Jeff Goldsmith

What Does It Mean to be a “Health System"?

Health care organizations have grown steadily larger and more complex over the past thirty years. Most of them call themselves “health systems”. But are they really systems and have patients and those who pay for care benefited from this growth and complexity? Why has the “health system” operating performance deteriorated sharply since the historic Affordable Care Act coverage expansion? How can health systems make changes in their operations and management that patients notice? What does it mean to be a health system?

Healthcare 2020

The US faces a potentially game-changing national election in 2020. The potential range of outcomes for US healthcare is significant: single-payer/Medicare for All on one end and repeal of the Affordable Care Act and a rollback of ACA’s coverage expansions on the other. How will this election affect hospitals, health systems, health plans, and physician groups? How are these effects compounded by the potential for an economic downturn during the next four years? How should care providers and insurers position themselves to weather this uncertainty?

2040: A Healthcare Odyssey

In 1986, in Hospitals’, Jeff Goldsmith looked ahead fifty years to the US healthcare system in 2036. In 2016, Jeff revisited these forecasts, noting both accurate and inaccurate predictions, and looked ahead yet again to the health system in twenty years. In 2037: A Healthcare Odyssey, Jeff examines the digital health revolution he foresaw in his 1986 piece, and how it is likely to affect care. He also looks at the concluding chapter of the baby boomer’s saga, as well as promising new progress in the neurosciences and produces a fresh forecast for the US health system in twenty years.

Opiate Crisis: Tip of a Population Health Iceberg

In 2016, more than sixty thousand Americans died of drug overdoses, 42 thousand from opioids. Drug death is the SuperStorm Sandy of public health threats, likely to claim more victims than the AIDS Epidemic. Yet it is the most visible manifestation of a more troubling trend-declining American life expectancy. In both 2015 and 2016, American life expectancy declined, the first two-year decline since the early 1960s. During the same two years, the US spent nearly $7 trillion on healthcare. What are the underlying drivers of this deeply troubling trend., and what can policymakers and the care system do about it?

The Future of Medical Practice: What Does it Look Like? 

Physicians have vigorously defended the institution of private medical practice for more than century. Yet, in the past five years, the medical practice appears to be consolidating under hospital and, to a lesser degree, health plan control. The uncertainties introduced by health reform, economic pressures from the sustained US recession and the impending retirement of the large baby-boom era cohort of practicing physicians all have contributed to a sense that private medical practice is doomed. Is there a future for private medical practice? This lecture discusses the turnaround strategy for physician practice in the post-health reform era, as well as the role that hospitals, health plans, private equity and technology firms can play in reforming and strengthening medical practice.

Organizing for Risk: How hospitals and physicians can collaborate both to contain cost and improve quality.

Health reform is changing both how and how much the care system is paid. This lecture reviews the history of both hospital and physician efforts both to sponsor and to contract with health plans and discusses how they can become more accountable for both the cost and value of what they do. It will also review what’s happened to the idea of “accountable care organizations” (ACO’s) and what some viable alternatives to the strategy might be.

Health Reform: What can the US Learn from Other Countries The United States spends almost double per capita what other countries spend on healthcare, yet produces inferior health outcomes.

Why does health care cost so much more in the United States than anywhere else in the world? How do other countries finance and organize health care? What can we learn from their experience that will help the United States reshape its health system? What can other countries learn from the United States' experience?

*VIRTUAL-The Post-COVID Healthcare Landscape: Implications for Strategy. Climbing out of the Crater

What will the US health system look like post-COVID-19? Hospitals and health systems will be facing the financial aftereffects of a COVID related economic slowdown or recession. They will also have to deal with the political uncertainties created by the 2020 national election. Finally, they will face the continued threat of disruption of their existing businesses by new technologies and new competitors. What are the most significant threats, and also opportunities, in this post-COVID landscape? How do health system boards and leadership set strategic priorities for this uncertain near term future?