This analysis has two key findings. The answer to our first research question – who uses provider rating system – is that older, sicker individuals and women are more likely to use the system. The second finding, addressing our second research question, is that the UHG provider rating system appears to have a negative impact on expenditures. The effect is found for total expenditures and out-of-pocket medical spending, but not for out-of-pocket pharmacy costs. With respect to prevention, the story is more mixed. Overall preventive visits go up when the patient has an improved provider portfolio. We do not see the same effect for colonoscopy procedures.