New federal health literacy initiatives can help break the cycle of costly care, according to a new Health Affairs article. The authors, including former Administrator of the Centers for Medicare & Medicaid Services Donald Berwick and Director of the Agency for Healthcare Research and Quality Carolyn Clancy, said health literacy--the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions--has historically been relegated to the sidelines of healthcare improvement efforts. In fact, only 12 percent of U.S. adults are proficient enough in health literacy to understand and use health information effectively. But with federal policies under health reform, the Department of Health and Human Services' National Action Plan to Improve Health Literacy and the Plain Writing Act of 2010, bring health literacy to the forefront. The authors recommend simplifying written materials so they are easier to understand, improving providers' communication skills and enhancing patients' self-management skills. Article