Jeff Goldsmith is National Advisor to Navigant Healthcare and Associate Professor, Public Health Sciences University of Virginia.

Recent Posts by Jeff Goldsmith

The Tangled Hospital-Physician Relationship

In its 2014 National Health Expenditures estimates, the Centers for Medicare and Medicaid Services’ actuaries make the hospital and physician practice sectors appear to be independent and non-overlapping. This is an optical illusion. Hospitals and physicians are hopelessly intertwined.

2014 National Health Spending: The Great Moderation Likely Is Not Over

The 2014 US health spending estimate showed the highest national health spending growth rate since 2008 -- 5.3 percent. Is this the end of the Great Moderation? In my view, the answer is “no.”

Moral Failure And Health Costs: Two Simplistic Spending Narratives

Over the past 30 years, there have been two warring political narratives explaining health spending growth, with two different culprits and indicated remedies. At their cores, these narratives blame the main actors in the health care drama---patients and physicians---for rising costs.

Pioneer ACOs: Anatomy Of A ‘Victory’

If the HHS Secretary’s goal of having 50 percent of regular Medicare’s payments come through “Alternative Payment Methodologies” by 2018 is to be met, that growth is unlikely to come from either the Pioneer ACOs or the larger Medicare Shared Savings Program.

An Interview With George Halvorson: The Kaiser Permanente Renaissance, And Health Reform’s Unfinished Business

For decades, health policymakers considered Kaiser Permanente the lode star of delivery system reform.  Yet by the end of 1999, the nation’s oldest and largest group model HMO had experienced almost three years of significant operating losses, the first in the plan’s history. It was struggling...

How Much Market Power Do Hospital Systems Have?

Sometimes big game hunters find frustration when their prey moves by the time they’ve lined up to blast it. That certainly appears to be the case with the health policy target de jour: whether providers, hospital systems in particular, exert too much market power. A recent cluster of papers in...

Primum Non Nocere: Congress’s Inadequate Medicare Physician Payment Fix

Editor's note: You can read other perspectives on the Medicare physician payment reform pending in Congress in Health Affairs and Health Affairs Blog (here, here and here). Partisan gridlock in Washington regarding health policy has been so pervasive and bitter that any bipartisan...

Pioneer ACOs’ Disappointing First Year

On July 16, the CMS Innovation Center reported the first year results for the Pioneer ACO program: 13 Pioneers, or about 40 percent of the participants, earned bonuses. The program saved the Medicare program a gross $87.6 million before bonus distributions, cutting the rate of growth in...

Health Industry Price Inflation At Historical Low

One hesitates to make too much of a single report, but the Altarum Institute’s July Report, “Health Care Price Growth at 20+ Year Low,” certainly commands one’s attention. According to Altarum’s analysis, the health sector pricing trend ran at a 1.0 percent annual rate in May 2013, lowest...

Practice Redesign Isn’t Going To Erase The Primary Care Shortage

Most experts agree that primary care needs to be re-invented. There are a lot of promising ingredients of practice redesign: better scheduling, electronic medical records with patient portals, redesigned clinician workflow, and work sharing. Linda Green’s intriguing article in the January...