This article examines consumer-directed healthcare and concludes that it is associated with lower costs but that effects on quality are still unclear.  The authors highlight the need for additional information about consumer-directed health care in order to make more robust assessments. 

Beeuwkes-Buntin, M., Damberg, C., Haviland, A., Kapur, K., Lurie, N., McDevitt, R., et al. (2006). Consumer-directed health care: Early evidence about effects on cost and quality. Health Affairs, 25(6), w516-w30.  24 Oct. 2006. DOI: 10.1377/hlthaff.25.w516.  http://content.healthaffairs.org/cgi/content/abstract/25/6/w516 © 2006 by Project HOPE.  

Authors: Melinda Beeuwkes Buntin, Cheryl Damberg, Amelia Haviland, Kanika Kapur, Nicole Lurie, Roland McDevitt, M. Susan Marquis