...Kaiser Permanente as a System Introduction Kaiser Permanente (KP) was founded in California in 1945. It is one of the largest non-profit healthcare organizations in the United States, made up of three entities: the Kaiser Foundation Hospital, the Kaiser Foundation Health Plan and the Permanente Medical Groups. It currently serves about 9.1 members within the following states: California, Colorado, Washington DC, Maryland, Virginia, Washington, Oregon, Hawaii, and Georgia. With a few exceptions, it mostly operates under a managed care model, owning the physician network and the facilities its members use to receive medical services (Fast Facts, 2013). In this paper I will present the systems thinking model, its definition and its use as a diagnosis model. Then, I will evaluate Kaiser Permanente as a system and identify a problem or challenge. Finally, I will offer recommendations on how to overcome this problem. Systems Thinking Systems thinking is used to analyze how all departments within an organization function and can affect each other. When we analyze an organization as a system, we learn how it can work in an efficient manner and how to fix it when it’s not working properly. An organization functions effectively if all its parts or departments are well-integrated. In systems thinking we look at the organization as a whole and how all its parts work together (Ackoff, 1999). The open systems model presents the organization as a system...
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...Affordable Care Act signed by President Obama on March 23, 2010 as the means to enforce Health Insurance reform. Its main object is to make Health Insurance and Preventive care accessible and affordable to the American population. The Affordable Care Act The ACA major components include: Medicaid expansion, allowing states the opportunity to expand their existing Medicaid programs to include, (OPA, 1015) “individuals under 65 years of age with incomes up to 133% of the federal poverty level… (as well as) certain low-income adults without children” (Medicaid Expansion). Health Insurance Marketplace (HIM), available for access to individuals and small businesses enabling them to compare a variety of plans on the basis of price, quality and benefits and to choose the most affordable option according to their needs. The proposed three models are State Operated, State and Government Operated, and Federal Government Operated, for States that choose not to establish a program. Under the ACA, health services provided by all Insurance companies (participating or not on the HIM) are required to offer individuals and small businesses, affordable health Insurance plans that allow access to ten services identified as Essential Health Benefits (EHB). EHB services include, Ambulatory and Emergency services, Hospitalization, Maternity and newborn care, Mental health, substance use disorder, and behavioral health treatment, Prescription drugs, Rehabilitative and “habilitative” services and devices...
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...OAKLAND OAKLAND Consolidated Community Benefit Plan 2012 Kaiser Foundation Hospital – Oakland Northern California Region KAISER FOUNDATION HOSPITAL (KFH)-OAKLAND 280 West MacArthur Boulevard Oakland, CA 94611 (510) 752-1105 The KFH-Oakland service area includes Alameda, Albany, Berkeley, Emeryville, Oakland, and Piedmont. COMMUNITY SNAPSHOT (*county-level data) Total population: Median age:* Average household income:* Percentage living in poverty: Percentage unemployed: Percentage uninsured: 633,114 36.1 $70,217 16.92% 8.92% 14.67% White: Latino: African American: Asian and Pacific Islander: Native American: Other: 32.41% 21.76% 21.12% 19.84% 0.33% 4.55% KEY STATISTICS Year opened: KFH full-time equivalent personnel: KFHP members in KFH service area: 1942 1,884.0 188,929 Total licensed beds: Inpatient days: Emergency room visits: 341 74,218 50,725 KEY LEADERSHIP AT KFH-OAKLAND Nathaniel L. Oubré, Jr. Belia Marshall, RN, MPA Dennis Morris John Loftus, MD Shirley Steinback Julie Hadnot Glenda Monterroza Senior Vice President and Area Manager Chief Operating Officer Area Finance Director Physician in Chief Medical Group Administrator Public Affairs Director Interim Community Benefit/Community Health Manager 227 Consolidated Community Benefit Plan 2012 Kaiser Foundation Hospital – Oakland Northern California Region THE 2010 COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARY AND FINDINGS 2010 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) SUMMARY The 2010 CHNA for...
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...Week 2-Effective Communication Paper Kaiser Permanente based in Oakland California is the largest not-for-profit health plan in the United States. They do primary, secondary and hospital care emphasizing prevention to its members. They use electronic medical records and use care pathways that provide its 8.7 million members cost effective and high quality care ("What Health Systems Can Learn from Kaiser Permanente: An Interview with Hal Wolf", 2009). Kaiser covers all of the health care needs to its members in one place which includes hospitals, laboratories and pharmacies. In this essay we will discuss the organizational model used, the communication style, both positive and negative communications and how technology could affect the organization. Kaiser Permanente is made up of 3 organizations which are Kaiser Foundations Health Plan (KFHP), Kaiser Foundation Hospitals (KFH) and the Permanente Medical Group (TPMG) ("Our Business Structure", n.d.). KFHP is a nonprofit prepaid plan that contracts with individuals and groups to receive health care. KFH is a nonprofit public corporation that owns and operates its own facilities in California, Oregon and Hawaii to provide services such as hospital stays, sponsors charitable, educational and research endeavors ("Our Business Structure", n.d.). TPMG is the group of physicians that contract strictly with Kaiser Foundation Health Plan to deliver care for the patients and members. Also with our organization is one known as...
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...There are several different models of integrated healthcare systems including a multispecialty group practice with a health plan which is both provider and payer. The Kaiser Permanente is one of the most well-known examples of this model and only serves members in its health plan. The Kaiser Permanente has been used in California since the 1940s and is well known for its cost-effective care with high quality services to its members. Kaiser Permanente was formed in response to the Great Depression under Dr. Sidney R. Garfield’s four core principles: “group medical practice, prepayment of services, a focus on prevention, and a cornucopia of services under one roof” (Kaiser Permanente, 2016). During World War II, a nonprofit, charitable trust...
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...Name: Kaiser Foundation Health Plan of the Northwest Kaiser Foundation Hospitals HR #: DOB: Clinician: Personal Health Profile Medications (Prescription and over-the-counter drugs) Drug Names Strength Frequency Medical Office: Occupation: Medication Allergies Drug Reaction Major Surgeries or Injuries (Include year if known) Other Hospitalizations (Include year) Have you been treated for any of the following? Yes No Yes No Yes Diabetes High Cholesterol High Blood Pressure Heart Disease Thyroid Disease Lung Disease Other (Explain) Does your mother, father, sister or brother have any of the following? Yes No Yes No Yes Diabetes High Cholesterol Alcohol/Drug Abuse Have you been sexually active in the past 6 months? No Do you use birth control? No Yes Method: When was your last tetanus shot? High Blood Pressure No Cancer Mental/Emotional Problems Heart attack before age 55 Breast, Colon or Prostate Cancer Yes If yes, how many partners? No Yes No If over 65, have you had a pneumovax vaccine? Have you ever smoked? No Yes Do you smoke or use smokeless tobacco? No Yes Do you use alcoholic beverages? No Yes If yes, how many drinks on an average per week (1 drink=1glass beer/wine or 1 shot hard liquor) 1 to 5 6 to 10 11 to 20 More than 20 Do you exercise regularly? If yes, what type? No Yes Do you use recreational or “street drugs”? No Yes 12803...
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... This paper explores the reasons Kaiser is one of the top 100 hospitals, using research conducted online and offline, by using patient and customer feedback, and also by explaining how Kaiser Permanente achieves its quality of care to become a top hospital. Kaiser Permanente has marketed itself as one of the top 100 hospitals in the U.S., proclaiming their exceeded cares for those who are Kaiser Permanente Members. They have been administering healthcare for many years, through inpatient and outpatient care. A plethora of accolades in various categories shows Kaiser Permanente’s success in keeping long term patients under their provided care. Keywords: Kaiser Permanente Today’s Top 100 Hospitals In today’s world, people believe in researching who can provide the best quality service in the healthcare industry. We are keenly aware of how our health service is provided when we are struck with an illness or injury, which makes it imperative to learn who ranks among the top hospitals. Kaiser Permanente has been well known to give the best quality care for those who are Kaiser Permanente Members. They are known to be highly ranked in various aspects, ranging from internal medicine, cancer research, surgery, cardiology, orthopedic care, pediatrics, and geriatrics, to name a few. Back in the 80’s and 90’s, Kaiser Permanente was well known for its less than stellar reputation. At the time, it was not fathomable that Kaiser Permanente would be able to provide the...
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...Health Care Spending The current health care expenditures raise the eyebrows of many Americans in the United States because of the increasing costs of health care services. Government officials are taking steps to consider the medical needs of Americans. “Health expenditures in the United States neared $2.6 trillion in 2010, over ten times the $256 billion spent in 1980” (The Henry Kaiser Family Foundation, 2012, para 1). For Americans to understand the spending of health care, this paper will consider the current national health expenditures, if the spending is too much or not enough, where the nation should add or cut costs, and how the public receives payment for health care needs. In addition, the paper will provide a forecast and the importance of the future economic needs of the health care system, and envision how the needs of health care will receive financing. Health care expenditures are not only a burden for people but also are an overwhelming thought for the government to consider a health care reform. The impact of the recession caused many Americans to consider other ways to afford coverage for medical expenses and with the growing changes of the economy, Americans placed concern on health care spending and if it is affordable (The Henry Kaiser Family Foundation, 2012). According to the Henry Kaiser Family Foundation (2012) states, “Since 2001, employer-sponsored health coverage for family premiums have increased by 113%, placing increasing cost burdens...
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...HEALTH MAINTANENCE ORGANIZATION IVAN D. HALOL HCS/212 - HEALTH CARE VOCABULARY APRIL 15, 2013 INSTRUCTOR DEBORAH DOHERTY In 1990 Kaiser Permanente became the largest Health Maintenance Organization in the country. This was the result of a great man. His name was Dr. Sydney R. Garfield MD. Dr. Garfield is one of the pioneers in voluntary prepaid healthcare plans which was a direct precedent to the federal government enacting the Health Maintenance Organization Act of 1973. Dr. Sydney Garfield opened up a fee for service hospital in 1933. However, insurance companies were slow to compensate his practice and delinquent or non-payment from patients had negative impacts on his practice. This led Dr. Garfield to initiate an agreement with insurance companies to charge a prepaid fee of five cents a day to workers. Under a Health Maintenance Organization (HMO) plan patients and/or employers paid a fixed monthly payment. This provided patients with healthcare that included preventive medicine checkups, immunizations, office visits, and hospitalization. Professionally and personally, Kaiser Permanente has been my employer and healthcare provider for the past several years. The HMO system is cost effective to our patients compared to a pay as you go healthcare plan. Dr. Sidney Garfield opened up his first hospital in 1933 called Contractor’s General Hospital. Its purpose was to provide healthcare for over 5,000 workers that were constructing the Metropolitan Water District of Southern...
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...having adequate health coverage as well. However, federally funded programs such as Medicare, Medicaid and, the Children’s Health Insurance Program insure the majority of the elderly and children. The age of the uninsured expands across the age spectrum. The ethnicity, age and gender of the average uninsured adult are the Hispanic male, 19 to 25 years of age. Minorities tend to make up the vast majority of the uninsured. Hispanics account for 32% of the uninsured in America. American Indians 30%, African Americans 22%, and Caucasians 14%, make up the remainder of the uninsured population (Kaiser Family Foundation, 2011). The average educational level is high school diploma or GED. The lack of higher education puts this group at risk for not being able to qualify for higher paying jobs that would give them the opportunity to afford health care coverage. The average income of the uninsured population is approximately $30,000 to $35,000 per year (Kaiser Family Foundation, 2011). In the uninsured population there are two additional groups. This group is the uninsured young adult who is not eligible for continued health coverage on their parents’ health plan and the older working adult who cannot afford health care premiums. This adult population usually does not qualify for federally funded health care programs such as Medicare and Medicaid. These risk factors identify the uninsured population as vulnerable with many challenges to overcome in their health care. The uninsured...
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...the biggest steps towards a comprehensive health care reform for all Americans. The fundamental goals of the ACA are to decrease the cost of health care, increase the quality of health care services and make health care accessible to all, particularly the uninsured (Williams, 2013). The increase of individuals that will be soon be insured will have a huge impact on the existing structure of our health care system, especially the quality of care that can be provided to patients along with the implementation or improvements that are being made to the electronic health record systems being used (or implemented) in hospitals or other health care settings. There have been many critics and supporters of the ACA since it was signed into law in 2010. One of the most significant changes being discussed is the requirement for all individuals to have health insurance either provided by their employer or by purchasing an individual insurance plan; all individuals are required to have health insurance by January 1, 2014 or pay tax penalties that will be imposed. Individual health insurance plans will be available through a state-based American Health Benefit Exchange (Kaiser Family Foundation, 2013). These exchanges promise to make purchasing qualified insurance coverage easier by requiring all states to adopt a single set of operating rules for eligibility verification (Kaiser Family Foundation, 2013). In order to make these insurance plans more affordable for individuals that are struggling...
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...TECHNOLOGY INTRODUCTION The health care industry in the United States was troubled. Most of the world’s state-of-the-art health care research occurred in U.S. university and corporate laboratories. Similarly, most of the best centers in the world for delivery of health care were located in the U.S. However, the costs of health care in the United States were exploding and overall quality, along many dimensions, was not increasing. For U.S. consumers it was the best of times and the worst of times—health care services were often terrific if judged by the ability of individual physicians to do more for patients and yet, as judged on almost any broad parameter such as life expectancy or infant mortality, the United States was at best average compared to other developed countries. In most developed countries, spending on health care grew dramatically over the past several years. This increase in spending, combined with lower overall economic growth, pushed up the share of health care expenditure as a percentage of gross domestic product (GDP) of OECD countries from an average 7.8 percent in 1997 to 8.5 percent in 2002. By comparison, the share of GDP spent on health care remained almost unchanged from 1992 to 1997 (Exhibit 1). In the United States, health care expenditure grew 2.3 times faster than GDP, rising from 13 percent in 1997 to 14.6 percent in 2002. Spending was $5,267 per capita in 2002, almost 140 percent above the OECD average of $2,144.1 The cost of health care in the United States...
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...estimated 16 million newly insured people by the end of 2014. However, there are public policies that need to be resolved. The public policy question that warrants further inquiry and needs to be addressed is section 3502 of PL111-148 does not include nurse practitioners. The public policy question is: Should the federal government mandate inclusion of nurse practitioners. The resolution to the public policy problem is to amend section 2703 of PL 111-148 to say: Section 3503 would include nurse practitioners provided they are practicing with and/or under a licensed health care professional. “Coupled with an estimated shortage of over 60,000 primary care physicians, the country's public health care system will be at a challenging crossroads, as there will be more patients waiting to see fewer doctors. Nurse practitioners (NPs) can help to ease this crisis” (Hansen-Turton et. al, 2013). Nurse practitioners are health care professionals who are more than capable of providing and critical access to primary care, particularly for vulnerable populations. Nurse practitioners are vital resources to help rural hospitals, create more financial sustainability by reducing costs to per patient, and maximizing patient outcomes. It would be extremely advantageous to expand the roles of NPs to include preventive services (Marsh, Diers, & Jenkins, 2012). It is vital for the sake of the nation's healthcare to break the barriers preventing nurse practitioner to provide care for the patient-centered...
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...Health Care Spending The United States is one of the biggest spenders when it comes to health care. In 2010, the U.S. spent over $8,000 per person totaling $2.6 trillion. Currently 18% of our Gross Domestic Product (GDP) is health care expenditures according to Romer (2009). Half of the expenditure payments go to hospital and physicians. With all this spending why are we not healthier than countries that spend one-third less on health care? Here are some key points of our nation’s health care The Kaiser Family Foundation (2012) notes: • In 2010, the U.S. spent $2.6 trillion on health care, an average of $8,402 per person. • The share of economic activity (gross domestic product, or GDP) devoted to health care has increased from 7.2% in 1970 to 17.9% in 2009 and 2010. • Health care costs per capita have grown an average 2.4 percentage points faster than the GDP since 1970. • Since 2002, the rate of increase in national health care spending has fallen from 9.5% to 3.9%. • Half of health care spending is used to treat just 5% of the population. • Although only 10% of total health expenditures, spending on prescription drugs has received considerable attention because of its rapid growth (114% from 2000 to 2010). • In 2008, 27% of the nonelderly with 3+ chronic conditions spent more than 10% of their income on health, compared to 11% of the total nonelderly population. • Many policy experts believe new technologies...
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...Hygiene and Public Health 1977-81 Johns Hopkins University Professor of Health Education 1981-82 Harvard University Visiting lecturer 1988-91 Kaiser Family Foundation Vice President 1991 - Now University of British Columbia Professor of Health Care and Epidemiology, and Director of Institute of Health Promotion Research Marshall Krueter 2. ORIGIN:Approximate years of origin 1968 - 1974 for PRECEDE, late 1980s for PROCEED. 3. PURPOSE OF MODEL The PRECEDE model is a framework for the process of systematic development and evaluation of health education programs. An underlying premise of this model is that health education is dependent on voluntary cooperation and participation of the client in a process which allows personal determination of behavioral practices; and that the degree of change in knowledge and health practice is directly related to the degree of active participation of the client. Therefore, in this model, appropriate health education is considered to be the intervention (treatment) for a properly diagnosed problem in a target population. This model is multidimensional, founded in the social/behavioral sciences, epidemiology, administration and education. As such, it recognizes that health and health behaviors have multiple causations which must be evaluated in order to assure appropriate intervention. The comprehensive nature of PRECEDE allows for application in a variety of settings such as school health education, patient education,...
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