Tag: Arnold Ventures

Arnold Ventures Part II “Structuring Information Felicitously”

Feb 3, 2026

By JEFF GOLDSMITH

In the first part of our look at Arnold Ventures, we explored its business model and generous support of elite University health policy experts to further an ambitious health policy agenda. In this second part, we will explore some of the questions raised by Arnold’s aggressive approach.

Zack Cooper is an Associate Professor of Economics and Health Policy at Yale University*. He is the academic investigator at the heart of the so-called the 1% Solution, an Arnold Ventures funded project which encompasses most of its health policy agenda. The core idea of the “1% solution” is that while comprehensive health reform (e.g. “Medicare for All”) may not be achievable, pursuit of a bevy of policy goals with smaller price tags could generate savings that could be reinvested in policy improvements.

Cooper was the object of unwanted press scrutiny for receiving extensive sub rosa funding from United Healthcare for research work and writing instrumental in the enactment of the No Surprises Act in 2021, which was aimed at controlling out-of-network health insurance billing. United was expected to be the largest single beneficiary of this legislation. (The biggest “surprise” emerging from the No Surprises Act was that providers are winning 80% or more of the independent mediations of these disputes, suggesting that it was health insurers, not providers, who were gouging the public).

According to Arnold’s 990s, Cooper and his Yale policy shop, the Tobin Center for Economic Policy, received over $5 million from 2018 to 2024. Of this amount, $700 thousand funded the 1% Project itself, including more than a dozen papers by academic colleagues on topics ranging from surprise billing to PBM reforms to site neutral outpatient payment to hospital market concentration.

As part of this project, Cooper and a University of Chicago colleague, Zarek Brot-Goldberg, published a paper in early 2024 of the economic impact of hospital mergers: “Is There Too little Anti-trust Enforcement in the Hospital Sector?” which found that 20% of hospital mergers had an adverse economic impact on their communities. The alternative off-message headline, “80% of hospital mergers had no adverse economic on their communities” never surfaced.

However, a follow on piece got wide circulation thanks to a June, 2024 Wall Street Journal article, which exposed it to millions of readers without any reference to Arnold Ventures funding. The paper, which featured an astonishingly complex multivariate econometric model, was originally published by the National Bureau of Economic Research (NBER is also funded by Arnold Ventures). This paper linked hospital mergers to widespread layoffs in the communities where the mergers took place and a subsequent wave of suicides and drug overdoses (!).

John Arnold: The Most Powerful Man in Healthcare Nobody has Ever Heard Of (Pt I)

Jan 30, 2026

By JEFF GOLDSMITH

It has happened at least a dozen times. I mention John Arnold and am greeted by knowledgeable healthcare colleagues with a blank stare. Houston billionaire John Arnold is the most powerful man in US healthcare that nobody has ever heard of. An investing savant, Arnold made $50k in high school trading collectors’ hockey cards over the Internet. He became the star natural gas trader at Enron in his early twenties. Arnold, who played no role whatever in Enron’s storied collapse, left the company in 2001 with an $8 million bonus. In 2002, at age 28, Arnold founded a hedge fund, Centaurus Advisors, focusing on energy investing, and reeled off a decade of 100% annual returns.

Bored with investing and by then a multi-billionaire, Arnold shut down Centaurus in 2012, and decided to change the world. With his Yale trained attorney wife Laura, John created a family foundation. and funded it with a large share of their personal wealth. For reasons we will explore more fully below, in 2019, Arnold converted their foundation to a ”for-profit charity” known as Arnold Ventures. At nearly $4.7 billion in assets in 2024, Arnold Ventures was about a third of the size of the lions in foundation world, Robert Wood Johnson ($14.7 billion in 2023) and Ford ($13.7 billion in 2024). Arnold Ventures 501c3 grantmaking subsidiary gave away a cool $194 million in 2024 to a bewildering array of grantees from American Enterprise Institute to Families USA.

But Arnold’s business model is fundamentally different than these legacy charitable foundations.

“Hospital Mergers Kill”: An Economists’ Exercise in Reality Distortion

Jan 7, 2025

By JEFF GOLDSMITH

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 study characterizes these mergers as “rent seeking activities” by hospitals seeking to use their economic power to extort financial gains from their communities without providing any value.

The Brot-Goldberg-Cooper analysis was a spin-off of a larger study decrying the lack of federal anti-trust enforcement regarding hospital mergers. These two studies used the same economic model. The data were derived from the Healthcare Cost Institute, a repository of commercial insurance claims information from three of the four largest commercial health insurers, United Healthcare, Humana and Aetna (a subsidiary of struggling pharmacy giant CVS) plus Blue Cross/Blue Shield. HCCI’s contributors account for 28% of the commercial health insurance market.

The authors use a complex econometric model to manipulate a huge, multifactorial data base comprising hospital merger activity, employer health benefits data, county level employment data and morbidity and mortality statistics. This data model enabled a raft of regression analyses attempting to ferret out “associations” between the various domains of these data.

Using HCCI’s data, the authors construct what they termed a “causal chain” leading from hospital mergers to community damage during their study period–2010 to 2015. It looked like this: hospital mergers raise prices for private insurers-these prices are passed on to employers–who respond by laying off workers–some of whom end up killing themselves. So, according to the logic, hospital mergers kill people. Using the same methodology, the authors argued that between 2007 and 2014, hospital price increases of all sorts killed ten thousand people.

A classic problem with correlational studies of this kind is their failure to clarify the direction of causality of data elements. The model lacked a control group–comparable communities that did not experience hospital mergers during this period–because the authors argued that mergers were so pervasive they could not locate comparable communities that did not experience them.

The model focused on a subset of 304 hospital mergers from 2010 to 2015, culled from a universe of 484 mergers nationally during the same period. The authors excluded mergers of hospitals that were further than fifty miles apart, as well as hospitals with low census. The effect of these assumptions was to exclude most rural hospitals and concentrate the mergers studied in metropolitan areas and cities. The densest cluster was in the I-95 corridor between Washington DC and Boston. See the map below:

According to the model, these mergers resulted in an average increase of 1.2% in hospital prices to commercial insurers, 91% of which were passed to their employer customers in those markets. This minuscule rate increase had a curiously focused and outsized effect–a $10,584 increase in the median employer’s health spending in the merged hospitals’ market.

According to the model, local employers “responded” to this cost increase by reducing their payrolls by a median amount of $17,900, all through layoffs–70% more than the alleged merger cost increase. This large overage was not explained by the authors. Moreover, the layoffs took place almost immediately, in the same year as the merger-induced increases, even though many health insurance contracts are multi-year affairs, and lock hospitals in to rates for that period.

At the end of the “causal chain,” 1 in 140 laid off people in those communities for whatever reason killed themselves through suicide or drug overdoses. By extrapolation, the authors accuse the perpetrators of overall hospital rate increases of killing ten thousand people in the affected communities during seven years overlapping the study period.

assetto corsa mods