Canadians Love Kaiser Permanente

Canada loves Molly Porter.  She gets invited to speak all across Canada, and for good reason.  Her enthusiasm for patient experience at Kaiser Permanente (KP)   shines through every time she speaks.

Canadians see Kaiser as the apotheosis of Medicare utopia.  We recognize similarities to our system and lust after great outcomes, but entirely overlook KP’s secret to greatness.

What We Love

• Uniform care pathways
• Uniform approach to preventative care
• Uniform IT system
• Community health programs
• Healthy living services
• Docs on competitive salaries
• Nurses and allied health workers unionized
• Generous pensions and benefits
• Peer review and a probationary period for new physicians
• MDs do not control office bookings – any clerk can book appointments

What We Lust For

• Smoking rates < nation average
• Over 10 national awards for service and excellence
• Less costly than competitors in many groups
• Lower malpractice rates
• No or short waits in Emergency Department
• Same day appointments
• Rated in top 6% of 484 comparator plans
• Shortest hospital length of stay (others are catching up)
• Outstanding IT functionality
• Patient online access to records
• “Care Anywhere; Care Anytime”

What We Overlook

• “Competition played a huge role in success…we almost went under in 1997-98.”
• While most patients have co-pays for face-to-face visits and for prescriptions, there are no co-pays for secure e-mail exchanges with providers and scheduled telephone visits.
• Physicians call the shots on medical care
• Physicians have parallel leadership corporation with own CEO (Permanente Medical Group)
• Physicians profit share
• Many unions have performance measures for group outcomes
• Care moves down to the least trained professional who can provide it safely
• Outcomes drive process…relentlessly devoted to patient outcomes, service and convenience
• Costs $53 billion for the services given to 9.3 million patients.  Ontario spends $50 billion serving 13.5 million patients, but with a different mix of services covered.
• Serves 3% of US population
• Pulled out of OHIO and Texas (losing money)

Canadian love Kaiser Permanente.  KP is cool.  It reminds us of ourselves, and Ms. Porter does an amazing job describing it.

Idealists ignore Kaiser’s secret to greatness.  Kaiser Permante’s radical devotion to patient experience defines their competitive advantage.

Kaiser must compete or die.  

Kaiser Permanente knows each operational decision risks the life of KP.  They must focus on patients.  Although Kaiser is nonprofit, it must have operational income to invest in its infrastructure and growth as it owns and runs most of its own delivery system.

Kaiser must succeed or close down.  They cannot raise taxes to cover deficits.  They cannot ignore patient satisfaction, ever.

Canadians can learn from KP.  But let’s look at the whole package instead of picking and choosing only the things that appeal to our Medicare sensibilities.

(Thank you, Molly, for reading this over and helping with the details!  Any remaining mistakes are entirely my own.)