Kaiser Permanente and J.D. Power and Associates announced this month that four Kaiser Permanente regions rated the highest in customer satisfaction in the 2010 U.S. Member Health Insurance Plan Study. The Georgia Region was ranked 52 points higher than the average for the South Atlantic Region. Constantly, in study after study Kaiser Permanente is ranking #1 in quality of care while maintaining very competitive rates with their competition. Why has Kaiser Permanente experienced such success in the health care industry? Why are other health insurance carriers having a more and more difficult time competing with Kaiser Permanente?

In This System, It Pays to Keep You Healthy
The Kaiser Permanente Health Insurance Company with its integrated care model is becoming very difficult to compete with. The integrated model allows for high quality care at some of the most affordable rates available in the health insurance industry. This HMO integrated model makes it advantageous for the carrier to improve your health. HMO doctors benefit when their clients stay healthy. Not so with PPO doctors. With PPO models and those of most other health insurance carriers, it is to the advantage of the physicians for you to be sick, not for you to be well. The more doctor visits, surgeries and hospital stays you incur, the more money they make. With Kaiser’s integrated model, they make more money by keeping you healthy. They’d much rather keep you from needing the hospitalization or the surgery because it’s in their best interest (as well as yours).

Why You Can’t Email Your PPO Doctor
Recently a PPO doctor I spoke with raved about the Kaiser System. He pointed out that it’s hard to compete with Kaiser’s pricing and quality of care. Kaiser can save time and money by having doctors write emails to patients. “It makes sense to email your patients in the Kaiser model. We can’t do that in the PPO world,” he explained. “If we want to make money, we have to get them to come in for a doctor visit.” In the PPO world, there is a constant drive to give billable treatment, medical care that you can charge for whether or not it’s necessary.

Why Kaiser Permanente Is Years Ahead of Many Other Health Care Providers
Advances in medical science that increase health and decrease the need for expensive medical intervention are very appealing to Kaiser Permanente and not as appealing to physicians within the PPO realm. Kaiser doctors will not push you to get expensive surgeries or tests that aren’t needed. There is no need for duplicate tests in the Kaiser Permanente world. When you get labs, x-rays and other tests, your primary care physician and the specialists you see have access to those tests. Your specialist does not need to give duplicate tests that have already been done by your primary doctor. This saves you money and it saves Kaiser Permanente money. Ultimately, the HMO model of integrated care makes it advantageous for Kaiser Permanente to keep you healthy, to keep costs down, and to be constantly on top of the latest scientific advances in modern medicine.

The Power of Financial Incentive
Financial incentive drives PPO doctors to give you more and more unnecessary treatment, which increases costs to the health insurance carrier and ultimately increases the monthly premiums you pay without improving your health or advancing the quality of care dispensed. On the other hand, the financial incentives of the integrated HMO health insurance systems, drives Kaiser Permanente to stay cutting edge at all times on the latest research in the medical field and the latest advances in medical technology. Dispensing medical treatment is the business of the PPO doctors, while dispensing health is the business of Kaiser Permanente.

Posted: July 26th, 2010 under Kaiser Permanente.
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