There is sufficient evidence that financial literacy education interventions contribute to improved healthcare cost, utilization & value, as well as social outcomes.
This assessment was made possible through support from Elevance Health. HealthBegins retains full editorial independence, and the content herein reflects its sole views and conclusions.
The findings below synthesize the results of the studies on Financial Literacy Education across three domains of measurement:
Economic stability, including income, debt burden, and financial strain, is formally recognized as a key driver of health outcomes and healthcare access[1]. Financial stress is associated with higher rates of anxiety and depression, poorer self-rated health, and adverse physical health outcomes[2],[3]. In addition, individuals experiencing financial hardship are significantly more likely to delay or forgo necessary medical care due to the cost, contributing to preventable disease progression and long-term morbidity[4],[5].
For payers and providers, financial literacy education has direct implications for utilization, quality performance, and total cost of care. Not taking medications as prescribed because of cost can lead to worse health outcomes and increase preventable hospital visits[6],[7]. As health plans take on greater accountability for population health outcomes and preventable utilization, financial literacy education could help address utilization by improving medication affordability and engagement in preventive care.
Financial literacy education refers to a wide range of interventions that can strengthen individuals’ economic well-being and their financial decision-making. This may include budgeting, debt management, credit optimization, savings, and understanding health insurance, all aimed at strengthening financial resilience, reducing chronic financial stress, and improving individuals’ capacity to engage in preventive and ongoing care.
Medicaid does not directly reimburse for financial literacy education as a standalone benefit. However, the policy landscape is shifting and mechanisms such as Medicaid managed care flexibilities and waivers are increasingly being used to fund non-clinical services that address health-related social needs (HRSN), including those tied to economic instability[8]. Additionally, financial literacy programming can often be delivered through partnerships with community-based organizations, and managed care plans are increasingly supporting these partnerships as part of their broader HRSN strategies[9]. This positions financial literacy education as not only a clinically meaningful intervention, but one that fits within the community partnership infrastructure that Medicaid managed care organizations are building[10].
Low-to-moderate income earners of Hispanic ethnicity residing in the Greater Los Angeles area.
A digital financial education program called Mind Your Money (MYM).
Randomized controlled trial (RCT). N=125.
Social: The digital financial education program had a statistically significant positive effect on financial capability, with a Difference-in-Difference (DD) estimate of 1.06 (Standard Error [SE]=0.51, p<0.05).
Participants who completed program activities were 32.7 percentage points more likely to have a budget or spending plan (SE=0.129, p<0.05) and felt more confident about their ability to pay for unexpected expenses, showing a DD increase of 27.6 percentage points (SE=0.131, p<0.05).
Those in the treatment group showed lower levels of financial stress in comparison to those in the control group, reflected by a Financial Stress Indicator (FSI) reduction of 0.175 (SE=0.101, p<0.10).
People aged 45 and older. 60% were aged 60 or older, 62% were married, and 40% had at least a bachelor's degree.
A scalable low-cost online financial education program. The experiment presented people with short stories covering three financial education topics identified as important basic knowledge and called the ‘Big 3’ in prior literature: compound interest, risk diversification, and inflation. Each of the stories took around two minutes to read. Participants were randomly assigned to four groups: a control group not exposed to any story, and three treated groups, each of which received a different story.
Randomized controlled trial. N=2271.
Social: For the treatment group, the intervention demonstrated a sizable positive short-term effect on financial knowledge. Specifically, the risk diversification story was most effective, increasing the likelihood of correct answers by 17–18 percentage points (p<0.01) in the short term, with a gain of 8.5 percentage points (p<0.05) persisting after eight months. The inflation story produced significant short-term gains of 6–8 percentage points (p<0.05), while the compound interest story increased correct responses to the "Rule of 72" question by 16.6 percentage points (p<0.01).
Despite these knowledge gains, no significant effect on financial behaviors was observed over the eight-month period. The intervention did not lead to statistically significant changes in the four financial distress indicators (financial fragility, over-indebtedness, financial dissatisfaction, and difficulty making ends meet) or the financial resilience index. The researchers suggested the eight-month timeframe may be too short to capture shifts in complex financial habits.
Working age members (16-65 years) of the largest credit union in Northern Ireland (Derry Credit Union).
Provision of four smartphone apps, packaged together under the title ‘Money Matters’. The smartphone apps consisted of a loan interest comparison app, an expenditure comparison app, a cash calendar app, and a debt management app.
Randomized controlled trial. N=500 in the pre-intervention survey and 403 in the post-intervention survey.
Social: For the treatment group, statistically significant improvements were found in measures designed to gauge financial knowledge, understanding, and basic skills. Specifically, the study found an increase in loan confidence, where the CACE (Complier Average Causal Effect) estimates indicate a difference of 17.2 percent (Intention-to-Treat [ITT]=0.095). Financial literacy also improved, with scores "almost twenty percent higher" among those using the apps (CACE=0.199).
These gains extended to attitudes and motivations where there was a shift away from a "living for today" mindset, with a difference of 19.3 percentage points for those actually using the apps (ITT=0.106; CACE=0.193). Additionally, there was a notable increase in financial self-efficacy (CACE=0.156).
Those receiving the apps were more likely to keep track of their income and expenditure by regularly checking their current account (ITT=0.062; CACE=0.113). Participants also proved to be more resilient when faced with a financial shock, as they were more likely to report they would rely on their own resources to deal with an unexpected bill (ITT=0.121; CACE=0.221).
Children of single mothers with low incomes enrolled in the Finances First randomized controlled trial in Omaha, Nebraska.
Mothers were employed, aged 19–55, and earned no more than 200% of the 2017 Federal Poverty Level.
The mean maternal household income was $26,150 per year across both groups. Fifty-four percent of mothers identified as Black or African American and 13–16% identified as Hispanic or Latina.
A year-long financial education and coaching program, the Financial Success Program (FSP), delivered to mothers through Creighton University's Financial Hope Collaborative including a nine-week set of group classes followed by one year of one-on-one financial coaching. Child health outcomes were assessed as a secondary analysis of the parent RCT. The intervention was not delivered directly to children; improvements in child outcomes were hypothesized to occur through reductions in maternal financial strain.
Post-hoc analysis of an RCT (White et al describe below). N=345 mother-child dyads (184 intervention, 161 control).
Healthcare Cost, Utilization & Value: Children of mothers in the FSP intervention experienced one fewer physician visit per year compared to children of control group mothers (p=0.032). No statistically significant difference was observed in emergency room visits (p=0.55) or hospitalization days (p=0.92).
Social: Financial stress as measured by the Family Economic Strain Scale (FESS) decreased to a greater degree in the intervention group (difference of 3.67, 95% Confidence Interval [CI]: 1.60-5.75, p<0.001). The odds of reporting negative effects of financial strain on relationships was 32% lower in the intervention group compared to the control group (p=0.010). The odds of reporting negative effects of financial strain on health was 28% lower in the intervention group compared to the control group (p=0.021), and the rate of participants failing to seek health care due to cost was 13% lower in the intervention group compared to the control group (p=0.030). Children of FSP intervention participants experienced one fewer day of school absence per year compared to children of control group mothers (p=0.049).
Adults with low incomes who are smokers in New York City with household income below 200% of the federal poverty level. Participants spoke either English or Spanish. The mean age was 51 years and the mean annual income was $13,641. Sixty-five percent of participants were male, 54% identified as Black or African American, 59% had a high school education or less, and 60% had Medicaid insurance.
An integrated intervention combining smoking cessation coaching, nicotine replacement therapy, money management coaching, and referral to financial benefits and empowerment services. The intervention was designed to reduce financial stress as a barrier to cessation and to help participants redirect funds spent on cigarettes toward health-promoting essentials. Participants were recruited from two medical centers and the community.
Randomized waitlist control trial. N=410 (208 intervention, 202 control).
Social: At 6 months, intervention participants reported higher smoking abstinence (17% vs. 9%, p=0.03). Outcomes were stronger among participants recruited from the medical centers (versus from the community). Among medical center participants, the intervention was associated with higher abstinence (20% vs. 8%, p=0.01).
Among medical center participants, the intervention was associated with higher satisfaction with present financial situation (β, 1.0 [SE, 0.4], p=0.01), reduced frequency of being unable to afford activities (β, −1.0 [SE, 0.5], p=0.04), reduced frequency in living paycheck-to-paycheck (β, −1.0 [SE, 0.4], p=0.03), and lower stress about finances in general (β, −1.0 [SE, 0.4], p=0.02).
There were no group differences in outcomes among people recruited from the community (p>0.05).
Parent-infant dyads with low incomes and attending pediatric preventive care visits at Harbor-UCLA Medical Center in Los Angeles. Families were attending a safety-net medical center and had Medicaid insurance. Nearly all parents were mothers, and more than half identified as Latina.
A medical-financial partnership embedding financial coaching within pediatric primary care. Financial coaches were in social work training programs and received at least 16 hours of additional financial coaching training before working with participants under direct supervision by a licensed clinical social worker and pediatrician.
Trained coaches delivered a longitudinal financial intervention addressing parent-identified, strengths-based financial goals including employment, savings, and public benefits enrollment. Coaches also conducted social needs screening and resource referrals. Coaching typically took place in examination rooms during well-child visits, with monthly follow-up by phone or text.
Randomized controlled trial. N=81 (35 intervention, 46 control).
Healthcare Cost, Utilization & Value: The rate of missed preventive care visits among those in the intervention was half that of controls (0.46 vs. 1.07 missed visits; p=0.01). Intervention participants were more likely to have up-to-date immunizations at each visit (relative risk [RR], 1.26; p=0.01) with fewer missed vaccinations by the end of the 6-month visit period (2.52 vs. 3.98; p=0.002).
Social: Parents who received financial coaching reported increased monthly household income by $1761 (95% CI: $457-$3065) relative to enrollment and their increase in monthly income was $876 (95% CI: −$717-$2469) greater than control participants.
Employed single mothers aged 19–55 earning no more than 200% of the 2017 Federal Poverty Level in Omaha, Nebraska. Participants spoke either English or Spanish. The mean age was 35 years and the mean household income was $26,150 per year across both groups. The majority of participants were Black/African American (54%), single (68.9%), with at least some college education (85%).
A year-long financial education and coaching program called the Financial Success Program (FSP), delivered through Creighton University's Financial Hope Collaborative. The program combined nine weeks of financial education curriculum with 12 months of individualized one-on-one coaching designed to reduce financial strain and improve economic stability. The program was offered in English and Spanish.
Randomized controlled trial. N=345 (184 intervention, 161 control).
Healthcare Cost, Utilization & Value: At 12 months, participants in the FSP reduced their avoidance of medical care due to cost from 49% to 32.6% (Relative risk [RR]: .54; p=0.002), compared to no meaningful change in the control group (45.5% at baseline to 45.1% at follow-up; p=0.966). The between-group difference was statistically significant (p=0.030).
Social: FSP participants significantly reduced tobacco use from 23.4% to 18.3% (RR: 0.74; p=0.025), while the control group's rate increased from 19.3% to 22.2%. The between-group difference was statistically significant (p=0.013).
FSP participants demonstrated a significantly greater reduction in perceived financial strain compared to controls, as measured by the FESS (change difference: 3.67; p<0.001). FSP participants also reported significantly greater reductions in the effect of financial strain on their health (p=0.021) and relationships (p=.010).
Populations in the US.
Interventions designed to improve financial capability. Financial capability interventions combine financial education and financial products and/or services.
Systematic review. The review summarizes evidence from 63 reports from 24 unique studies, which included 17 randomized controlled trials and 7 quasi-experimental designs. In addition, 17 duplicate or summary reports were located.
Social: Evidence is sparse about whether participants’ financial behaviors and/or financial outcomes are improved by interventions to improve financial capability. While the majority of the studies used random assignment (72%), many of the studies had some important methodological weaknesses.
Patients with lower-incomes that had Medicaid insurance in US healthcare settings. Three of the four studies included in the review were conducted in pediatric settings.
Medical-financial partnerships (MFPs) delivering financial services within US healthcare settings, including at least one of the following: (1) financial education, counseling or coaching, (2) credit counseling, or (3) the provision of services that assist patients to access financial products or services, such as free tax preparation services, or (4) services to increase income, such as screening for public benefits and assistance with the application process, as well as employment services (e.g., assistance with resume writing and job interviewing skills).
Systematic review. Four studies included (two randomized controlled trials, two quasi-experimental designs).
Health: Two studies reported at least one health-related outcome with some positive findings. However, the authors noted that the evidence base is still limited due to the small number of studies and inconsistent reporting of effect sizes, and called for further research.
Social: All four studies reported at least one financial outcome, with results indicating some positive effects on financial outcomes, though effects were small and not always statistically significant.
[1] Office of Disease Prevention and Health Promotion. Economic Stability. Healthy People 2030. U.S. Department of Health and Human Services. https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/economic-stability
[2] Guan, N., Guariglia, A., Moore, P., Xu, F., Al-Janabi, H. (2022). Financial Stress and Depression in Adults: A Systematic Review. PLoS One, 17(2):e0264041. https://doi.org/10.1371/journal.pone.0264041
[3] Bialowolski, P., Weziak-Bialowolska, D., Lee, M. T., Chen, Y., VanderWeele, T. J., McNeely, E. (2021). The Role of Financial Conditions for Physical and Mental Health. Evidence from a Longitudinal Survey and Insurance Claims Data. Soc Sci & Med, 281(114041). doi:10.1016/j.socscimed.2021.114041
[4] Yabroff, K. R., Zhao, J., Han, X., Zheng, Z. (2019). Prevalence and Correlates of Medical Financial Hardship in the USA. J Gen Intern Med, 34(8):1494-1502. doi:10.1007/s11606-019-05002-w
[5] Rakshit, S., McGough, M., Cotter, L., Claxton, G.. (2026, March) How Does Cost Affect Access to Healthcare? Peterson-KFF Health System Tracker. https://www.healthsystemtracker.org/chart-collection/cost-affect-access-care/
[6] Van Alsten, S. C., Harris, J. K. (2020). Cost-Related Nonadherence and Mortality in Patients with Chronic Disease: A Multiyear Investigation, National Health Interview Survey, 2000–2014. Prev Chronic Dis, 17:200244. doi:10.5888/pcd17.200244
[7] Pittman, T. (2018, November). Medication Nonadherence Increases Health Costs, Hospital Readmissions. Duke Health Referring Physicians. https://physicians.dukehealth.org/articles/medication-nonadherence-increases-health-costs-hospital-readmissions
[8] Crumley, D. (2024, June). Using In Lieu of Services to Address Health-Related Social Needs: Upshots from the Recent Federal Rule. Center for Health Care Strategies. https://www.chcs.org/resource/using-in-lieu-of-services-to-address-health-related-social-needs-upshots-from-the-recent-federal-rule/
[9] Crumley, D., Houston, R., Bank, A. (2023, April). Incorporating Community‑Based Organizations in Medicaid Efforts to Address Health‑Related Social Needs: Key State Considerations. Center for Health Care Strategies. https://www.chcs.org/resource/incorporating-community-based-organizations-in-medicaid-efforts-to-address-health-related-social-needs-key-state-considerations/
[10] Spencer, A., Bank, A., Melo, N. (2025, June). Coordinating Medicaid Health‑Related Social Services through Community Care Hubs. Center for Health Care Strategies. https://www.chcs.org/resource/coordinating-medicaid-health-related-social-services-through-community-care-hubs/
