The Tangled Hospital-Physician Relationship
The Tangled Hospital Physician Relationship Hospitals have employed tens of thousands of physicians in the past decade, a sixty percent increase from 2003 to 2014. Tens of thousands more depend on hospital subsidies of various kinds. And yet the private practice of medicine is far from dead, as single specialty physician groups increasingly dominate lucrative medical and surgical specialty markets. Power is shifting between hospitals and physicians with the growth in new payment models, but in which direction? How to make sense of this troubled and tangled relationship is discussed in The Tangled Hospital Physician Relationship.
The C Word
The C Word: Why Calling Patients “Consumers” Is an Insulting Caricature: That patients are becoming consumers of healthcare implies both discretionary purchasing power and leverage that, in most real world situations does not accurately reflect either their powerlessness or their priorities. Why we need to find better language to describe the patient role in the health system.
2014 National Health Spending: The Great Moderation Likely Is Not Over
2014 Health Spending: The Great Moderation is Likely Not Over: Health spending growth spiked upward in 2014, after a decade of moderation.
In this posting, Jeff Goldsmith argues that the factors leading to the 2014 spike are one time costs related to the Affordable Care Act’s implementation and does not alter the trajectory of core costs.
Moral Failure And Health Costs: Two Simplistic Spending Narratives
In attempting to explain the seemingly endless rise in health costs, politicians and the health policy community have evolved two explanations of the root cause: moral failure by either care providers or by patients. Read why both conservative and progressive policy narratives are flawed, and should be replaced by a broader and more nuanced explanation, leading to different remedies. Read Moral Failure and Health Costs: Two Simplistic Spending Narratives
Commentary: Shift to population-health payment unlikely to come anytime soon
Population health-based payment (e.g. capitation) is expected by many in the health industry to replace the current fee-for-service methods of paying doctors and per admission or per procedure payment of hospitals. Read why this is unlikely to happen: Shift to Population-health payment unlikely to come anytime soon
Commentary | Integrated delivery networks: Is the whole less than sum of the parts?
Is it inevitable that most care in the US will be delivered by so-called Integrated Delivery Networks, that span hospital, physician and post-acute services and offer these services through their own health plans? This model of care organization was felt to offer less expensive care at higher quality than less integrated enterprises. In a comprehensive review of the economics literature as well as a preliminary look at new data, Jeff Goldsmith and Rob Burns of the Wharton School of Finance at the University of Pennsylvania found no evidence either of savings or improved quality from these complex care models. Read Integrated Delivery Networks: Is the Whole Less than the Sum of the Parts?
An Interview With George Halvorson: The Kaiser Permanente Renaissance, And Health Reform’s Unfinished Business
In this interview, Jeff Goldsmith talks with the recently retired CEO of the $60 billion Kaiser Permanente Health Plan about his turnaround strategy at Kaiser, his activism during the 2008-2010 health reform debate, the health system’s unfinished business and his future plans as an advocate for reducing healthcare disparities. Interview with George Halvorson
How Much Market Power Do Hospital Systems Have?
Hospital systems like Boston’s Partners Healthcare and Northern California’s Sutter Health are supposed to exert virtually unchecked economic power in their local health insurance markets. Many health policy experts believe they have enough clout with health insurers to charge what they wish for their own services. So why did these and other high quality health systems suffer sharp economic reversals at the end of 2013? See How Much Market Power Do Hospital Systems Have:
A Modest Proposal: Charting Day
Physicians are spending more than a day a week on paperwork, and nearly $85 thousand a year on administrative costs related to billing and “quality reporting”. Administrative costs are drowning independent physicians and driving them to sell their practices. Jeff Goldsmith proposes a solution: Charting Day
Can Hospitals Survive? Part II
Hospitals all over the United States are seeing fewer inpatients and their revenues have basically ceased growing, despite five years of economic recovery. Traditional strategies such as merging to get market power with health insurers and acquiring physician practices don’t seem to be working. What is happening to the nation’s hospital industry and what do boards and managements need to do to cope with a rapidly worsening economic outlook? Can Hospitals Survive, Part II