studies regarding consumer-driven health plans have been mixed. While a 2005 survey by the Blue Cross and Blue Shield Association found widespread satisfaction among HSA customers, a survey published in 2007 by employee benefits consultants Towers Perrin came to the opposite conclusion; it found that employees currently enrolled in such plans were significantly less satisfied with many elements of the health benefit plan compared to those enrolled in traditional health benefit plans. Some policy analysts say that patient satisfaction does not reflect quality of healthcare. Researchers at RAND Corp and the Department of Veterans Affairs asked 236 elderly patients from two managed care plans in 2005 to rate their care, and then examined care in medical records, as reported in Annals of Internal Medicine. No correlation was found. "Patient ratings of healthcare are easy to obtain and report, but do not accurately measure the technical quality of medical care," said John T. Chang, UCLA, the study's lead author. Price and quality transparency Healthcare markets are known for a lack of price transparency, which affects the health care prices in the United States. Consumers are unable to make health care decisions based on cost due to a lack of free market, a system in which price transparency is essential. CDHPs cannot effectively decrease health care costs without the ability for consumers to compare prices prior to use. While cost-estimator tools have become available as part of a broad trend towards consumer-driven health technology in the United States, they often do not use actual negotiated rates and lack quality information. Conversely, some companies such as MyMedicalShopper have attempted to address the problem by sharing negotiated rate estimates along with quality scores. See also Consumers for health care choices Flexible spending account Health care systems Health economics References External links "The Impact of Consumer-Driven Health Plans on Health Care Costs: A Closer Look at Plans with Health Reimbursement Accounts." Public Policy Monograph, American Academy of Actuaries, January 2004 Health insurance in the United States Health care reform