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Consumer-Directed Health Plans: Implications for Health Care Quality and Cost

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Health care premiums comprise a growing percentage of corporate spending, leading employers --large and small -- to search for new ways to contain costs. Under the rubric of "consumer-directed" health care, employers are adding high-deductible health plans, personal health care spending accounts, such as Health Savings Accounts (HSAs), and tiered benefit designs to their plan offerings. They are also providing tools to help employees make more informed decisions. Proponents of high-deductible plans believe that financial incentives, coupled with decision-making tools, will encourage consumers to eliminate unnecessary care and seek lower-cost, higher-quality providers. Critics wonder if such incentives (or disincentives) may lead patients to skimp on care that could drive up costs in the long run. This report provides an overview of trends in the adoption of these consumer-directed approaches and a synthesis of what is known about their effectiveness.