Kaiser Permanente is an American integrated managed care consortium of for-profit and not-for-profit entities.
According to their Wikipedia entry, 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 operated in seven other states in addition to California and is one of the largest nonprofit healthcare plans in the United States, with over 12 million members. It currently provides 39 hospitals and more than 700 medical offices, with over 300,000 personnel, including more than 80,000 physicians and nurses.
In Northern California, Kaiser Permanente has 8,000 doctors in 237 locations representing 24 counties.
Kaiser Permanente for Individual Plans
According to another source,
“Kaiser is by far the State’s largest health plan as measured in revenue and membership. It is a not-for-profit corporation that operates in California and eight additional states. Kaiser offers coverage in the individual, small and large group markets. Kaiser is a “staff model” HMO where the doctors, hospitals and insurance company are combined as one entity. While Kaiser offers small and large employer groups PPO plans, the company is really focused on offering a ‘comprehensive health care delivery system’ through Kaiser providers.”
Kaiser Permanente is the largest insurer in the state by enrollment, covering over 6.1 million Californians. Kaiser doctors share medical information using a cutting edge, multi-billion dollar electronic medical record system that enables them to collaborate and consult on patient care. One of the goals with this system is to eliminate the need for duplicate tests.
And, because Kaiser is a “comprehensive health care delivery system” it can offer upper-end benefit plans at comparatively low rates.
In addition, their business model of an integrated system provides for a distinctly different profit approach. As a report from the Brookings Institution on Kaiser Permanente noted,
“KP is a pre-paid integrated system consisting of three distinctly separate, but related entities: a health plan that bears insurance risk, medical groups of physicians, and a hospital system. The financial incentive is to provide high quality, affordable care and manage population health rather than generating high volume of compensable services.”
This bodes well for those who are in need of an individual health care plan.
Kaiser Permanente, offers a range of individual plans from which to choose, making it easy to select a plan that’s right for you and your family.
Whether you’re looking for lower monthly premiums or broad coverage, there are most likely several Kaiser Permanente plans that fit your budget and lifestyle needs. At J. C. Lewis Insurance, we can assist you in choosing among Kaiser Permanente’s variety of affordable, quality health insurance plans for you and your family.
In addition to medical coverage, Kaiser Permanente members also have access to vision and dental care.
For vision care in Northern California, Kaiser vision coverage includes simple copay for vision exams, while coverage for contact lenses and glasses varies by plan. Dental care is also provided in Northern California for Kaiser Permanente members.
Dental plans are underwritten by Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc., and are administered by Delta Dental of California. The dental plan features include:
- More than 25,000 affiliated dental providers in California
- No deductible for preventive services
- Up to $1,000 of services per year
How Well Does Kaiser Permanente Health Score?
As we noted in previous articles in this series, the State of California’s Office of the Patient Advocate (OPA) provides annual Health Care Quality Report Cards, which are a service provided for California health care coverage consumers.
These resources include a Health Plan Report Card for each provider that operates in the state of California.
Here are the results of the OPA report card for Kaiser Permanente – Northern California – HMO 2020-21 Edition
- QUALITY OF MEDICAL CARE – Excellent
- Appropriate Use of Tests, Treatments, and Procedures – Excellent
- Asthma and Lung Disease Care – Excellent
- Diabetes Care – Excellent
- Heart Care – Excellent
- Maternity Care – Excellent
- Behavioral and Mental Health Care – Excellent
- Preventive Screenings – Excellent
- Treating Adults – Excellent
- Treating Children – Excellent
In addition, the state’s report card includes a patient rating scorecard:
- PATIENTS RATE OVERALL EXPERIENCE – Good
- Getting Care Easily – Fair
- Satisfaction with Plan Services – Good
- Satisfaction with Plan Doctors – Good
We Are Your Local Resource for Health Insurance in California
JC Lewis Insurance offers California health insurance plans only from the leading health insurance carriers licensed to do business in California. We are a family-owned and operated California health insurance agent located in Sonoma County and we specialize in medical insurance plans for small businesses, as well as for individuals and families and people with Medicare.
Not only are we expert brokers, but we are also licensed and certified by each of these insurance carriers to offer coverage to individuals, families, and small group employers in addition to Medicare supplemental and prescription drug plans for seniors.
If you are self-employed, or your employer doesn’t provide health benefits, an individual or family plan may be the best option for you or you and your family.
And if you’re looking to purchase medical insurance for you and your family, you will likely have many questions and concerns. Bring your questions about health coverage insurance and you can be confident that JC Lewis Insurance Services will help you find the right solution.