States are increasingly adopting consumer directed health strategies to encourage Medicaid beneficiaries to make informed, cost-effective health care decisions. In 2006, several states, including Florida and Idaho, incorporated consumer direction into their overall Medicaid reform strategies. While these reform efforts have received considerable media attention, it is not widely known how many states are actually implementing consumer-directed approaches for Medicaid recipients. This brief, developed through a national survey of Medicaid agencies, summarizes how states are incorporating a variety of consumer-directed strategies to help beneficiaries use health care dollars more efficiently.