Will money really talk in a consumer-driven health care environment?

We keep hearing a lot about how consumers, increasingly with more skin in the game, will take the same approach to purchasing health care as they do with a dishwasher or car. Cost and quality will be on equal (or nearly equal) footing.

In big and small ways, we are seeing various forces in the market trying to use the power of the purse to influence behavior.

Just this week, the Wall Street Journal and others reported that Caremark, the pharmacy benefits manager division of retail giant CVS Health, would essentially start penalizing patients who fill their prescriptions at pharmacies that still sell tobacco products. Earlier this month, CVS Health made good on a promise to stop selling tobacco at all of its stores. Of course, there's a straight economic play here for CVS, which stands to lose an estimated $2 billion annually by yanking cigarettes from its shelves. The addition of a $15 co-pay could help close that gap.

However, as CVS spokeswoman Carolyn Castel told the Chicago Tribune, large employers "had begun speaking with us about a tobacco-free network."

Is a $15 co-pay enough to force patients to cross the street from Walgreens to CVS? Perhaps. We've all made purchasing decisions for far less money, right?

Similar tactics are playing out in our sphere of the health care world. Whether it is refined benefits plans, pay for performance, narrow networks, or some other innovation, employers are continually looking for opportunities to drive workers to make better decisions regarding their health care. This urgency was highlighted at the Health Forum–AHA Leadership Summit earlier this year, where a panel of HR execs from large purchasers explained why they are directing their business toward high-quality, low-cost providers. Oh, and handing workers who opt out of that effort a larger portion of the bill.

And if that's not happening yet in your market, what about unique relationships between employers and your competitors, like the one evolving between Boeing and Providence-Swedish in Seattle?

As always, we welcome your thoughts. Comment below or directly to me via emailTwitter or Google+.