Kaiser Permanente : A Large Nonprofit Integrated Healthcare Plan

HMO- Is the most popular of the plans and is a group of providers that provides services to subscribers with a very small or even co copay when services are rendered. There actually are various types of HMO's that link providers to create a healthcare delivery system, they are Group Model HMO, Individual Practice Association HMO, Network Model HMO, Staff Model HMO, and Open Access HMO.

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.

According to HCA’s website, they are provider of nearly five percent of the U.S. hospital services. HCA’s mission “strives to deliver high quality, cost-effective healthcare in the communities they serve (mission).” HCA operates 165 acute care hospitals,

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

Apart from healthcare issue, the country has adopted the fast-moving life style, which has pushed most of our citizens to succumb to obesity as a result of fast foods. In fact, a recent report by the UN has ranked the United States as the most obese country in the world. Parramore (2012) outlines that, “Obesity is currently being considered as a national crisis in the United States and that it contributes 100,000 to 400,000 deaths per year. Statistics at the CDC and Prevention in 2010 indicate that 35.7% of the American adult is obese.” Many input trends exist in the American society, “First and foremost, people are highly used to fried foods, sugary drinks, and processed meats among others. There is also the sedentary lifestyle that has been adopted by many,” (Huffington Post, 2013). In fact, most of us love relaxing without exercise and too much television watching. These are some of the factors that contribute to obesity. The result is health complications problems such as diabetes, stroke, and heart disease just to mention but a few. These affect the longevity of life.

For the last five weeks research has been done on Kaiser Permanente, an organization that contains Kaiser Foundation Health Plan, Kaiser Foundation Hospitals and Permanente Medical Groups in eight regions. Since its inception in 1945, Kaiser Permanente has become the largest not-for-profit, integrated health care delivery system in the United States, serving 8.6 million members in eight regions: Northern and Southern California, Colorado, Georgia, Hawaii, the Mid-Atlantic States, Ohio, and the Northwest. About three quarters of the members are in California, the organization’s birthplace. It is the largest nonprofit integrated health care delivery system in the United States. Its mission is to provide affordable, high-quality health care services to improve the health of their members and the communities they serve. For the purpose of this research, focus will be on Northern California in a randomly selected hospital.

The hospital that I worked for while working as a case manager was not in network with Kaiser Permanente. It was also the time when the hospital started to hire hospitalists to manage patient care while they are a patient in the hospital. It actually worked out because it filled in the gap in patient care. The hospitalists were acting as the patient's primary care provider. Kaiser as with many other insurance have a case manager designated to ensure that the patient is meeting criteria not only for an inpatient hospital stay but for the level of care they are receiving as well such as ICU, Stepdown, or Med-Surg. I would have to give them an updated clinical information daily or every 3 days depending on the severity of illness. As a case manager, I was responsible for discharge planning and I preferred to transfer the patients to

As per Healthy People 2020 most Americans do not consume healthy diets and are not physically active at levels needed to maintain proper health. As a result of these behaviors the nation has experienced a dramatic increase in obesity in the U.S with 1 in 3 adults (34.0%) and 1 and 6 children and adolescents (16.2%) are obese. In addition to grave health consequences of being overweight and obese. It significantly raises medical cost and causes a great burden on the U.S medical care delivery system ("Healthy People 2020," 2014, p. 1).

For example, if you had shoulder pain, you could see an orthopedic specialist the very same day with no visit to a general practitioner. The consolidation of insurance and care is characteristic of Kaiser Permanente in the United States, however being a private company and smaller than a national system, they are forced to require the general practitioner as a middleman to presumably control unnecessary visits. Another system Taiwan has in place is the “Smart Card” the card is carried by every citizen and allows a physician to pull up a complete patient history and bill the government insurance. Additionally this system can track abuse of visits and have a member of the Bureau of National Health Insurance visit the abuser, a system that the Taiwanese people are satisfied with. Kaiser Permanente has a similar system in place that allows any Kaiser physician to look up a complete patient history, stored on secure databases. However, as previously stated the general practitioner is used in Kaiser to prevent the abuse of services as that is the only realistic solution, but is fortunately not too restricting. Based upon my experience as a Kaiser patient, once you are established with a specialist, you may schedule an appointment without any gatekeeper interference. This just shows the similarities of Kaiser Permanente to a nationalized system and that the Kaiser model is one that can be successful on a large scale.

Kaiser Permanente is a large health care delivery system that serves over eight million individuals across nine states, and the District of Columbia. In 1990 Kaiser Permanente developed a internet patient portal, KP Online. KP Online enabled members to make appointments, request prescription refills, seek clinical advice, obtain health care information, and interact with patients in forums.

We have two primary care doctors available to see patients for any of their medical needs. We have a dental program set up for families that need it. We provide immunizations for school age children. Perform school physicals.

Kaiser Permanente is a health system which serves over eight million members in nine states and the District of Columbia. In the 1990’s the KP Northern California region created an Internet Patient Portal known as “Kaiser Permanente Online” (KP Online)(Wager, 2009). KP Online provides members access to request appointments and prescription refills, obtain health information, and receive medical advice from staff.

One way to see Kaiser is as both the health insurance and the healthcare provider. Kaiser has been cited as the face of the future of healthcare. In fact, its model, a combination of a nonprofit health insurance plan with its own physicians, medical offices and hospitals, has been mentioned and used by President Obama when creating healthcare reform (Abelson, 2013). As an open system, Kaiser Permanente is affected by many external factors, such as Medicare, the National Committee for Quality Assurance (NCQA), the Division of Insurance and laws like the Healthcare Reform.

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

United Healthcare assesses that it services approximately 70 million Americans . Its entire system spans 676,287 physicians and health care professionals, 80,000 dentists and 5,190 hospitals, whilst their pharmaceutical management provides more affordable drugs to 13 million people.