Bloom is Off the Rose at UnitedHealth Group
A Forty Year Growth Saga is Coming to an End After market close Wednesday April 16, UnitedHealth Group reported its First Quarter 2025 earnings. UNH missed their expected 1Q earnings by 9 cents a share, but the firm also lowered its full year 2025 earnings estimate by 12%. On Thursday opening, investors reacted with an […]
Hospital Mergers Kill
An Economist’s Exercise in Reality Distortion In late June, 2024, two economists, Zarek Brot-Goldberg and Zack Cooper, from the University of Chicago and Yale respectively, released an economic analysis arguing that hospital mergers damage local economies and result in an increase in deaths by suicide and drug overdoses in the markets where mergers occur. Funded by Arnold Ventures their […]
The Clinical Enterprise is the Beating Heart of Health Systems
As health systems struggle to emerge from the post-COVID financial crisis, the importance of the clinical enterprise to these systems has dramatically increased. Healthcare organizations are getting larger, as failing enterprises are absorbed into growing systems. Yet clinicians of all stripes but particularly physicians feel a deepening sense of alienation from the expanding care systems […]
What the Health System Can Expect from a Second Trump Term
Health Policy as a Weapon in the Culture War Though the results of the November election are by no means a foregone conclusion, it is worth thinking about how a second Trump administration might affect the nation’s $4.7 trillion health system. People were not the problem with the first Trump term; his healthcare team was […]
Maryland’s example is no solution to healthcare’s true crises
Will the Change Healthcare Incident Change Healthcare?
Don’t Blame the Health System for the US Health Cost Problem
Collapsing regional economies (particularly in our inner cities, the Deep South and greater Appalachia), an epidemic of obesity, soaring gun violence and escalating mental health issues- these drivers of socially determined demand have flooded hospital emergency departments and surgical suites with casualties. As society has failed many of its most vulnerable citizens, it has also allowed its […]
The future for practicing physicians in a corporate world
The Future of Practicing Physicians in a Corporate World The past two decades have seen a marked decline in physicians’ economic and political power. Private medical practice has withered, and as many as one-third of physicians are now employed by hospitals in the US. More than a hundred thousand more physicians are employed by corporations, health insurers and private equity firms. As the baby boom generation retires, however, physicians will become increasingly scarce, driving up not only their incomes but also their professional power. How will they use their increasing power?
United Healthcare: Anatomy of a Behemoth
United Healthcare Anatomy of a Behemoth On May 25, Jeff Goldsmith posted on Medium a detailed analysis of the business model and strategy of UnitedHealth Group, a $300 billion integrated health insurer. In addition to being the US largest health insurance enterprise, United has greater assets and earnings than Exxon Mobil. It is the also largest employer of physicians in the US, and second only to the British National Health Service in the world. Yet this vast enterprise, which is within reach of being 10% of total US health spending, is poorly understood and appreciated in the industry.
The Reckoning: What Happens to Digital Health After COVID?
The Reckoning: What Happens to Digital Health After COVIDWith Advisory Board President Eric Larsen, Jeff Goldsmith laid out the root causes of the crash in digital health company valuations in 2021-22 and explored how customer needs will determine the size and shape of this promising field. It is wrong to think of digital health in isolation from the existing care system; it is not a new care system, but rather a force multiplier of the core relationships that are at the heart of medicine. What forces will govern the consolidation of the digital heatlh sector?