The self-directed care model—in which patients are given choices and control over their health care services—has been widely adopted for seniors and the long-term care of people with physical and cognitive disabilities. It has been shown to improve patients' satisfaction and quality of life, as well as to reduce costs. This issue brief examines a range of innovative self-directed care programs in England, Germany, the Netherlands, and the United States and explores potential for further advancement of the self-directed care model.