The (Unapproved) Kaiser Permanente Health Insurance Blog

One man’s experience with Kaiser.   I have been a member of Kaiser for several years, so I decided to share my experiences (mostly good) and (some) bad about the company.  When many people whine about the company, they are really complaining about a specific Doctor.  It’s just that the Dr. happens to work for Kaiser.  Sometimes young, sometime foreign.  There around truth in some stereotypes, or they would not continue to be around, right?

Also some Doctors at Kaiser have less than a great bedside manner.  You get 15 minutes, they go over your condition and that’s it.  If you want to complain about some other health issue, many will urge you to make an appointment or refer you to a specialist.  That’s not rudeness, it’s efficient! If the Doctors took an hour per patient, premiums would go up 400%! Instead of complaining about the care, people would riot because of the price.  So there will be complaints, many legit.  But compare the size of Kaiser to the complaints.  There were only 7 complaints on the BBB for the San Diego Kaiser on Mt. Zion.

Legal law stuff: I am unauthorized and unsponsored by Kaiser Permanente.  I do not represent Kaiser or have client info or policy data.  Did I mention I am not in any way affiliated or connected to Kaiser?

Kaiser Permanente nearing launch of nationwide info exchange

Kaiser Permanente has implemented a secure health information exchange that is going to be expanded nationwide.  Kaiser Permanente and VA engaged in first Nationwide Health Information Network (NHIN) production exchange for treatment purposes on December 17th, 2009 in San Diego, CA.

Kaiser Permanente is nearing the launch of a nationwide information exchange, giving its 9 million members an opportunity to have their medical records shared over the Internet with public- and private-sector partners.  Kaiser’s membership includes about 500,000 veterans, who receive care at Kaiser facilities and Veterans Affairs Department hospitals.

The software that allows providers to view and extract medical record data uses the standards and specifications set by HHS. The data is encrypted, and patients have to give their consent before their health information is shared.

Kaiser Permanente adds 90,000 insureds to health plan

Details in the new health care law (aka Obamacare) meant to add people to insurance rolls appear to be working for Kaiser Permanente who added 90,000 insureds to their membership.  In the Affordable Care Act, young adults who are not full-time students can remain on their parents’ insurance plans until they are 26.

Adding young people to the number of insured customers is a big benefit to everyone else, because young people do not get sick as often or for as long a period as older customers. So insurance companies made record profits. Insurance regulators could use those record profits to deny rate hikes.

2,000 Kaiser Workers Strike

2,000 employees at Kaiser Permanente walked off Wednesday in a 1 day strike because of  nurse-to- patient ratios and health care benefits.  The strike was organized by the National Union of Health care Workers and centered around Kaiser Los Angeles Medical Center plus Kaiser’s South Bay Medical Center.

There was a rescheduling of some appointments  but Kaiser had sufficient employees to handle day appointments and emergencies.

Kaiser is negotiating with three bargaining units of the union that represents registered nurses, social workers, psychologists, speech pathologists, audiologists, health educators and dieticians throughout Southern California.

One of the issues workers are asking for solutions to is that patients must wait five to six weeks for a mental health appointment, and are limited to 30 minutes.  Mental health specialists want patients to get more counseling.  Patients should not have to wait 4-6 weeks for an appointment.

 

600,000 Young Adults Join Parents’ Health Plans Under New Law

By Phil Galewitz, KHN

Hundreds of thousands of young adults are taking advantage of the health care law provision that allows people under 26 to remain on their parents’ health plans, some of the nation’s largest insurers are reporting. That pace appears to be faster than the government expected.

WellPoint, the nation’s largest publicly traded health insurer with 34 million customers, said the dependent provision was responsible for adding 280,000 new members. That was about one third its total enrollment growth in the first three months of 2011.

Others large insurers said they have added tens of thousands of young adults. Aetna, for example, added fewer than 100,000; Kaiser Permanente, about 90,000; Highmark Inc., about 72,000, and Health Care Service Corp., about 82,000.

The Health and Human Services Department has estimated that about 1.2 million young adults would sign up for coverage in 2011. The early numbers from insurers show it could be much higher, said Aaron Smith, executive director of the Young Invincibles, a Washington-based nonprofit group that advocates for young adults.

Insurers described the growth in young-adult enrollment as the industry began reporting first-quarter earnings that showed better than expected profits. But Carl McDonald, an analyst for Citigroup, said that the higher profits weren’t related to the new young-adult enrollees. That’s because, he said, most of the increase in young people’s enrollment has occurred among self-insured employers; in those firms, insurers act as administrators and don’t not assume financial risk.

McDonald attributed most of insurers’ profit increases this year to their customers using fewer health services, especially hospital care.

Under the health law, health plans and employers must offer coverage to enrollees’ adult children until age 26 even if the young adult no longer lives with his or her parents, is not a dependent on a parent’s tax return, or is no longer a student.

The dependent coverage provision went into effect Sept. 23. However, health plans didn’t have to adopt the change until the start of the subsequent plan year, which for many companies was January. In addition, dozens of insurers voluntarily adopted the change earlier, soon after President Barack Obama signed the health overhaul law in March 2010.

That helped Alexander Lataille, 23, of Laurel, Md., who graduated from college last spring and was worried about being kicked off his parents’ plan. But Blue Cross and Blue Shield of Rhode Island adopted the under-26 provision early – and that kept him insured, even as he took jobs that didn’t offer insurance. “It was a big relief,” said Lataille, who has asthma.

But while federal officials and consumer advocates are pleased that demand for dependent coverage appears greater than projected, some employers are worried about the cost of the additional coverage.

Helen Darling, CEO of the National Business Group on Health, which represents more than 300 large employers, said employers generally don’t like the idea of anything that will add to their health costs. “I don’t think anyone is eager to spend more money,” Darling said. “This is not something employers would have done on their own.”

Darling questioned why employers should be required to cover adult children who no longer live with their parents and might be married themselves.

According to the federal estimates, adding young adult coverage is likely to increase average family premiums by about 1 percent.

People in their 20s have the highest uninsured rate of any age group—about 30 percent, federal data show. Two factors are largely behind this: Young adults are most likely to work for employers that don’t provide coverage and young adults don’t understand the need for health insurance.

Until 2014, health plans don’t have to provide dependent coverage if the adult child’s employer offers any type of health coverage.

The federal government added 280,000 people to its insurance rolls because of the dependent coverage, said a spokeswoman for the Office of Personnel Management.

Before the federal law was passed, many insurers dropped coverage of children either at age 18 or 21 or when the children graduated from college. More than half the states required coverage to continue until at least age 25, but those laws often had several restrictions.

Federal health officials say they are happy with the response to the law.

“We are pleased to see the embrace of this key provision of the Affordable Care Act,” said Jessica Santillo, spokeswoman for HHS. “Young adults are more than twice as likely to be uninsured than older adults, making it harder to get the health care they need, and putting them at risk of going into debt from high medical bills.”

Former Kaiser Doctor loses license for sexual battery

An Anaheim Hills doctor accused of sexually molesting patients during exams was stripped of his medical license Friday.

The California Medical Board revoked the license of Dr. David Hung Do, 40, after five female Kaiser Permanente patients alleged that he examined them inappropriately between 2006 and 2008.

In September, he pleaded not guilty to four counts of sexual battery. A pretrial hearing is set for May 3, according to the Orange County District Attorney’s office.

Medical board documents conclude that Do engaged in sexual misconduct with three of the patients.

In one case, a woman came to see him for a prescription for a seasickness patch. Do touched her breast and put his bare hand down her pants, touching her genitals. She testified at a medical board hearing that she was too shocked too say anything. Do then wrote her the prescription. The patient reported the incident to Kaiser.

He was terminated from Kaiser and later arrested by police.

In deciding to revoke his license, administrative law judge James Ahler described Do as a sexual predator.

Do’s attorney, John Barnett, could not be reached for comment late Friday.

S&P rates Kaiser Permanente, CA 2011 bonds ‘A+/A-1′

Standard & Poor’s Ratings Services assigned its ‘A+/A-1′ rating to the $204.5 million series 2011A, 2011B, 2011C, and 2011D bonds, issued by the California Health Facilities Financing Authority on behalf of Kaiser Permanente (Kaiser). At the same time, we affirmed our ‘A+/A-1′, ‘A+’, and ‘A-1′ ratings on Kaiser’s outstanding bonds (various issues). The outlook on all long-term ratings is stable. Management is considering a private placement for the 2011A, 2011B, 2011C, and 2011D series, which will be floating-rate notes; management reports that there are no cross-default provisions and no acceleration events. Kaiser is also planning to convert its 2002E bonds to variable-rate demand obligations backed by self-liquidity, its 2004I bonds to commercial paper, and its 2009E-1 and 2009E-2 bonds to short-term put bonds.

“The ‘A+’ long-term rating reflects our view of Kaiser’s solid and well-established market position, sound revenue increases, and ability to contain costs through its care management model and information technology,” said Standard & Poor’s credit analyst Geraldine Poon. “The ‘A-1′ short-term rating reflects our view of the ample liquidity and sufficiency of the assets available to support the full and timely purchase of any bonds tendered upon the event of a failed remarketing.”

The stable outlook reflects our view of Kaiser’s sound business position, relatively stable operating performance, and sound liquidity. We consider Kaiser’s credit fundamentals solid, and we expect consistent operating performance going forward. The outlook assumes that Kaiser will be able to fund its significant capital program from cash flow. The outlook also assumes maintenance of Kaiser’s solid market position, particularly in its core HMO market, as well as growth in new product offerings. We continue to monitor the system’s unfunded pension liability.

Pharmacists Could Strike At Kaiser Permanente

Southern California Kaiser Permanente pharmacists, represented by the Guild For Professional Pharmacists, have notified Kaiser Permanente of the Guild’s intention to strike, following a breakdown in contract negotiations.

The strike would affect over 100 pharmacies across southern California including several in the Coachella Valley. The strike would stop work on Thurday and Friday April 21st and 22nd.

One of the goals of the strike is to prove how important pharmacists are to the hospital. “Oh, very, very important,” said Kaiser member James Petersen. “In this environment here where we have a lot of seniors, everybody needs their pharmacy and it’s going to be a real inconvenience if there’s a prolonged strike.”

Although negotiations are still ongoing, some patients are already dealing with inconveniences. “They told me that I could pick up my prescription on Thursday, and they called me this morning and told me that it wouldn’t be ready until Monday,” said David Schmoll. “That’s not acceptable, this isn’t right.”

One of the major points of contention in the negotiations has to do with a cutting of benefits for pharmacists. “Basically cut in half, actually to a third of what they have now,” said Guild for Professional Pharamcists’ representative Cheryl Asperger. “And, they would be working alongside the other people in the Pharmacy and the hospital who actually have much better benefits and they want us to do this, for the next couple of years. We believe it’s extremely unfair.”

Kaiser Permanente Director of Media Relations Jim Anderson responded with this written statement:

“These pharmacists are valued members of our team. We will welcome them back to the job when their strike is concluded, will continue to reach a fair and equitable contract with them…While our outpatient pharmacies will be closed during this 48-hour work stoppage, we have contracted with Walgreens pharmacies, so that members who need a new or refilled prescription during the strike will be able to have their prescriptions filled.”

Kaiser Permanente opens at U.S. Capitol.

On Monday, Kaiser Permanente opened its Center for Total Health, located a couple blocks from the U.S. Capitol. The space, next to a new Kaiser medical facility, will serve as a conference and education center and a showcase for innovative health care technology.

President and CEO of the Mid-Atlantic Permanente Medical Group Robert Pearl told guests at a grand opening event that he wanted every schoolteacher, every city planner and every application developer who comes to Washington to visit the center. He said he wants them all to take part in the health care dialogue and help create solutions—whether it’s in the form of city walking paths or new mobile technology.

Among several large touch-screen exhibits designed by Brand New School (using Electrosonic screens), the centerpiece is an 80-foot-long touch-screen mural—one of the largest in the world—that builds on Kaiser’s Every Body Walk! campaign. The screen has several touch points during different periods of a day, with fast facts about walking, body part icons that show how we benefit from walking and ways people can incorporate walking into their daily lives.

The center, open to the public, has several stations that demonstrate new health technology prototypes (from Sprint, RIM, GE, Cisco and Philips) currently being piloted at Kaiser medical centers. Visitors can interact with the tablet, handheld and smart phone devices in areas such as telemedicine and facial recognition.

South LA welcomes new Kaiser Permanente Center

Elected officials, hospital administrators and health care activists are celebrating a new medical center in South Los Angeles.

Long-time Kaiser Permanente member Norris Byrd said she’s thrilled the non-profit medical group opened a facility that’s practically in her own backyard.

“We as a community needed this so much. We have longed to see this is in South LA,” she said.

Byrd is among 80,000 members in South L.A. that Kaiser says it intends to serve. The 15,000 square foot medical center is located on Manchester Avenue near Inglewood. The project cost $10 million.

LA Mayor Antonio Villaraigosa took a tour on Friday with other city officials and medical staffers.

“I actually believe that if America’s going to get to the point where every American has health care when we can truly say it’s a high quality health care, this is the model,” said Villaraigosa. “It’s gotta be non-profit.”

The two-story, eco-friendly building includes a pharmacy, examination rooms and offices. The lobby displays a glass etching dedicated to the late Dr. Fred Alexander — Kaiser’s first African-American medical director. Colleagues say he was a strong advocate for diversity within the medical profession.

Dr. Tumani Leatherwood, head physician at the new medical offices, says her team will work to preserve Dr. Alexander’s legacy.

“I can tell you now that this staff has some goals,” Leatherwood said. “And one of their primary goals is to try to encourage more youth especially from this community to go into careers in health and come back and serve as leaders like we have.”

Kaiser Permanente South Los Angeles will provide primary care services including X-rays, prescriptions, mammograms and health classes. The center’s staff will begin seeing patients April 11.

Kaiser Permanente health plans highest in member satisfaction

Kaiser Permanente announced today that its members in four geographic regions rated the organization’s health plans highest in member satisfaction in the J.D. Power and Associates 2011 Member Health Insurance Plan Study(SM). The regions are California, Colorado, South Atlantic (Georgia), and Virginia-Maryland-Washington D.C. (Mid-Atlantic). In a fifth region, Kaiser Permanente in the Northwest, ranked second. These five regions serve more than 8.3 million of Kaiser Permanente’s more than 8.7 million members.

“We are very pleased to once again receive high marks in J.D. Power’s member satisfaction study for health plans. The results are particularly meaningful to us, since they are a measure of member satisfaction relative to all other health plans,” said Arthur M. Southam, MD, executive vice president, Health Plan Operations for Kaiser Permanente.

“Our integrated model puts our patients and members at the center of all that we do, which enables us to better coordinate and deliver high-quality health care, and be more engaged in supporting all aspects of our members’ total health,” Dr. Southam said.

Kaiser Permanente’s integrated approach to health care delivery provides access to services in-person, online and by phone. With easy-to-use, Web-based tools, all members have access to their personal health information in their secure medical record, as well as tools to communicate with their providers. My Health Manager on kp.org gives members the ability to perform important tasks online such as scheduling appointments and ordering prescription refills. Users also have 24/7 online access to lab test results, eligibility and benefits information, and even their children’s immunization records. In addition, all Kaiser Permanente physicians routinely use an electronic health record when caring for their patients in medical offices and hospitals.

Now in its fifth year, the J.D. Power and Associates 2011 Member Health Insurance Plan Study(SM) measures member satisfaction among 137 health plans in 17 regions throughout the United States by examining seven key factors that each represent a distinct part of the member experience and together encompass the relationship between the health plan and its member: coverage and benefits; provider choice; information and communication; claims processing; statements; customer service; and approval processes. The study reports on the results of nearly 34,000 members of commercial health plans, and was conducted online in December 2010 and January 2011.

Each health plan included in the J.D. Power and Associates 2011 Member Health Insurance Plan Study(SM) was measured on a scale of 1,000 points. Details of the results in each of the regions where Kaiser Permanente ranked highly are outlined below:

* California Region: Kaiser Permanente earned 751 points, 57 above the average score for this region. This is the fourth year that Kaiser Permanente has ranked highest in the California region.
* Colorado Region: Kaiser Permanente earned 703 points, 21 points above the average score for this region. This is the fourth year that Kaiser Permanente has ranked highest in the Colorado region.
* South Atlantic (Georgia) Region: Kaiser Permanente earned 747 points, 47 points above the average for this region. This is the second year that Kaiser Permanente has ranked highest in the South Atlantic region.
* Virginia-Maryland-Washington D.C. (Mid-Atlantic) Region: Kaiser Permanente earned 751 points, 54 points above the average for this region. This is the third year that Kaiser Permanente has ranked highest in the Virginia-Maryland-Washington D.C. region.
* Northwest Region: Kaiser Permanente ranks second and earned 737 points, 33 points above the average in the Northwest region.
* J.D. Power and Associates 2011 Member Health Insurance Plan Study(SM) did not include Kaiser Permanente’s Hawaii or Ohio regions in its research.