Kaiser Permanente as a Sysem
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
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In the past, Kaiser Permanente used to function as a traditional health maintenance organization (HMO) where patients paid a fixed copayment for services. Now, with the increase in healthcare costs causing an increase in premiums, most people are signing up to deductible plans where they share the cost for services. Kaiser Permanente realized a little later in the game that they also needed to offer deductible plans in order to remain competitive. This implicated making many changes in the parts that make up the system, such as Coding, Billing, Customer Service, Ancillary, and even the physicians. Many of these changes have been implemented, but members still don’t have access to cost information prior to receiving services. This is a problem that is affecting several parts of the system, due to causing dissatisfaction on the members who have deductible plans. These dissatisfied customers use the complaint process to express their disatisfaction, causing an increase of complaints. They also use external regulatory agencies to file their concerns. In order to fix this problem, Kaiser Permanente created a team called Medical Financial Counseling, available for members who called them to request cost information for upcoming services. However, they are only available by phone, which does not help the members who are at the clinics and need the information “in the moment”.