Original ArticlesCompeting Visions for Consumer Engagement in the Dawn of the Trump AdministrationHwang, Ann MD; Garrett, Danielle MPA; Miller, Michael MPP Author Information Center for Consumer Engagement in Health Innovation (Dr Hwang and Ms Garrett), Community Catalyst (Mr Miller), Boston, Massachusetts. Correspondence: Ann Hwang, MD, Center for Consumer Engagement in Health Innovation, Community Catalyst, One Federal St, 5th Floor, Boston, MA 02110 ([email protected]). In addition to her role at Community Catalyst, Dr Hwang is a primary care physician for Commonwealth Community Care.The Center for Consumer Engagement in Health Innovation is generously supported by The Atlantic Philanthropies and The John A. Hartford Foundation, and provides consulting and training services related to consumer engagement.The authors have disclosed that they have no significant relationships with, or financial interest in, any other commercial companies pertaining to this article. Journal of Ambulatory Care Management 40(4):p 259-264, October/December 2017. | DOI: 10.1097/JAC.0000000000000211 Buy Metrics Abstract Two different models of consumer engagement use largely the same language but represent 2 distinct paradigms: the first focuses on patients as partners in health care decision making and the second focuses on financial incentives/penalties for patients. While the 2 paradigms coexist to some degree, they have different implications particularly for populations with complex health and social needs. For these populations, financial barriers can undermine the ability to recognize and promote patients as partners in a system of integrated, coordinated care. We describe these 2 competing visions and their adoption to date and offer our assessment of future directions for consumer engagement. © 2017 Wolters Kluwer Health, Inc. All rights reserved.