According to research, only half of patients understand what their health care team tells them or gives them to read. Patients with poor health literacy are difficult to identify, and they cost more than $200 billion a year to the healthcare system. The average reading skill level in the US is between the 8th and 9th grade, although many are understandably ashamed of their low literacy and are reluctant to admit it. Practitioners should consider literacy concerns with "non-compliant" patients that do not take their medications correctly or lack follow through with laboratory tests, imaging tests, or referrals to consultants: they may not be able to read directions. Assessing comprehension of patient education via a "teach -back" method is also highly recommended.  

American Medical Association Health Literacy video