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.
The SEIU United Healthcare Workers West (SEIU-UHW) is a statewide local union of the Service Employees International Union in California in the United States. In 2020, it had 97,000 members, down from nearly 150,000 in 2013.
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.
Kaiser Richmond Medical Center is a large Kaiser Permanente hospital in downtown Richmond, California which serves 77,000 members registered under its medical plans. It opened in 1995 replacing the historic 1942 Richmond Field Hospital that serviced Liberty shipyard workers and thus gave birth to the HMO. However it was deemed seismically unsafe and this new campus was built.
John Muir Health is a hospital network headquartered in Walnut Creek, California and serving Contra Costa County, California and surrounding communities. It was formed in 1997 from the merger of John Muir Medical Center and Mount Diablo Medical Center.
The Priscilla Chan and MarkZuckerberg San Francisco General Hospital and Trauma Center (ZSFG) is a public hospital in San Francisco, California, under the purview of the city's Department of Public Health. It serves as the only Level I trauma center for the 1.5 million residents of San Francisco and northern San Mateo County. It is the largest acute inpatient and rehabilitation hospital for psychiatric patients in the city. Additionally, it is the only acute hospital in San Francisco that provides 24-hour psychiatric emergency services.
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.
Healthy San Francisco is a health access program launched in 2007 to subsidize medical care for uninsured residents of San Francisco, California. The program's stated objective is to bring universal health care to the city. Healthy San Francisco is not a true insurance program, as it does not cover services such as dental and vision care, and only covers services received in the city and county of San Francisco. The program itself acknowledges its limitations, and has stated that "insurance is always a better choice." Healthy San Francisco represents the first time a local government has attempted to provide health insurance for all of its constituents. The program is open to low-income city residents over the age of 18 who do not qualify for other public coverage, and who have had no insurance for at least 90 days. Eligibility is not conditional on citizenship, immigration, employment or health status. The program covers a range of services, but only pays providers within San Francisco. By July 2010, almost 90% of the uninsured adults in San Francisco — over 50,000 people — had enrolled in Healthy San Francisco.
Santa Clara Valley Medical Center, commonly known as Valley Medical Center or simply Valley Medical, is a prominent 731-bed public tertiary, teaching, and research hospital in San Jose, California. Located in the Fruitdale neighborhood of West San Jose, Valley Medical Center is the anchor facility of the Santa Clara County Health System, serving Santa Clara County. Valley Medical is home to numerous innovative research and care centers, such as the Rehabilitation Trauma Center, the only federally-designated spinal cord injury center in Northern California.
Kaiser Westside Medical Center is a hospital in the Tanasbourne neighborhood in Hillsboro in the U.S. state of Oregon. Opened in August 2013 with 126 hospital beds, the Kaiser Permanente facility is planned to later expand to 174 beds. It was designed by Ellerbe Becket Architects and Petersen Kolberg & Associates Architects/Planners. The $220 million hospital includes Kaiser's Sunset Medical Office that opened in 1987 on the west side of the Portland metropolitan area.
Kaiser Sunnyside Medical Center is a not-for-profit, general care hospital in the Sunnyside area of Clackamas County in the U.S. state of Oregon. Opened in 1975, the Kaiser Permanente owned facility is licensed for 233 hospital beds. Located in the Portland metropolitan area along Interstate 205 on the eastside, after Bess Kaiser Hospital in north Portland closed, it was Kaiser's only hospital in the Portland area until Westside Medical Center opened in 2013. The hospital includes Clackamas County's only heart surgery facility.
Alameda Health System (AHS), formerly Alameda County Medical Center (ACMC), is an integrated public health care system organized as a public hospital authority.
St. Rose Hospital is an independent, non-profit hospital located in Hayward, California. It is a designated cardiac arrest receiving center in the Alameda County emergency medical services system, and provides basic emergency medical services.
Doctors Medical Center was an eight-story, 120-bed public hospital in San Pablo, California which served 250,000 residents in western Contra Costa County from 1954 to 2015.
Seton Medical Center is a 398-bed hospital owned by AHMC Healthcare. Founded in San Francisco, the current facility is located in Daly City, California, United States. It is the largest employer in Daly City and is credited in part with attracting the initial influx of Filipino immigrants to the city, which has the highest concentration of Filipinos in the U.S.
Bernard J. Tyson was an American health executive. He was the CEO of integrated managed care consortium Kaiser Permanente, the largest such organization in the United States, which provides health care to 12 million people.
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.
