The reasons consumers choose one service provider over another are not necessarily the same as the reasons for changing service providers. The distinctions may be even more important when the service in question is health care, specifically the decision to reenroll or switch HMO providers. The authors undertook a consumer survey to gauge the importance of 41 variables in the decision process. Using logistic regression analysis, they concluded that variables associated with access to emergency care services had the greatest impact on decisions to switch. This is contrary to other studies, which have ranked emergency care access much lower, and additional research is recommended.