Keiser Permanent encompasses the Keiser Foundation Health Plan, Permanente Medical Group in eight regions and Keiser Foundation Hospitals. Keiser Permanente is the biggest health care provision non-profit organization in the United States. Over the years, the organization has undergone subsequent successful developments in its formation due to the constant changes in the competitive healthcare marketplace. Based on this, the healthcare marketplace in the United States has necessitated a close partnership that links healthcare administrators as well as physicians through the support of physician culture.
Fig: Image showing the three entities of Kaiser Permanente Program
The support of has mainly been embarked by the principles of accountability, quality healthcare delivery and efficiency. An overreaching approach to realizing excellence in the delivery of healthcare predominantly focuses on the realization of high-impact healthcare conditions. It offers goal-oriented tools of analysis for population information. It enhances a proactive identification of patients who require health interventions and upholds support for a systematic process of improving and fostering partnership linking the healthcare professionals and patients as an approach of improving the overall quality of healthcare delivery. Keiser Permanente health partnership has been a central player in all these efforts which entails a complete structure which integrates digital health data record to facilitate delivery of quality care to patients by health professionals.
Since its conception in 1945, Keiser Permanente has developed to become the biggest non-for-profit integrated health care provision structure in the United States. Today, Keiser Permanente serves over 8.6 people in eight regions in the United States. These regions include; Colorado, Ohio, Northwest region, Hawaii, Northern and Southern California, Georgia and the Mid-Atlantic States. Approximately three-quarter of the population served by the organization is situated in California which the conception state of the organization.
The primary mission of Keiser Permanente has been the delivery of cost-effective and high-quality to advance the well-being of its members as well as communities in which the organization operate. Kaiser Permanente is composed of three distinct entities whose primary mandates are to organize, deliver medical services under the mutual contracts constructed on the common visions, combined decision-making as well as incentives (Tuso 58). Moreover, these entities are mandated to fund the organization’s operations.
Fig: Image showing the working of different Kaiser Permanente Entities
KFHP and KFH are nonprofit entities whose head offices are in Oakland, California. The headquarters are shared by the common board of organization directors. KFHP and all its regional subsidiaries contract with private entities, groups as well as public buyers of licenses to fund the overall healthcare services for its enlisted members. KFH is responsible for the organization of inpatient care, home health care, and the extended healthcare services for the members in contracted and owned healthcare amenities.
KFH owns and manages 35 hospitals in regions across the United States like California, Hawaii, and Oregon. The hospitals are fitted with multispecialty outpatient as well as ancillary services. Also, KFH is in ownership of 431 outpatient medical office buildings across all regions within which its operations are based (Papanicolas, Irene & Peter 255). Typically, these medical buildings provide the patients with laboratory services, primary care, pharmacy services and radiology. Some of the medical buildings provide behavioral and specialty healthcare services.
Keiser Permanente comprises a cluster of medical physicians who accept fixed settlements to offer exclusive healthcare services to members in Kaiser healthcare amenities. As currently constituted, Keiser Permanente workforce is made up of 167,000 laborers in both KFH and KFHP. Also, there are 14,600 health physicians in Permanente Medical Group (Papanicolas, Irene & Peter 246).
For over four decades, Kaiser Permanente has embarked on the use of information technology to improve the quality of their services regarding healthcare delivery to its members. The organization has employed electronic health record system in its care delivery process. One of such systems is Keiser HealthConnect an electronic health data record initiated in 2003 which is used to date. The system of patient information record enhances a connection of Kaiser Permanente members to their healthcare clusters and their individual health information. Besides, the Keiser HealthConnect links the member to a broad range of medical information as a way of enhancing an integrated healthcare (Papanicolas, Irene & Peter 250). Regarding this, Keiser Permanente members can take part in an online health risk assessment. Members can also acquire customized responses on behavioral interventions and take part in the health conduct alteration programs.
Over the recent years, Kaiser Permanente has encouraged its members to fully engage in their online healthcare services as a way of being fully integrated into the organization’s care process. As a result, over half of its members have embarked on the use of online Web portal known as My Health Manager for tracking chosen medical data from the electronic health records (Papanicolas, Irene & Peter 246). With the utilization of online portal, Keiser Permanente has managed to efficiently manage its care delivery and incorporate new methods of patient meetings. The result of this has been improved patient engagement and utilization of healthcare services provided by the organization.
In Northern California, Keiser Permanente has emphasized on the need to continually keep in touch with the patients and not only the time of their primary visits to check the unresolved preventive care that is required and ensure scheduling of healthcare services. Keiser Permanente medical professionals receive a response regarding patient health which demands them to be in constant follow-ups with the patient in need of the of the preventative care.
The in-reach and the outreach efforts by the organization have significantly impacted the rate at which breast cancer screening is done. For the past eight years, the health statistics have shown that around 80% women who have breast cancer have undergone screening. 86% of screening patients comprised the members of Medicaid plan (Jaffe, Marc, Stephen Sidney & Joseph, 28). These numbers show that Keiser Permanente has been more effective in the delivery of its healthcare services to members compared to the public health sector whose breast cancer screening rate was at 69%.
With the huge spectrum of healthcare service delivery by the organization, the integrated healthcare model has focused on the spectrum of medical care required by patients at some given point. Keiser Permanente has also focused on the interaction of members and the organization from time to time. The organization has embarked on the utilization of patient-panel management approach and population to better the health care results for patients at high risk of acquiring chronic ailments. The development of this strategy is based on a principle of basic interactions with members, and appreciate that some patients may need more attention and support than others to attain competent results.
Fig: Image showing Kaiser Permanente’s Spectrum of Integration
Kaiser Permanente has adopted a primary care process which contains a self-care support. This care comprises between 65% and 80% of the patients’ who have been responsive to the changes in lifestyle as well as medication (Jaffe, Marc, Stephen Sidney & Joseph , 29). Also, the organization has established an assistive care management plan whose main aim is to address the adherence health challenges and the complex medication regimes. According to the Keiser membership statistics, this plan comprises between 20% and 30% of patients whose health complications are under management through level one care (Jaffe, Marc, Stephen Sidney & Joseph , 29). Besides, there is an intensive care management as well as specialty care program that is made up of between 1% and 5% patients suffering from advanced health complications as well as complex comorbidities (McCarthy, Douglas, Kimberly & Jennifer 28).
Fig: Image showing Kaiser Permanente Member-centered Philosophy
According to the disease control measures put into place, Keiser Permanente has established that 89% of cardiac patients are subjected to high risks of death. Close to 80% of the patients have been in contact with the program (McCarthy, Douglas, Kimberly & Jennifer 28). As a result, the organization has significantly contributed to the minimization of cardiac event related deaths each year by 300 due to some of the healthcare improvements made. Also, the statistical analysis provides that, Cholesterol screening has risen to over 97% (Jaffe, Marc, Stephen Sidney & Joseph , 28). As a result, Cholesterol control in the United States has tripled in regions where Kaiser Permanente operations are based over the past eight years. Colorado is ranked among the best performing states regarding cholesterol control and cholesterol screening among patients diagnosed with cardiovascular health conditions.
Fig: Graph showing comparison of 2010 and 2016 CAPHS results of Mid-Atlantic States
Over the last eight years, Keiser Permanente has put considerable efforts to address the challenge of blood pressure among its members across the eight regions in the United States. Consequently, control of blood pressure has doubled in the last eight years. Currently, the statistics show that Keiser Permanente has contributed to a decline in the blood pressure cases among its members to over 85% (Jaffe, Marc, Stephen Sidney & Joseph , 31). Moreover, the hospitalization rates have significantly declined by over 40% over the last eight years.
Regarding the financial advantages associated disease management by Kaiser Permanente, the measure of financial results shows that healthcare costs have increased at lower rates in disease managed clusters of patients. Nonetheless, the overall health expenses did not decline. The financial data shows that there was no tendency for the costs of healthcare to increase despite the quality improvement (Papanicolas, Irene & Peter 248). Keiser Permanente disease control plan has assisted in keeping the healthcare premiums below the national mean. Through its healthcare programs, it has been possible to offer improved value of the healthcare services to members regarding costs, improved health care results as well as workplace productivity.
Over the last eight years, Kaiser Permanente has enhanced its relationship with different labor unions in the United States. The organization’s management board has laid strategic measures which have significantly boosted positive relationships. Such efforts to promote the organization’s relationship with the labor unions is evidenced by the definition of Keiser Permanente’s jointly agreed upon commitment as well as the vision to shared decision-making that encompasses the managers, healthcare providers, workers and healthcare physicians (Friedman 270). As a result, the organization has been successful in promoting the quality of healthcare delivery to member patients. The labor unions have been integrated into the decision-making panel to facilitate improvements in financial and operational aspects of the organization through boosted employee morale.
Friedman, Gary D., et al. “Kaiser Permanente Medical Care Program: Division of Research, Northern California, and Center for Health Research, Northwest Division.” Pharmacoepidemiology, Third Edition (2000): 263-283. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116268/>
Jaffe, Marc, Stephen Sidney, and Joseph D. Young. “The Kaiser Permanente Northern California Hypertension Project 2001-2012: How an integrated care delivery system increased and maintained blood pressure control rates from 44% to 86% in 11 years.” Journal of the American Society of Hypertension8.4 (2014): e11.
McCarthy, Douglas, Kimberly Mueller, and Jennifer Wrenn. Kaiser Permanente: Bridging the quality divide with integrated practice, group accountability, and health information technology. New York: Commonwealth Fund, 2009.
Papanicolas, Irene, and Peter Smith. Health system performance comparison: an agenda for policy, information and research: an agenda for policy, information and research. McGraw-Hill Education (UK), 2013.
Sim, John J., et al. “Kaiser Permanente Creatinine Safety Program: a mechanism to ensure widespread detection and care for chronic kidney disease.” The American journal of medicine 128.11 (2015): 1204-1211.Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/26087046
Tuso, Philip, et al. “The readmission reduction program of Kaiser Permanente Southern California—knowledge transfer and performance improvement.” The Permanente Journal17.3 (2013): 58. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783066/