After 25 Years Of Consumer-Directed Healthcare, What’s Missing?

After 25 years, consumer-directed healthcare has not failed because patients refuse to shop; it has struggled because healthcare lacks the price tools and decision support of mature consumer markets.

Research shows higher cost-sharing can reduce both low-value and high-value care, suggesting mixed outcomes rather than a simple success or failure.

The article argues that price transparency, insurer data, and AI could improve shopping, but weak incentives and physician-centered workflows have slowed adoption.

Programs like HSAs and high-deductible plans changed patient behavior, but the broader market has not adapted in the way 401(k)s or tools like GoodRx did in other sectors.