Vishal Agrawal, Paul D. Mango, and Kimberly O. Packard:

Eager to curb the rising cost of health care, many US insurers and employers are considering consumer-directed health plans (CDHPs), which are designed to lower costs by giving consumers more responsibility for managing their own health care spending.1 Indeed, a survey indicates that this interest is more than justified. We found that the plans encourage value-conscious behavior, increase the consumers’ level of engagement with their well-being, and may even promote behavior that leads to better long-term health.

In March 2005 we surveyed 2,500 consumers, 1,000 of whom had been enrolled in a CDHP for at least one year.2 We also conducted extensive interviews with 25 of these CDHP consumers and with seven benefits managers who administer the plans.3 Our goal was to learn how consumers’ behavior changes when they become responsible for a greater share of their health care costs.