In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers on a prepaid basis. The US Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status.
Kaiser Permanente is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. 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 2023, Kaiser Permanente operates in eight states and the District of Columbia, and is the largest managed care organization in the United States.
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.
Seattle is the largest city in the U.S. state of Washington and has several large medical facilities and institutions that serve the Pacific Northwest region. The University of Washington is consistently ranked among the country's leading institutions in medical research and manages the UW Medicine system, which owns and operates Harborview Medical Center, University of Washington Medical Center, and Northwest Hospital & Medical Center. Harborview is the only Level I trauma center in the Pacific Northwest and serves patients with traumatic injuries from the states of Washington, Alaska, Idaho, and Montana.
Geisinger Health System (GHS) is a regional health care provider to central, south-central and northeastern Pennsylvania. Headquartered in Danville, Pennsylvania, Geisinger services over 3 million patients in 45 counties.
The Vaccine Safety Datalink Project (VSD) was established in 1990 by the United States Centers for Disease Control and Prevention (CDC) to study the adverse effects of vaccines.
KFF, which was formerly known as The Kaiser Family Foundation or The Henry J. Kaiser Family Foundation, is an American non-profit organization, headquartered in San Francisco, California. It prefers KFF, which is its business operating name, to reduce confusion because it is not affiliated with Kaiser Permanente and it is no longer a foundation. KFF states that it is a non-partisan organization focused on health policy. It conducts its own research, polling, journalism, and specialized public health information campaigns. and its website has been heralded for having the "most up-to-date and accurate information on health policy" and as a "must-read for healthcare devotees."
Sidney R. Garfield was an American medical doctor and a pioneer of health maintenance organizations. He co-founded the Kaiser Permanente healthcare system with businessman Henry J. Kaiser. He graduated from the University of Iowa College of Medicine in 1928, which is now called the Roy J. and Lucille A. Carver College of Medicine.
The Kaiser Richmond Field Hospital was the first Kaiser Permanente Hospital and is a historic site resource of the city of Richmond, California, and a contributing property to Rosie the Riveter/World War II Home Front National Historical Park, listed on the National Register of Historic Places. The hospital provided health services for surrounding communities until 1995 when it was replaced by the then state-of-the-art Richmond Medical Center in downtown Richmond. The field hospital is now closed and remains in its original location in South Richmond along Cutting Boulevard.
Walter Charles Crowley was an American historian and activist from Washington state. He first entered the public sphere in Seattle through his involvement with the social and political movements of the 1960s, especially the underground press. He later became more widely known as a local television personality and for his pioneering work as a local historian, including co-creating the website HistoryLink.org, which he considered to be his crowning achievement.
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.
An integrated delivery system (IDS), also known as integrated delivery network (IDN), is a health system with a goal of logical integration of the delivery (provision) of health care as opposed to a fragmented system or a disorganized lack of system.
Paul Murdock Ellwood Jr. was an American physician and a controversial figure in American health care. Often referred to as the "father of the health maintenance organization", he not only coined the term, he also played a role in bringing about structural changes to the American health care system to simultaneously control cost and promote health by replacing fee-for-service with prepaid, comprehensive care. The term "HMO" was coined by Ellwood in a January 1970 Fortune magazine article. More recently, he had advanced an agenda for monitoring health outcomes, so that patients, providers, and payers can make health care decisions based on real information about what treatments and providers are actually effective.
Kaiser Oakland Medical Center is a hospital in Oakland, California. It is located at the intersection of Broadway and West MacArthur Boulevard, immediately north of Downtown. It is the flagship hospital of Kaiser Permanente, the largest managed care organization in the United States, through its Kaiser Foundation Hospitals division.
This article summarizes healthcare in California.
Richard N.W. Wohns is a neurosurgeon who is the founder and president of NeoSpine, LLC. He has been listed one of the 50 Spine Surgeons and Specialists to Know by Becker's ASC Review. He currently practices and teaches medicine in the Puget Sound Region of Washington, United States.
Donna Lynne is the chief executive officer of Denver Health. She was the senior vice president and chief operating officer of Columbia University Irving Medical Center before joining Denver Health in September 2022. Lynne is a member of the Democratic Party who served as the 49th Lieutenant Governor of Colorado, from 2016 to 2019. She also served in a dual capacity as the chief operating officer of the State of Colorado. She was appointed to the position by Colorado governor John Hickenlooper on March 23, 2016, and was confirmed by the Colorado House of Representatives and the state Senate on May 4, 2016. Lynne replaced the outgoing lieutenant governor, Joseph A. Garcia. Prior to her appointment, Lynne was an executive with Kaiser Permanente.
Learning health systems (LHS) are health and healthcare systems in which knowledge generation processes are embedded in daily practice to improve individual and population health. At its most fundamental level, a learning health system applies a conceptual approach wherein science, informatics, incentives, and culture are aligned to support continuous improvement, innovation, and equity, and seamlessly embed knowledge and best practices into care delivery
The Kaiser Permanente Bernard J. Tyson School of Medicine is a medical school associated with the Kaiser Permanente health system and located in Pasadena, California. The school matriculated its inaugural class of 50 students in July 2020. In November 2019, the school was renamed in honor of late Kaiser Permanente Chairman and CEO Bernard J. Tyson.
