Kaiser Permanente Case Study

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

Case Managers have a challenging job, often dealing with patients, community agencies and facilitating their hospital discharge to the next level of care. They collaborate and communicate with the entire healthcare team and mostly with the patient during the hospitalization process. They act as support for all stakeholders to achieve positive patient outcomes. In this paper, I will be interviewing Ian Mopas, who is a Patient Care Coordinator at Kaiser Permanente in Redwood City about his education, work training, goals, and objectives as a Care Coordinator, and his responsibilities in his organization.

1. Kaiser Permanente starting in 1945 when Sydney Garfield and Henry Kaiser came together to form the healthcare system still used today. During the Industrial Revolution, many workers were found to have healthcare needs and not all were insured. In collaboration to help these members, Kaiser and Garfield created a system in which employers paid a set monthly premium and physicians joined a prepaid group practice in efforts to ensure care for all employees. This evolved Kaiser Permanente into the healthcare giant it is now.

The Case Management program is offered by Kaiser Permanente to support members with complex medical, psychosocial, and care management essentials. This specialized service is provided by case managers. The case managers are either Registered Nurses who are certified in case management or qualified Social Workers. Case managers provide necessary information and education to promote understanding, reduce the chance of possible complications, and facilitate effective and proper delivery of care and services.

Poor nutrition in the United States is indeed a scary factor that continues to lead our citizens to chronic healthcare conditions. The article notes “Health People 2020 states the most affected are non-White, Hispanic adult populations are disproportionately affected by obesity” (Kaiser Foundation Hospital, 2014, p. 6)

2. San Diego Business Journal  Best Places to work and HR Professional Of The Year Awards Supplement, August 20, 2012 v33 i34 pS29(1)

Volunteering in the Emergency Department has been a fulfilling experience, while learning as much as possible helping the staff and patients. I have enhanced my listening skills and adapted my approach when communicating with patients and medical staff, being cognizant of non-verbal cues. I have become more perceptive of the wide array of ailments and injuries that prompt patients to visit the ER, while gaining a deeper appreciation of the delicate

This role does not only allow me to shadow doctors while they engage with patients, providing an opportunity to gain invaluable information and advises. This role requires most of my attention towards patients’ needs, which helps to establish a professional relationship and understand what they expect a doctor to be: caring and sensitive but decisive. As English is not my first language, my bilingual skills give me a chance to help some patients through being a translator. It is not the dream job anyone imagines, hours of sleepless shifts, tremendous responsibility with no room for errors as dealing with fragile lives and not products. This only further strengthens my decision to pursue medicine. What I most admire is how empathetic a doctor can be yet unaffected during a critical situation. It is more than just a skill; it is a talent.

Kaiser Permanente s a company that was registered to deliver healthcare services to individuals who are geographically distributed. The organization is dedicated to increasing the medical quality for its members and their immediate environment. The firm has been operating for sixty years, it evolved from programs that were operating in the industrial sector especially shipyards, construction, and steel mill workers in the late 1930s (Kaiser, 2015). In 1945 it was opened for the enrolment of the public who wanted to get their services. The enterprise started with one surgeon and a hospital that had twelve beds in Mojave Desert. The managing director (MD), Sidney Garfield, observed the young people who were involved in different development projects. The MD took a loan to cater for his expenses as he started building the Project of Colorado River Aqueduct since he noticed an opportunity. As the operations begun, most individuals were not in a position of

Managed care is a system that incorporates the delivery and funding of health care using a wide-ranging set of services. Managed care is any method of organizing health care providers to achieve the dual goals of reducing health care costs and improving quality of care.

Established in the 1930s by Henry J. Kaiser and Dr. Sidney as a health care program for construction, shipyard, and steel mill employees, in 1945 Kaiser Permanente (KP) opened enrollment to the public (Our History, 2016). Despite many challenges and setbacks, KP has grown to become one of the largest leading healthcare providers (SPEC Associates, 2011; "Labor Management," n.d.). However, is KP ready to meet the health care needs of citizens in the next decade? This paper will delve into KP to assess their readiness as well as their strategic plans regarding network growth, adequately staffing nurses, managing resources, and maintaining patient satisfaction.

On this date worker received a call from Ms. Kimbrell, Medicaid Caseworker. Ms. Kimbrell stated Mr. Duncan's nephew who is living at the residence in Curry would need to fill out a Statement from Dependent Relative/Community Spouse form. Because he is living in a home, Mr. Duncan is part owner. She also stated Mr. Duncan would be denied institutional Medicaid because he was not transferred to a long-term facility. However, he could receive hospital Medicaid because he was in the hospital longer than 30 days. The transfer penalty does not apply to hospital Medicaid but if Mr. Duncan ever applies for institutional Medicaid, they would need the person who purchased the home from Mr. Duncan to provide something showing the amount of money he spent

The metropolitan classification program is used to determine home mortgage loans, loyalty pay program and varying policies within the Medicare program. The geographic established boundaries of a metropolitan area are representative of that area’s marketplace. Property data collected from the area is reported to bank regulators who will use the data to evaluate lending performance. The data collected could potentially cause bank regulators to consider altering lending practices to suit the area.

Due to such a small town, I am unable to find many options of accepted health insurance, so I will have to use the Blue Cross Blue Shield that I used in the first assignment to compare for Sandra Winters (my patient). Sandra is not old enough to qualify for Medicare and she does not meet the qualifications to receive Medicaid, therefore she must find a company that her local hospital and family doctor accepts.

Providing quality delivery care is the cornerstone of Kaiser operation and addressing language needs of the diverse communities it serves is receiving attention from the National Diversity and Inclusion Office. Kaiser’s National Diversity and Inclusion was established with the objective to promote, support, and assist the regions in implementing the Kaiser Permanente Board of Directors agenda in providing culturally competent medical care and culturally appropriate services to improve the health and satisfaction of its members.