As health care costs for large employers have continued their meteoric rise, virtually unchecked by the traditional levers of cost containment like care management, utilization review, billing audit, chronic condition management to name a few, some of us believe we need some level setting and to look at how health plans, their ancillary partners and other payers face-off in the market and deliver their respective value propositions. Oh, and there are many very well-articulated value propositions.

We set aside for the moment PPACA and all of its administrative burdens and reforms around expanding coverage, compelling all to get coverage and the slew of employer mandates.

The exchanges also are part of the story as they have been billed as the resurrection of managed competition and a magical portal through which all will get covered at reduced costs and double digit trends will cease to exist.