Demand for health services is rising steadily. At current growth rates, we estimate that most Organisation for Economic Co-operation and Development (OECD) countries will spend more than 20 percent of GDP on health care by 2050.¹ Two important contributors to this growth—the increasing prevalence of largely preventable chronic conditions and the suboptimal use of health care resources—are strongly influenced by the behavioral choices consumers make. For example, obesity, which is largely preventable, significantly raises the risk of diabetes, heart disease, stroke, and some cancers. And because most health systems have not encouraged patients to take appropriate control of their care, consumers often seek the wrong type of treatment for many conditions. Misuse of the health care system only intensifies the cost burden imposed by the increased prevalence of chronic illness.

As the principal bearers of health risks and costs, payors—both governmental agencies and private insurers—have an interest in helping consumers adopt healthier lifestyles and in promoting more value-conscious health care consumption. By encouraging their members to make better choices, payors can prevent or control many chronic diseases, ensure that health care resources are used more wisely, and—in many cases—reduce costs. Recognizing this, a growing number of payors have made consumer engagement a priority, employing strategies with different degrees of effectiveness. In this article, we discuss three increasingly common approaches: educating consumers about health and preventive care, encouraging them to be more proactive in making choices about health services, and creating incentives for behavioral change. We review how these approaches are being used and what impact they are having. We also suggest ways they can be used more effectively.