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


Recent Posts by Jeff Goldsmith

California’s Coverage Expansion: Fiscal And Political Risks

Even if the US Senate substantially changes the American Health Care Act, California’s notoriously cyclical economy may ultimately render the state’s heroic health care coverage expansion untenable.

Geisinger’s Transformation: Balancing Growth And Risk

By the dawn of the millennium, Geisinger Health System was facing a bleak future. It recruited a new leader, Dr. Glenn Steele. How Steele reinvigorated Geisinger raises questions about how integration actually works and what drives success in the Integrated Delivery Network model.

Oregon’s High-Risk, High-Reward Gamble On Medicaid Expansion

Health policy in Oregon is like football in the SEC: not only a contact sport but also a source of intense civic pride. The state's Medicaid expansion was similarly turbulent.

Fail To Scale: Why Great Ideas In Health Care Don’t Thrive Everywhere

In the world of fine wine, it is well known that some types of wine grapes grow only in very specific climates and ecologies. Is it possible that the concept of terroir also applies in health care?

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...