Kaiser Managed Care: Kaiser Permanente

Today, health care is one of the most the important subjects in United States. There are many Private and nonprofitmaking organization dedicated to health care. This paper discusses the readiness of Kaiser Permanente as a health care organization to respond the future health care needs of citizens. This paper also contains its strategic plan that addresses issues relating to network growth, nurse staffing, resource management and patient satisfaction.

Managed care dominates health care in the United States. It is any health care delivery system that combines the functions of health insurance and the actual delivery of care, where costs and utilization of services are controlled by methods such as gatekeeping, case management, and utilization review. Different types of managed care plans came into development by three major factors. These factors include choice of providers, different ways of arranging the delivery of services, and payment and risk sharing. Types of managed care organizations include Health Maintenance Organizations (HMOs) which consist of five common models that differ according to how the HMO is related to the participating physicians, Preferred Provider Organizations

Reinvest current net income into interest accounts for future variable health care costs for years to come

What are the three main payment mechanisms managed care uses? In each mechanism who bears the risk.

Kaiser Permanente is a large nonprofit integrated healthcare plan. This organization serves a tremendous amount of patients all over the United States with more than 38 hospitals and more than 600 medical offices. They offer medical care from chronic care visits to deliveries and prescription refills ("Who We Are - Kaiser Permanente," n.d.) Kaiser Permanente conducts campaigns to spread their care knowledge to others. They perform sick care, prevention care, and treatment for those who need it.

Kaiser Permanente is a managed care facility that provides services across the health care continuum. Over the years the organization has continually made efforts toward improvements since it was first founded in 1945. These improvements generate a series of successes that set Kaiser apart from similar organizations. But, just as any health care delivery system, Kaiser has faced challenges in the past, present and may continue to do so in the future. In this paper I will explain what attributes to the success of Kaiser Permanente and some of the challenges they face.

As a managed care organization Kaiser Permanente has served as a model for informational healthcare systems and the recent demand for affordable care has prompted the organization to lower cost in services without hindering the quality of care. Kaiser Permanente has integrated a system in which the organization assumes all financial risk and a bundled enrollment fee for service strategy. What makes Kaiser Permanente unique from other HMOs is their accountability for quality, utilization management, financial risk, and business strategies (Kaiser Permanente, 2009).

In this country there are numerous concerns about health care economics. Several factors contribute to the increase of health care costs. One area of concern is the impact of managed care on health care finances. Managed care has been around since the early 1970s. The definition of managed care is a set of contractual and management methods implemented to manage the financing and delivery of health care services. Initial implementation of managed care was for health care cost saving (Getzen & Moore, 2007, p. 203, para. 1). Though Managed care initially addressed several health care finance issues, there are still problems with the current

Managed care organizations should have arrangement with both the medical insurers and providers to provide treatment for a contracted rate. Hospital should advertise the services they offer to members of healthcare plans through their healthcare provider by emphasizing on the technology, staff, and other quality of care they provide. Worker compensation plans are similar to commercial plans but treats injured employees. Hospital must contract with all workers compensation plans and must also negotiate coordination of benefits with other insurance carriers of the injured person to full compensate services. For Self pay patients hospital can reach out to them by having pre negotiate rates for treatment when payments are made in advance for certain procedures. Hospital should have system to accept payments when made in any

Managed care has been adopted into the government funded care organizations. Medicare managed care plans provide all coverage themselves, including basic Medicare coverage. Managed care plans cover above and beyond the basic benefits of Medicare, the size of premiums and copayments, and the decisions about paying for treatment are controlled by the managed care plan. The basic premise of managed care is that the member/patient agrees to receive care from only a specific doctors and hospitals, in exchange for reduced healthcare costs. Medicare, like other insurance companies offer plans that give Medicare beneficiaries more choices in coverage, like HMO or PPO. Managed care has been used since the mid 1990’s in order to provide healthcare to beneficiaries with serious or life long illnesses. Today, managed care has become a way for states to provide quality care to both Medicaid and Medicare patients.

rising health care costs. Managed care can be defined a system of delivering health services in

Success Of Kaiser Permanente Health Care Model And The Group Health Cooperative Model Of Health Care Compared To Other Initiatives In Health Care “Kaiser Permanente is America's leading integrated health care organization. Founded in 1945, it is a nonprofit, group-practice health maintenance organization (HMO) with headquarters in Oakland, California. Kaiser Permanente serves the health care needs of members in 9 states and the District of Columbia.” Today, it encompasses Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals, and the Permanente Medical Groups, as well as affiliation with Group Health Cooperative based in Seattle, Washington. Kaiser Permanente aspires to be the world leader in improving health through high-quality, affordable, integrated health care. We will be distinguished by our strong social purpose, physician responsibility for clinical care, and an enduring partnership between our Health Plan and our medical groups. Kaiser Permanente provides coverage programs for thousands of uninsured children and adults who are ineligible for existing state or private programs due to family income or immigration status. The organization also partners with community-based clinics to provide expertise, clinical guidelines, and other support for these safety-net providers. Through its research centers across the country, “Kaiser Permanente conducts more research, over 1,000 studies annually, than any other non-academic institution in the U.S.” The

Managed care is a system of healthcare delivery that seeks to achieve efficiency by interpreting the basic functions of healthcare delivery. It employs mechanisms to control (manage) utilization of medical services and determines the price at which the services are purchased and how much the providers get paid.

In other to manage or curtail the ever rising healthcare cost in America, Managed Care was formed. The National Library of Medicine, defines managed care as programs or organizations “intended to reduce unnecessary health care costs

Today’s market demands organizations to have a strategic plan. The purpose of the strategic plan describes where the organization wants their organization to go. A strategic plan is a document used to communicate goals, and the actions needed to achieve those goals. In order to remain competitive every organization needs to innovate to stay ahead of the competition. They need to develop new products and services with increasing frequency. The design of these new products and services must meet, or exceed, customer expectations and at the same time, they must generate an acceptable financial return for the organization. However, any business that does not realize the importance of developing new products will not last very long as a consequence