Background In the current healthcare environment, health care providers do not always have the time needed to identify patients that have challenges understanding health related information. In order to improve health outcomes, it is imperative that patients understand the medical information and self-care instructions provided to them by clinicians. The purpose of this study was to utilize the Single Item Literacy Screen (SILS) and the Newest Vital Sign (NVS) to identify participants with limited reading ability and/or low health literacy in an outpatient primary care clinic and to determine if health literacy level and reading skills predicted higher healthcare utilization.Methods Participants receiving care in an out-patient clinic were screened for reading ability and health literacy using the SILS or NVS. Three months later, a medical record review was used to evaluate participant’s compliance with attending their scheduled follow-up visits to the out-patient clinic, as well as document unscheduled visits to the emergency department, urgent care, or clinic.ResultsA total of 71 participants were included the final analysis. Although there was not a statistically significant difference in health care utilization based on participant’s reading ability and health literacy level, useful information was discovered. Almost two thirds (63.7%) self-reported adequate reading skills while just over half (51.5%) screened for adequate literacy on the NVS. Of the scheduled follow-up visits, 63% were no-shows, and 50% of participants had unplanned, unrelated visits. Last, data suggested that patients considered their ability to read and understand health related information at a higher level than was self-reported.DiscussionResearch suggests that participant’s with low health literacy may not use health care services appropriately because they struggle to navigate the system and do not understand health information. Patients’ need for education, information, and direction regarding effective and efficient use of medical resources is needed to care for the patient in outpatient setting. Additional research is needed utilizing a more diverse population, as well as comparing health care use in participants with low health literacy to those with adequate health literacy.