Hospitals In Focus

Overpromised & Under-Delivered: Is Maryland a Model or a Warning Sign?

Maryland’s 50-year experiment with the hospital rate-setting system stands out as a unique and long-lasting initiative – but has it accomplished its goal of reducing health care costs? This rate-setting scheme has been sustained due to additional Medicare funds supplementing the model, an additional $20.6 billion through 2017. It’s also inspired CMS’s All-Payer Health Equity Approaches and Development (or AHEAD) pilot program.  

The Maryland model has come under scrutiny with a paper published in HFM Magazine entitled “Maryland’s example is no solution to healthcare’s true crises.” It finds that the state’s health costs remain higher than the national average, even though the system was designed to reduce hospital and overall health care costs. 

Our guest is the author of the paper and president of Health Futures, Inc. – Jeff Goldsmith. In this episode, will discuss the history of the Maryland model, the findings of his paper, the impact on hospitals and health care costs, and propose alternative solutions for reducing costs. 

Topics discussed include: 

  • Implications for the state – findings from Goldsmith’s paper 
  • Emulating the scheme – feasibility of replicating the Maryland model elsewhere and cautionary notes for policymakers 
  • Refocusing health care goals – what solutions to access and cost should CMS be considering instead? 
  • What’s next – the future for hospitals  


Jeff Goldsmith is the President of Health Futures, Inc. He speaks on the future of health care- covering topics like technology, economics, leadership health care trends and policy analysis. Goldsmith is also a strategist and mentor to leaders in the health care industry.  He has also taught at several prestigious universities and worked in the private sector as a consultant.  

Jeff Goldsmith, Ph.D.

Jeff Goldsmith is the President of Health Futures, Inc.   For eleven years ending in 1990, Jeff Goldsmith was a lecturer in the Graduate School of Business at the University of Chicago, on health services management and policy. He has also lectured on these topics at the Wharton School of Finance, Johns Hopkins, Washington University and the University of California at Berkeley. Jeff Goldsmith’s interests include: biotechnology, health policy, international health systems, and the future of health services.

From 2016 through 2019, Jeff Goldsmith was National Advisor for Strategy to Navigant Healthcare, a diversified consulting firm that is now part of Guidehouse. From 1982 to 1994, Jeff Goldsmith served as National Advisor for Healthcare for the firm Ernst and Young, and provided strategy consultation to a wide variety of healthcare systems, health plans, supply and technology firms. Prior to 1982, he was Director of Planning and Government Affairs at the University of Chicago Medical Center and Special Assistant to the Dean of the Pritzker School of Medicine. From 1973 to 1975, Jeff Goldsmith worked in the Office of the Governor, State of Illinois as a fiscal and policy analyst, and Special Assistant to the State Budget Director.

Jeff Goldsmith earned his doctorate in Sociology from the University of Chicago in 1973, studying complex organizations, sociology of the professions, and politics of developing nations. He graduated from Reed College in 1970, majoring in psychology and classics, earning a Woodrow Wilson Fellowship for graduate study in 1971.

Jeff Goldsmith was the recipient of the Corning Award for excellence in health planning from the American Hospital Association’s Society for Healthcare Planning in 1990, and has received the Dean Conley Award for best healthcare article three times (1985, 1990 and 1995) from the American College of Healthcare Executives. He has written six print articles and six online articles for the Harvard Business Review, and has been a source for articles on medical technology and health services for the Wall Street Journal, the New York TimesBusiness WeekTimeSTAT and other publications. Jeff Goldsmith is a member of the editorial board of Health Affairs.

Jeff Goldsmith is the father of two sons and a daughter.  He is an avid snow skier and collects Native American art and artifacts.  He is married to Karen Walker, a florist in Charlottesville, who owns Hedge Fine Blooms, specializing in fresh flowers and cutting edge floral design for businesses, weddings and events. Jeff Goldsmith is a native of Portland, Oregon and lives in Charlottesville, Virginia.