However, the survey does point to one flaw in HDHP plans today, which I’d also seen while working with CDHP plans at McKinsey & Co. There’s real frustration for the consumer to not be able to shop…they don’t have a sense of what providers or products are the equivalent of Costco vs. Bloomingdales. The HealthMarkets data would indicate that consumers do make different decisions when given cost data.

In that sense, despite all the focus on cost and quality, why does no one mention the service experience?

I’ve just started a company focused on identifying healthcare providers who provide superior service as a way to escape the reimbursement race to the bottom. I’m curious as to why I see few competitors…given companies differentiate on service in almost every other retail industry.

Your comment that “people make common sense decisions” when faced with financial incentives fits exactly with a piece last year by HealthMarkets Executive Vice President Phil Myhra (attached).

In an internal study, HealthMarkets reviewed claims from small business members in three markets where consumers have had access to consumer tools. The data represented about 1.5 million member-months.

HealthMarkets projected the expected use of high-cost doctors and hospitals, and compared that to actual utilization.

In Houston, for example, based on market share and bed types, HealthMarkets projected that 51 percent of members would use high-cost facilities. In fact, only 23 percent went to those facilities.

In Dallas, a projected 50 percent of members would pick high-cost doctors. In fact, only 20 percent did so.

Given the ability to compare relative prices, consumers consistently favored lower cost facilities. With incentives and information, our own data show that consumers – without anyone micromanaging their decisions — make their own prudent health care spending choices.