The following is a guest post from Elyse Rossler, National Director, Health at mobileStorm.
With close to 9 million members, treated by 180,000 employees and 16,000 physicians — and as the fifth largest hospital system in the U.S. generating $45 billion a year in revenue — Kaiser Permanente shines.
George Halvorson, CEO and Chairman of Kaiser, gave an inspirational talk to a select audience during the mHIMSS conference in Las Vegas last week. He outlined KP’s strategy and success very succinctly with simple principles; treat each Kaiser member in totality, with a comprehensive wellness plan, using a toolkit for addressing their health and well being. KP shies away from treating their members in “silos.”
It was easy to tell that he incurred the jealousy of other hospital system representatives in the room as he talked about the concept of “Team Care,” meaning care that’s patient-focused to achieve optimal results. For example, in a traditional hospital setting if someone should come to an emergency room for Asthma, they’re simply treated and released. He explained that there is no incentive for that hospital to be part of the comprehensive healing process for that patient, as they’re paid for their services each time the patient arrives for care. This system is aptly referred to as “buy and care.” In the traditional “buy and care” environment, a patient is treated by “health pieces.” However in the KP model, a system where members purchase a monthly package and not just “pieces,” no matter the extent of care KP is incentivized to look at the Asthma patient’s total care. “Team Care” reduces their need to come to the emergency room, while also lowering other risk factors in their health ecosystem so that the KP Member experiences more comprehensive care while reducing the need for hospital visits. Everyone wins — the patient’s overall health needs are addressed, while KP can simultaneously lower costs for that patient.
KP’s goal is to have a completely paperless system. Their mantra is “All/All/All” – Having available all the information, on all members, all the time (in real time). KP has spent $4 billion in health IT, stating that “computer-supported care is better care.”
The majority of costs that the health industry must address — up to 70% of all expenses — deal with managing patients who have chronic diseases. Let’s take a person with Type II Diabetes for example. If their wellbeing in terms of diet and exercise are addressed and encouraged then the critical path is abated. KP understands this, so they’ve come up with a “tool kit” for each patient. A team of physicians, clinicians and dieticians address the overall health of the Diabetic patient, from automatically mailing medications each month to reduce the need for remembering to going to the pharmacy (i.e. targeting medication adherence issues before it’s an issue), to text-based appointment reminders to reduce the rate of “no-shows,” to seeking out what the right path is to make it easy to do the right thing for each patient. Kaiser’s “HEAL” program addresses such chronic conditions to try and influence member behavior with “Healthy Eating and Active Living.” Did you know that if you’re overweight and you walk 30 minutes a day, you’re better off health wise then someone who is thin and doesn’t walk?
There’s no argument about it, KP’s success has much to do with their connectivity with their patients, and they’ve long been pioneers on this front. LONG before any health payer or provider was thinking of messaging to simple cell phones, KP was piloting text-based appointment reminders (over 3 ½ years ago) to “connect” with their members using a mode of communication they desire the most. I don’t know about you, but I’d prefer a text reminder over an IVR phone call that has me listen to a tree for responses any day.
KP keeps growing, and it’s no mystery why. JD Powers rated KP as the #1 health plan in America for service. Medicare just completed an analysis of 459 health plans and gave each a 1 to 5 star rating. Only 9 health plans were given 5 stars. Five KP regions grabbed five stars, and their lowest clinic received 4.5 stars. Let’s face it, KP is incentivized to reduce costs and increase the health of their members. They’ve cut the death rate of HIV patients in half compared to the rest of their healthcare competitors, and boast having the lowest death rate for a number of cancers because of their comprehensive care package. The #1 killer in hospitals, believe it or not, is sepsis. There exists a “golden hour” when sepsis occurs, and due to KPs response care team model, they race to the members’ bedsides to abate this deadly killer.
As I sat listening, a relief filled my being, recalling that my company’s health plan is a Kaiser health plan.