Kaiser Permanente is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser Permanente is made up of three distinct but interdependent groups of entities: the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the regional Permanente Medical Groups. As of 2017, Kaiser Permanente operates in eight states (Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia) and the District of Columbia, and is the largest managed care organization in the United States.
As of October 2017, Kaiser Permanente had 11.7 million health plan members, 208,975 employees, 21,275 physicians, 54,072 nurses, 39 medical centers, and 720 medical facilities. As of December 31, 2017, the non-profit Kaiser Foundation Health Plan and Kaiser Foundation Hospitals entities reported a combined .8 billion in net income on .7 billion in operating revenues. Each Permanente Medical Group operates as a separate for-profit partnership or professional corporation in its individual territory, and while none publicly reports its financial results, each is primarily funded by reimbursements from its respective regional Kaiser Foundation Health Plan entity. KFHP is one of the largest not-for-profit organizations in the United States.
KP's quality of care has been highly rated and attributed to a strong emphasis on preventive care, its doctors being salaried rather than paid on a fee-for-service basis, and an attempt to minimize the time patients spend in high-cost hospitals by carefully planning their stay. However, Kaiser has had disputes with its employees' unions, repeatedly faced civil and criminal charges for falsification of records and patient dumping, faced action by regulators over the quality of care it provided, especially to patients with mental health issues, and has faced criticism from activists and action from regulators over the size of its cash reserves.
Kaiser Permanente has been providing health care for more than 60 years, they are dedicated to improving the health of their members, and also of the communities they serve. Their only goal is to provide a healthy and safe environment, and provide care and coverage for everyone.
Quality of care
In the California Healthcare Quality Report Card 2013 Edition, Kaiser Permanente's Northern California and Southern California regions, Kaiser received four out of four possible stars in Meeting National Standards of Care. Kaiser North and South also received three out of four stars in Members Rate Their HMO. KP's performance has been attributed to three practices: First, KP places a strong emphasis on preventive care, reducing costs later on. Second, its doctors are salaried rather than paid per service, which removes the main incentive for doctors to perform unnecessary procedures. Thirdly, KP attempts to minimize the time patients spend in high-cost hospitals by carefully planning their stay and by shifting care to outpatient clinics. This practice results in lower costs per member, cost savings for KP and greater doctor attention to patients. A comparison to the UK's National Health Service found that patients spend 2–5 times as much time in NHS hospitals as compared to KP hospitals.
In June 2013, the California Department of Managed Health Care (DMHC) levied a million fine, the second largest in the agency's history, against Kaiser for not providing adequate mental health care to its patients. Alleged violations of California's timely access laws included failures to accurately track wait times and track doctor availability amid evidence of inconsistent electronic and paper records. It was also found by the DMHC that patients received written materials circulated by Kaiser dissuading them from seeking care, a violation of state and federal laws. DMHC also issued a cease and desist order for Kaiser to end the practices. DMHC conducted a follow up investigation which published in April 2015. The report found Kaiser had put systems in place to better track how patients were being cared for, but still had not addressed problems with actually providing mental health care that complied with state and federal laws. Kaiser's challenges on this front were exacerbated by a long, unresolved labor dispute with the union representing therapists.
Kaiser appealed the findings, the order, and the fine, and sought to keep the proceedings closed, but in September 2014, in the face of the administrative judge's order to keep the proceedings open, and facing the beginning of public testimony, Kaiser withdrew the appeal and paid the million. It also issued a statement which denied much of the wrongdoing. Kaiser faces ongoing inspections by DMHC and three class-action lawsuits related to the issues identified by the DMHC.
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