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Will Consumer-Directed Health Care Improve System Performance?

Consumer-directed health plans are being promoted as a way to curb rising health care spending. Based on the premise that health care services are overutilized, these plans give consumers financial incentives to reduce the use of "nonessential" care. At the same time, they shift the financial burden of health care to patients through higher cost-sharing. But as Commonwealth Fund President Karen Davis writes in a new special issue of Health Services Research, consumer-directed plans' high deductibles and out-of-pocket costs can prevent patients from receiving necessary and effective care, potentially costing the health care system more in the long run. In the article and a companion Fund issue brief, Davis says these new plans raise serious concerns, particularly for low-income individuals and those with serious or chronic illnesses. Through special arrangement, the Fund is pleased to provide the full text of the Health Services Research special issue. Please see links to the individual articles, below.

Health Services Research
Vol. 39, No. 4, Part II, August 2004
Health Services Research journal is pleased to offer a special issue on consumer-driven health care. Supported by funding from the Health Research and Educational Trust (HRET), this special issue is a compilation of articles and commentaries from the "Consumer Driven Health Care: Evidence from the Field" conference on September 15, 2003, in Washington, D.C. Conference cosponsors were The Robert Wood Johnson Foundation's Changes in Health Care Financing and Organization (HCFO) Initiative and The Commonwealth Fund. Guest editors for this special issue are Carolyn M. Clancy and Anne K. Gauthier. To order the print edition of this issue of Health Services Research or to subscribe to a full volume of the journal, please contact Blackwell Publishing at 1-800-835-6770 or visit HSR Publication & Editorial Information Guest Editors' Introduction
Consumer-Driven Health Care—Beyond Rhetoric with Research and Experience
Anne K. Gauthier and Carolyn M. Clancy

Consumer-Driven Plans: What's Offered? Who Chooses?
Awakening Consumer Stewardship of Health Benefits: Prevalence and Differentiation of New Health Plan Models
Meredith Rosenthal and Arnold Milstein Tales from the New Frontier: Pioneers' Experiences with Consumer-Driven Health Care
Anthony T. Lo Sasso, Thomas Rice, Jon R. Gabel, and Heidi Whitmore Employee Choice of Consumer-Driven Health Insurance in a Multiplan, Multiproduct Setting
Stephen T. Parente, Roger Feldman, and Jon B. Christianson Commentary—How Consumer-Driven Health Care Evolves in a Dynamic Market
Greg Scandlen Commentary—Current MSA Theory: Well-Meaning but Futile
George C. Halvorson Evidence about Consumer Experiences
Consumer Experiences in a Consumer-Driven Health Plan
Jon B. Christianson, Stephen T. Parente, and Roger Feldman Early Experience with Employee Choice of Consumer-Directed Health Plans and Satisfaction with Enrollment
Jinnet Briggs Fowles, Elizabeth A. Kind, Barbara L. Braun, and John Bertko Commentary—Defined Contribution Health Plans: Attracting the Healthy and Well-Off
Gail Shearer Evidence about Utilization and Expenditures
Risk Segmentation Related to the Offering of a Consumer-Directed Health Plan: A Case Study of Humana Inc.
Laura A. Tollen, Murray N. Ross, and Stephen Poor Evaluation of the Effect of a Consumer-Driven Health Plan on Medical Care Expenditures and Utilization
Stephen T. Parente, Roger Feldman, and Jon B. Christianson Commentary—Looking at the Effects of Consumer-Centric Health Plans on Expenditures and Utilization
John Bertko Concluding Commentary
Consumer-Directed Health Care: Will It Improve Health System Performance?
Karen Davis

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