Health literacy has been identified as a barrier to patient engagement among older adults, especially within the home health care setting. This systematic literature review explores patient engagement; the relationship between patient engagement and health literacy; and finally, best practices for improving patient engagement through health literacy. Various interventions were explored but the “Ask Me Three®” tool created by the Institute for Healthcare Improvement and the National Patient Safety Foundation, was a best practice for improving patient engagement through increased health literacy. This educational intervention is a high-touch, low-cost, process designed to engage patients, and their informal caregivers in their own care through increased communication by asking three important questions: (1) What is my main problem?, (2) What do I need to do?, and (3) Why is it important for me to do this? These questions make the patient engage with their provider to identify their main health problem; what actions need to be taken to improve their health, and why those actions are important. Providers can potentially influence patient’s behavior through engagement and increased health literacy. The “Ask Me Three®” intervention is an example of how increased patient engagement and health literacy can lead to better health outcomes. The “Ask Me Three®” intervention may improve the quality of home health care.