The facts: There were fewer doctor visits, lab-tests, hospital admissions, and lower overall utilization in first three quarters of 2010 than the year before (1). Visits were down 7% in the first half of 2010 compared to 2009. Despite predictions that utilization would rebound in the third quarter when deductibles were met, it did not(2), which has surprised many. Such a downward trend is a new phenomenon. Insurers have never seen this before, even during past recessions.