2Kirsch IS, et al. (1993). Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey (NALS). Washington, DC: National Center for Education Statistics, U.S. Department of Education.
3Centers for Disease Control and Prevention (2019). What is health literacy? Centers for Disease Control and Prevention. https://www.cdc.gov/healthliteracy/learn/index.html. Accessed December 4, 2019.