Kaiser Permanente Southern California Is A Not Profit Healthcare Organization

The Iron triangle for healthcare consists of cost, quality, and access; these three characteristics when balanced create great healthcare. Managed Care Organizations combine the three to offer consumers with care that is appropriate for their individual needs. Our book describes managed care organizations as “the cost management of healthcare services by controlling who the consumer sees and how much the service cost” (Basics of the U.S Healthcare System, Niles). Taking a look at the history prior to the Health Maintenance Organization Act of 1973 (HMO ACT of 1973) the implementation has been significant in balancing cost, and quality control. Before this Act was signed in to law by President Nixon healthcare costs were determined by fee for service. A fee for service or indemnity plan is a plan that allows the provider to determine the cost of service, this fee for service plan caused for healthcare costs to increase rapidly. An example of this would be going to the doctor with neck pain, being told to stretch then receiving a bill for 25,000 dollars. As could be understood the cost of healthcare had became a problem.

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

RECOMMENDATION  There is “an inherent conflict between best care and financial performance”. The CEO states that “Finances are not, and never have been, our primary concern.” However, the business must address its decreasing profitability to be able to continue to survive. This will become even more urgent if the reduced government spending that the CEO foresees happens.  The organizational culture is high quality care, high-performance and non-profit which must be taken into account in any solution. The healthcare business has a clear focus and is very successful at continually improving its patient care and processes.  While clinical performance improvements have resulted in revenue losses for the Intermountain healthcare business the Intermountain health plan, SelectHealth, and other health plans that buy Intermountain health care services have benefitted. Intermountain needs to translate these benefits into additional profits to support its main business, healthcare.   Its skill at providing this care should translate into significant market advantage for SelectHealth and for Intermountain when selling

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.

There has been discussion to have universal healthcare system similar to Medicare as a method to have a centralized monitoring system of cost. There have also been other systems tried beginning with HMOs in the 1970s in an effort to streamline access to necessary healthcare services by employing a gatekeeper to their access at the primary care levels. With patient dissatisfaction, PPOs were tried which circumvent the necessity of referrals (Hacker, 1998). Either of these models had substantial effect on healthcare outcomes while the cost of healthcare continued to skyrocket. The US spends more than any other country on healthcare but outcomes are not better (Blackstone, 2016). In 2010, under President Obama’s leadership, Affordable Care Act was passed and one of the promising features is the formation of accountable care

In terms of space and resources, all of these hospitals provide emergency care and acute care facilities. Both UCSD Medical Center and Sharp Healthcare equally engage Scripps Mercy in providing a diversity of medical facilities. Moreover, UCSD Medical Center and Sharp Healthcare are the major competitors in this distinct segment. Kaiser Permanent poses a moderate risk to Scripps Mercy Hospital, as it outsources significant services to other hospitals. Kaiser permanent is planning to grow in this segment as it has plans to expand by three more hospitals by the end of 2030. In the near future, Kaiser Permanente will ultimately become a major competitor for Scripps (Tu et al., 2013).

(MCOs) operating. The hospital group is the state’s largest not-for-profit organization and boasts an impressive performance plan, serving the healthcare needs of approximately 8 million citizens in Virginia. Moreover, Chesapeake Health Plans was the first organization to successfully attempt to request and obtain the highest level of accreditation from the National Committee of Quality Assurance (NCQA). Furthermore, Chesapeake health plans are structured to provide medical plans that cover services under the HMO’s, PPO’s, POS, and Medicare HMO’s. Chesapeake health plans attributes a considerable portion of their net service revenue generated to their effective HMO health plans, which realized a 46% of total revenue, while their Medicare HMO produced an impressive 39% of total revenue. Furthermore, their Preferred Provider Plan (PPO) generated 10%, and the Point of Service Plan (POS) saw a 5% figure. This case study financial analysis will effectively assess Chesapeake Health Plans: HMO financial performance, focusing on a competitive analysis, a cash flow analysis, clear profitability ratios, liquidity ratios, debt management ratios, asset management ratios, operating indicator analysis, a comprehensive financial assessment of Chesapeake’s financial state, as well as effective fiscal recommendations for their organization.

The case of Ledina Lushko, a patient enrolled in a Blue Cross and Blue Shield of Illinois individual plan, highlights many of the issues that have plagued the United States healthcare system for some time. As an insurance plan provider, BCBS of Illinois takes pride in the health outcomes of our members and has a responsibility to contribute positively to their care. The fractured, ineffective care Mrs. Lushko received is disappointing, however, this case provides strong support for a shift in focus towards managed care and specifically, the Accountable Care Organization structure. The following details several aspects of Mrs. Lushko’s experience and how her care could have been improved by enrollment in BCBS of

Kaiser Permanente insures about one-third of the Greater Sacramento region’s population and has nearly 12,000 employees and more than 1,540 physicians. The not-for-profit organization is the largest care provider in the region. Collins began his position in January 2015. Prior to that, he had served since 2008 as the senior vice president and area manager for Kaiser Foundation Hospitals/Health Plan

It consists of five briefings: Four provide insights into critical strategic development, and one provides an update on the state of the overall strategy. All are connected by a commitment to put their members, consumers, customers, and communities at the forefront of everything they do (Kaiser Permanente, personal communication, February 2015). Focusing on these five strategies will fulfill the mission during the next 10 years and demonstrates what will be

Understanding the financial analysis of healthcare organizations is strategic to the organization by understanding their stand on the amount of revenue they gain, healthcare assets, and their financial goals. This paper will provide a comparison on the performance of financial analysis of several California Healthcare Organizations such as; Scripps Health, Palomar Health, Sharp Healthcare, and Tri-City Healthcare. The four healthcare organizations will be illustrated with an overview about what the organizations have been doing financially , where they have been growing financially, and what have they accomplished over the past year from examining their financial statement. As the nation’s healthcare model continues to evolve,

To provide Kaiser Permanente’s internal assessment as an organization we use a strategic S… W… O… Theory (SWOT) analysis that attempts to grain a comprehensive insight into Kaiser’s corporate strategy and key

Kaiser Permanente is one of the country’s foremost health maintenance organizations (HMOs), also referred to as integrated managed care organizations. HMOs provide health care that is fulfilled by hospitals, doctors, and other providers with which the HMO has a contract. While Kaiser is a non- profit organization, the company earned $ 34.4 billion in revenues in 2007. Kaiser has approximately 170,000 employees, over 13,000 doctors, and serves 8.7 million members in nine states. The company is headquartered in Oakland, CA. Kaiser is known for pioneering electronic medical records and currently boasts the world’s largest electronic medical record storage system. The company also

Located in nine states, KP currently is the largest not-for-profit medical care organization in the United States with approximately 8.7 million health plan members, 150,000 employees, 13,729 physicians, 32 medical centers, 416 medical offices, and $28 billion in annual operating revenue. Kaiser Permanente is unique among health care providers and hospitals because it serves both as a health maintenance organization and as a group physicians practice provider. Its revenue model is not based by the number of cases or patients served each day, but rather by the number of members enrolled in their health care system. Hence, Kaiser Permanente tracks costs at the gross level view of average cost per nursing unit per patient day.

Operations: Pacific Health Care has the main goal of providing health care services to low income residents. The Company provides a high level of service and they are well-received by the community they reside in. The way Pacific achieves revenues is by having 80% come from contracts with the city and the