Introduction to Kaiser Permanente. Robert M. Crane Director, Kaiser Permanente Institute for Health Policy. Overview Mission Structure & Key Features History Comparison To NHS & US Plans Areas Of Focus Care Management Information Technology. 8.4 million members.
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Robert M. Crane
Institute for Health Policy
America’s Largest Non-Profit Health Care Program
To provide high quality, affordable health care services and to improve the health of our members and the communities we serve.
With Aligned Incentives
1933: Dr. Garfield’s prepaid health plan in the California desert
1938: 6,500 workers at the Grand Coulee Dam, Washington
1942: Kaiser shipyards in Richmond,CA; Vancouver, WA; and steel mill in Fontana, CA
1945: Membership opened to the public
1948: The Permanente Medical Group founded
1955: The Tahoe agreement, roles of PMGs and KFHP set
1997: The Labor Management Partnership (LMP) was forged and ratified by 26 AFL-CIO unions. It is the largest and most complex health care partnership in the United States - both operationally and in scope.
1958: Hawaii added as 4th region
1969: Colorado and Ohio regions added
1980: Mid-Atlantic region added through acquisition
1985: Georgia region started
1998 Care Management Institute started
1999: Commitment to implement common automated medical record -
Feachem, et. al., BMJ January 19, 2002
Medicare, Medicaid, and SCHIP account for one-third of national health spending.
Total National Health Spending = $1.3 Trillion
1 Other public includes programs such as workers’ compensation, public health activity, Department of Defense, Department of Veterans Affairs, Indian Health Service, and State and local hospital subsidies and school health.
2 Other private includes industrial in-plant, privately funded construction, and non-patient revenues, including philanthropy.
Note: Numbers shown may not sum due to rounding.
Source: CMS, Office of the Actuary, National Health Statistics Group.
Over the 1990s, managed care grew dramatically.
Source:Employer Health Benefits, 2001 Annual Survey, The Kaiser Family Foundation and Health Research and Educational Trust. Trends and Indicators in the Changing Health Care Marketplace, 2002 – Chartbook.
7%: African American
Distribution of Annual Health Care Spending Across Entire US Population 2000
Cost of Healthcare
Source: Lewis 2000
Percent of Population
Distribution of total commercial population
Costs associated with each segment
Source: 2001 Northern California, Group XYZ Commercial Membership; DxCG methodology.
Those w/multiple chronic conditions
Those w/one chronic condition
Those w/no chronic conditions
Costs associated with each segment
Segments within the total population
Source: Kaiser Permanente Northern California commercial membership, DxCG methodology, 2001.
KP MembersClinical Areawith this Condition
Coronary Artery Disease 256,000
Depres sion 411,000
Heart Failure 94,000
Cancer 25,000 new cases/yr
Chronic Pain ~1,000,000
Elder Care 917,000
Obesity ~25% of adults
Self Care 8.4MM
Highly complex members
or Case Management
High risk members
Assisted Care or Care Management
Usual Care with Support
70-80% of a CCM pop
Population Management:More than Care & Case Management
Measurement of Outcomes & Feedback
Data Warehouse / EDR Enterprise Data Repository
Our Entire Organization is Impacted
Web Access Portal
Care Delivery Core
Scope of KP HealthConnect Suite