Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
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| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 11,527,857 | 9,807,549 | 8,613,103 | 10,958,451 | 14,549,684 | 55,456,644 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 2,160,542,030 | 2,271,435,768 | 2,340,697,699 | 2,587,673,738 | 2,850,877,885 | 12,211,227,120 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | 2,172,069,887 | 2,281,243,317 | 2,349,310,802 | 2,598,632,189 | 2,865,427,569 | 12,266,683,764 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | 12,266,683,764 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 2,172,069,887 | 2,281,243,317 | 2,349,310,802 | 2,598,632,189 | 2,865,427,569 | 12,266,683,764 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 9,408,477 | 29,515,635 | 26,091,143 | 22,888,156 | 22,406,248 | 110,309,659 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 9,408,477 | 29,515,635 | 26,091,143 | 22,888,156 | 22,406,248 | 110,309,659 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 2,181,478,364 | 2,310,758,952 | 2,375,401,945 | 2,621,520,345 | 2,887,833,817 | 12,376,993,423 |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990, Part I, Line 7b | Net Unrelated Business Taxable Income from Form 990-T, Line 34 | TOTAL UBI (FORM 990-T, LINE 30) $28,216 NET OPERATING LOSS (NOL) APPLIED <$28,216> __________ UBTI WITH NOL (FORM 990-T, LINE 34) NONE |
| Form 990, Part VI, Line 4 | Changes to governing documents | On March 3, 2011, Article E., Officers, of the Bylaws of the Corporation was amended to (a) provide that the officers of the Corporation may include one or more Group Presidents (Section E-1, Officers); (b) add a new Section E-8, Group President and/or Regional President, to describe the duties and responsibilities of those positions; (c) provide that the President shall be the Chief Operating Officer of the Corporation (Section E-7, President); (d) provide clarification regarding leadership in the event of the absence or disability of the President (Section E-9, Executive or National Senior Vice President); and (e) change the reference to "the President" in Sections E-3, E-4 and E-11 to "any President". On June 23, 2011, minor technical amendments were made to the Bylaws of the Corporation to make them more consistent with the Bylaws of Kaiser Foundation Health Plan, Inc. and its Health Plan subsidiaries and with organizational policies and current law. None of the changes were significant; and On December 1, 2011, Article A, Purpose, of the Bylaws of the Corporation was amended to (a) more clearly state the purposes in one Purpose section (A-1, former section A-2 was deleted); (b) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office (Section A-3 Nonprofit Character - now A-2); (c) make a reference to the Internal Revenue Code consistent with other references in the Bylaws (Section A-4 Disposition of Assets on Liquidation or Dissolution - now A-3); and (d) be consistent with current legal standards (Section A-5 Non-discrimination - now A-4). |
| Form 990, Part VI, Line 6 | Members or Stockholders | KAISER FOUNDATION HEALTH PLAN, INC IS SOLE MEMBER Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization |
| Form 990, Part VI, Line 7a | Elect members of the governing body | Kaiser Foundation Health Plan, Inc (KFHP) appoints the Directors (and fills vacancies and has authority to remove Directors). The same 14 individuals who comprise the Board of Directors of KFHP also serve as the 14 Directors of KFHP Colorado, Ohio, Northwest and Mid-Atlantic States. |
| Form 990, Part VI, Line 7b | Member's approval | The following actions of the corporation require approval of the sole member: a. removal of the Chairman of the Board or the Regional President; b. amendment of Article D, Section D-4 of the Bylaws - Election and Term of Office of Directors |
| Form 990, Part VI, Line 11b | Review process | 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Community benefits details are presented to the community benefit committee of the board for review. 3. Executive compensation details are presented to the compensation committee of the board for review. 4. The complete tax return is reviewed and signed by a PRICEWATERHOUSECOOPERs LLC tax advisor. 5. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer. 6. The tax return is discussed with the full board of directors. A copy of the return is provided to each board member in electronic format prior to filing. |
| Form 990, Part VI, Line 12c | Compliance enforcement | Regularly and Consistently Monitors Compliance with the Conflicts of Interest Policy- Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance Office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. The Chief Compliance Officer and the SVP of Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required; In addition, Conflicts of Interest Questionnaire reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually; and, 3. Annually, as a component of the external audit, KPMG LLP reviews the Annual Conflicts of Interest Questionnaires process completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/ Hospitals Audit and Compliance Committee. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy- To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: A. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B. Kaiser Permanente informs employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. C. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: - Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem - Written notice, with or without final warning - Paid or unpaid suspension, with or without final warning - Termination of employment |
| Form 990, Part VI, Line 15a/b | Compensation determination | The executive compensation program is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization. |
| Form 990, Part VI, Line 19 | Public inspection | Governing documents - are available as provided to state Dept. of Insurance and maintained on state agency website or upon request. Conflict of Interest is available on KP website under vendor Principles of Responsibility or upon request. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with audit opinion by KPMG LLP and is available upon request. To request copies contact: Vice President - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Ste 15L Oakland, CA 94612 |
| Form 990, Part VII, Section A, Column B | Hours for related organization | Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated. |
| Form 990, Part XI, Line 5 | Other changes in net assets or fund balances | Change in Capital Stock <$ 100> Change in Unrealized Gain (Loss) 10,456,211 Change in Other Comprehensive Inc. <104,176,778> Gain/Loss on Investments - Tax < 4,087,094> Gain/Loss on Investments - Book 6,313,213 OTTI Loss < 6,478,675> Equity Transfer to KF Hospitals <180,492,431> ______________ Total Other Changes in Net Assets <$278,465,654> |
| Form 990, Part III, Line 4a-d | Exempt purpose achievements - Program services | 2011 COMMUNITY BENEFIT REPORT KAISER FOUNDATION HEALTH PLAN OF COLORADO Kaiser Foundation Health Plan of Colorado or "Colorado Health Plan" is a tax-exempt subsidiary health plan of Kaiser Foundation Health Plan, Inc. (KFHP). Colorado Health Plan, as well as Kaiser Foundation Hospitals (KFH) are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." In 2011, Colorado Health Plan served 532,801 members and has more than 5,378 full-time administrative, clerical and technical employees. Colorado Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis and fulfills its contractual obligations to group and individual members by contracting with KFH, and a Permanente Medical Group to provide the required health care services. Membership in KFHP and its health plan subsidiaries is available without regard to sex, race, religion, ethnic background, sexual orientation, occupational status, or income level. Health Plan members are broadly representative of the various ages, social, and income groups within the areas served. Once enrolled, a member is free to maintain membership regardless of age, health status, or employment. KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY Kaiser Permanente believes its Direct Community Benefit Investment (DCBI), is fundamental to being a nonprofit organization. It embodies the organization's commitment to improve the health of communities beyond services to Health Plan members. It is more than traditional corporate citizenship or corporate philanthropy. It is an intentional, planned, budgeted, measurable, accountable creation for better health in our communities. It is done in collaboration with, not in isolation from, the community. DCBI serves to fulfill Kaiser Permanente's social purpose, justify its tax-exempt status, and differentiate it from other health care organizations. This tradition of community benefit dates from the earliest days of the Program, when charitable care to non-employees, and later, nonmembers, was initiated. That heritage has continued through the years in Kaiser Permanente's early participation in publicly financed programs such as Medicaid and Medicare, establishment of residency training and medical research programs, and later, in the development of the Educational Theatre Programs, Safety Net Partnerships, Community Health Initiatives and the Charitable Health Coverage Program. In 2007, the KFHP/H Board of Directors refined the focus of the organization's Community Benefit Program and established the following four priority areas which have come to be known as "streams of work": - Care and Coverage for Low-Income People - Creates and supports programs that lower the financial barriers for the under- and uninsured. - Community Health Initiatives (CHI) - Seeks to measurably improve the health of the communities we serve. CHI takes Kaiser Permanente beyond the doctor's office to ensure the healthy choice is an easy choice in schools, neighborhoods, workplaces, and health care settings. Through funding, technical expertise and community engagement, we invest in prevention and evidence-based practices. Our public health interventions, community activism, and environmental and policy work are designed to transform community conditions that influence health. Our Healthy Eating Active Living focus is advanced through additional investments in: Active Transportation, Schools, Healthy Eating in Hard Times, and Community to Clinic Integration. - Safety Net Partnerships - Builds partnerships with community clinics, local health departments, and public hospitals. Provides funding, technical assistance, dissemination of care management and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. - Developing and Disseminating Knowledge - Improves health care by sharing our knowledge- educating practitioners, advancing research, empowering consumers and informing policymakers about the evidence base for care and health. The Board elaborated that at least 75% of total community benefit funding will be directed to program priorities within the four streams of work and the remaining 25% of funding will be directed by local regions to respond to local community benefit needs and opportunities that may or may not be within the four priority areas. THE COMMUNITY BENEFIT PROGRAM IN THE COLORADO REGION In 2011, Colorado Health Plan expended $88.7 million to support community benefit activities. A breakdown of the 2011 Community Benefit dollars attributable to the Health Plan in Colorado is included in Attachment A. The following identifies many of the signature community benefit programs and services, grouped according to the national streams of work funded by the Health Plan of Colorado. CARE AND COVERAGE FOR LOW-INCOME PEOPLE There are roughly 49 million people in America without access to health care or coverage. Uninsured, low-income individuals and families who are not eligible for public programs often have to rely on traditional charity care. Frequently, individuals in this situation may wait to seek medical care until their conditions become critical, and end up in hospital emergency rooms for treatment of conditions that are preventable or easily treated in earlier stages. In 2011, the Colorado Health Plan expended $52 million to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age, or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a KP facility or by a KP provider. Charitable Care (Medical Financial Assistance and Charitable Health Coverage) In the Colorado Region, Health Plan provides charity care to low-income vulnerable populations through two programs: Medical Financial Assistance and their charitable health coverage program - KPSTEP. In 2011, the Colorado Health Plan Region spent approximately $19.3 million making high quality health care affordable for low income residents in the region. - Medical Financial Assistance Program This program assists patients in need by subsidizing all or a portion of the Kaiser Permanent medical expenses. Eligibility is based on prescribed level of income, expenses and assets. This charity care program also includes discounted charges for uninsured patients below 400% of the federal poverty guidelines and contracted collection agency practices which align with Kaiser Permanente social values. In 2011, 5,253 patients benefited from the program. In addition, charity care is also provided through one of our partner hospitals (Exempla). KP physicians provide care in the emergency room, in surgery settings, as rounding hospitalists, and in various other medical settings on the Exempla campus. Any additional follow-up care is provided in Colorado Health Plan's medical offices. - KPStep Charitable Health Coverage (CHC) is a unique approach to caring for low-income uninsured persons in the community. Participants receive a regular Kaiser Permanente membership card and access to the full range of our service and providers-a much better alternative to a brief and costly emergency room visit or hospitalization. This allows us to invest in the longer term health of patients and the community. Since inception in the early 1980s, CHC programs have made a real difference in the lives of persons who might otherwise have no other source of care. In Colorado, KPStep is a charitable health coverage program that allows uninsured low-income patients access to health care via a subsidized insurance product. The program offers a 24 month membership with rich benefits, subsidized premiums and low co-payments. Participants must qualify by income and asset standards, and can not be eligible for any other government sponsored health care program or private group health care coverage. Based on income, the plan subsidizes up to 95% of their premium. Referrals to KPStep come from community partners and from Colorado Health Plan members losing their coverage. |
| Participation in Medicaid and Other Government-Sponsored Programs | The Colorado Health Plan provided coverage and services valued at $31 million (in excess of reimbursement) for individuals in government-sponsored programs. - Medicaid - As part of the State of Colorado Medicaid Program's Primary Care Physician Program, Colorado Health Plan provides primary and specialty care to Medicaid beneficiaries that select Kaiser Permanente as their primary care provider. Beneficiaries have access to both primary and specialty care in Health Plan facilities, as well as pharmacy and durable medical equipment benefits. Health Plan submits charges to the state for payment on a fee-for-service basis. Additional outside services provided are billed directly to the state. In 2011, Colorado Health Plan provided care and services to more than 11,441 beneficiaries. - Child Health Plan Plus (CHP+) - Colorado Health Plan participates in this program, serving 5,229 beneficiaries in a fully capitated HMO arrangement. CHP+ serves children under age 19. Eligibility includes proof of US citizenship or permanent residency, ineligibility for Medicaid or Medicare and lack of access to employer-sponsored insurance. COMMUNITY HEALTH INITIAVITES As an innovator in health, Kaiser Permanente designs, delivers and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods, workplaces, and schools to support good health, particularly Healthy Eating, Active Living (HEAL). The Colorado Health Plan spent $641,086 on community health initiatives during 2011. Community Health Education and Prevention Programs The Colorado Health Plan provides a variety of health education classes, events and programs for the general public. The health education department staffed booths at local health fairs, conducted smoking cessation, weight loss, parenting classes, and hosted a series of seminars on health-related topics, such as diabetes, stress management, and managing chronic illness. Expenditures in this category exclude program cost for health education programs targeting or restricted to Health Plan members. Grants and Donations for Community Health Initiatives While Colorado is among the leanest states, with 41.5 percent of adults being at a healthy weight, the prevalence of overweight and obesity in the state is rising in concert with national rates, putting a large portion of the population at risk for cardiovascular disease, diabetes, cancer, hypertension and asthma. In addition, the health-related economic cost of obesity to Americans is substantial - over $900 million annually in Colorado. Colorado has the second fastest increasing rate of child obesity ranking 23rd nationally. Kaiser Health Plan of Colorado, (KPCO) is a co-founder of LiveWell Colorado, a statewide non-profit organization, dedicated to obesity prevention, multi-sector policy efforts, social marketing and 22 coalition-based community initiatives. Since 2006, over 800,000 Colorado residents have been reached by LiveWell community strategies. Over 1,550 partners representing schools, health agencies, healthcare organizations, senior services and local businesses have adopted LiveWell strategies. To date, the LiveWell Colorado Community Initiative has invested in the following strategies: - Comprehensive community coalition building - Increasing active living through community walk ability and bike ability - Creating access to fresh, affordable and health food - Promoting worksite wellness - Promoting healthy schools - Working with healthcare settings to increase breastfeeding hospital practices and build provider skills in weight management SAFETY NET PARTNERSHIPS Through funding, technical assistance, public policy advocacy, training and volunteering, dissemination of care-management and quality improvement technologies, Kaiser Permanente helps these vital health care providers improve care and expand treatment capacity for the communities and vulnerable people they serve. Grants and Donations for Safety Net Partnerships The Colorado Health Plan's Safety Net initiative develops partnerships with existing community health clinics and organizations that provide low-cost or free medical resources for low-income patients in efforts to support their ability to provide quality health care to the medically underserved populations of Colorado. Through various program elements, KPCO enable its Safety Net partners to provide increased access to health care, improved quality of care to its patients, and helps to build the capacity of the Safety Net clinics and organizations. The goal of this Community Benefit initiative is to work toward achieving Kaiser Permanente's mission to improve the health status of the community in which we serve. A significant part of our Safety Net program is through knowledge translation (including education) and grant making of strategic initiatives to fill existing gaps in the community clinic system. DEVELOPING AND DISSEMINATING KNOWLEDGE kaiser Permanente aims to improve health care by sharing its knowledge, educating practitioners, advancing research, empowering consumers, and informing policymakers about the evidence base for care and health. The Colorado Health Plan spent $34.5 million to support programs and services for the development and dissemination of knowledge and provided grants and donations to nonprofit organizations. Clinical and Health Services Research In 2011, the Colorado Health Plan spent approximately $21.5 million to support Community Benefit focused clinical and health services research. Many of the research studies address current health issues and improve care for common conditions where treatment often is linked to community-based efforts, and are broadly disseminated through articles and professional presentations. The Kaiser Permanente Colorado Institute for Health Research (IHR) publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the communities we serve. IHR has a specific focus on conducting research that can be translated into clinical practice, health promotion, and policies to influence the health of individuals and populations. Currently, the IHR's 120-plus staff is working on more than 160 epidemiological and health services research projects. Now in its 16th year of operation, the IHR is responsible for many landmark findings. Teams of investigators continue to collaborate on major research projects with national partners including the Centers for Disease Control and Prevention Vaccine Safety Datalink, and federally funded research networks in cardiovascular disease, cancer, and medication use and safety. In 2011, IHR published approximately 90 studies in peer-reviewed journals. Following are a few examples of those studies: - Magid DJ, Ho PM, Olson KL, Brand DW, Welch LK, Snow KE, Lambert-Kerzner AC, Plomondon ME, Havranek EP. A Multimodal Blood Pressure Control Intervention in 3 Healthcare Systems. Am J Manag Care. 2011 Apr 1;17(4):e96-e103. PMID: 21657813 OBJECTIVE: To determine if a multimodal intervention composed of patient education, home blood pressure (BP) monitoring, BP measurement reporting to an interactive voice response (IVR) phone system, and clinical pharmacist follow-up improves BP control compared with usual care. STUDY DESIGN: Prospective study with patient enrollment, medication consultation and adjustment, remote BP monitoring, and follow-up at 6 months. METHODS: This randomized controlled trial was conducted at 3 healthcare systems in Denver, Colorado, including a large health maintenance organization, a Veterans Affairs medical center, and a county hospital. At each site, patients with uncontrolled BP were randomized to the multimodal intervention vs usual care for 6 months, with the primary end point of BP reduction. RESULTS: Of 338 patients randomized, 283 (84%) completed the study, including 138 intervention patients and 145 usual care patients. Baseline BP was higher in the intervention group vs the usual care group (150.5/89.4 vs 143.8/85.3 mm Hg). At 6 months, BPs were similar in the intervention group vs the usual care group (137.4 vs 136.7 mm Hg, P = .85 for systolic; 82.9 vs 81.1 mm Hg, P = .14 for diastolic). However, BP reductions were greater in the intervention group vs the usual care group (-13.1 vs -7.1 mm Hg, P = .006 for systolic; -6.5 vs -4.2 mm Hg, P = .07 for diastolic). Adherence to medications was similar between the 2 groups, but intervention patients had a greater increase in medication regimen intensity. | |
| . | CONCLUSIONS: A multimodal intervention of patient education, home BP monitoring, BP measurement reporting to an IVR system, and clinical pharmacist follow-up achieved greater reductions in BP compared with usual care. - Bayliss EA, Bhardwaja B, Ross C, Beck A, Lanese, DM. Multidisciplinary Team Care May Slow the Rate of Decline in Renal Function. Clin J Am Soc Nephrol. 2011 Apr;6(4):704-10. PMID: 21273376. OBJECTIVE: A multidisciplinary team (MDT) approach to chronic kidney disease (CKD) may help optimize care of CKD and comorbidities. We implemented an MDT quality improvement project for persons with stage 3 CKD and comorbid diabetes and/or hypertension. Our objective was to decrease the rate of decline of GFR. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used a 4-year historical cohort to compare 1769 persons referred for usual nephrology care versus 233 referred for MDT care within an integrated, not-for-profit Health Maintenance Organization (HMO). Usual care consisted of referral to an outside nephrologist. The MDT consisted of an HMO-based nephrologist, pharmacy specialist, diabetes educator, dietitian, social worker, and nephrology nurse. Both groups received usual primary care. The primary outcome was rate of decline of GFR. Secondary outcomes were LDL, hemoglobin A1c, and BP. RESULTS: In multivariate repeated-measures analyses, MDT care was associated with a mean annual decline in GFR of 1.2 versus 2.5 ml/min per 1.73 m2 for usual care. In stratified analyses, the significant difference in GFR decline persisted only in those who completed their referrals. There were no differences in the secondary outcomes between groups. CONCLUSIONS: In this integrated care setting, MDT care resulted in a slower decline in GFR than usual care. This occurred despite a lack of significant differences for secondary disease-specific measures, suggesting that other differences in the MDT population or care process accounted for the slower decline in GFR in the MDT group. Tumor Board and Cancer Registry Colorado Health Plan collects specific cancer patient data to be sent to the state at particular intervals after diagnosis. Each patient is followed on an annual basis for the remainder of his or her life. Educational Theatre Programs The Colorado Health Plan spent approximately $1.7 million in 2011 to produce the Educational Theatre Programs (ETP) in Colorado. Since 1985, ETP has provided free, award-winning, health education programs reaching almost three million people in Colorado. In 2011, the Colorado ETP program touched approximately 147 thousand people. Following are highlights of the various program offerings: - Choose Your Life - A bullying prevention play for upper elementary students based on the evidence based Olweus bully proofing program that promotes a caring school climate. - Amazing Food Detective - An interactive theatre program for elementary students that delivers four key nutrition and activity messages and supports the HEAL community health initiative. - Teens Take It On - A youth engagement program that involves high school students as peer educators and advocates for health. Teens work in partnership with adults, school districts and community organizations to address health issues. The issues addressed align with community benefit focus areas and initiatives. - It's Your Health - A fun, fast educational game that promotes healthy eating and active living. The game is used to activate Kaiser Permanente sponsorships and engage people at community events. - Educational Theatre Internship Program - Students from Metropolitan State College serve as interns and tour two days a week presenting Health Team Four, a play that delivers HEAL messages to upper elementary students. - Situational Communications - A positive communication skills workshop for families of teens and adolescents to improve family relationships. - Laugheceuticals -Laughter as Wellness. An interactive workshop engaging participants in activities that promote interaction, positive communication and highlight the health benefits of laughter. - Care Equity Project - A collaborative effort involving the Kaiser Permanente Safety Net team, ETP and other community and KP partners. The project provides awareness building and education to assist community providers and Kaiser Permanente staff and physicians in caring for low income patients. The project offerings include a theatre piece called Loose Change, as well as 4 Care Equity Workshops. Continuing Medical Education Continuing Medical Education (CME) provides physicians with the tools to continue to educate themselves about new, innovative practices, better ways to care for patients and more. In 2011, the Colorado region provided 696 credit hours to physician education. An example of community-based CME courses offered is - In 2011, 8 accredited course hours were provided to safety net physicians to learn about the importance of providing the medication bundle A-L-L (aspirin, lipid lower medication and a statin) to patients at risk for heart events. This medication bundle is proven to reduce heart events for at-risk patients by over 50%. Graduate Medical Education Colorado Health Plan spent approximately $7.9 million to support the graduate medical education of 100+ residents in collaboration with the University of Colorado. The program runs two tracks, From January through June, residents rotate through preventive medicine, urology, and otolaryngology. From July through December, residents rotate through urology and otolaryngology. Nurse Practitioner and Other Non-Physician Training Programs Colorado Health Plan spent approximately $1.8 million in training programs for physician assistants, pharmacy residents, technicians, and other non-physician health professionals. During 2011, the Health Plan supported the training and education of students, interns and externs pursuing a career, or working in, the health care field including preceptorships, clinical internships nursing students and rotations with Permanente physicians for physician assistants from Red Rock Community College. Several programs are described below. Nurse Precepting - Colorado Health Plan offers nurses the opportunity for preceptorship in primarily outpatient settings. Nearly 300 community nurses participate in this program annually. Pharmacy Programs supported by Colorado Health Plan Pharmacy Student Advanced Experiential Program - Experiential unpaid training opportunities exist for Pharmacy students, in their last/fourth year of pharmacy school, from Colorado and other states. Students spend time at each of the medical offices in the Colorado region in a variety of outpatient, operational, clinical and specialty areas within pharmacy services. These rotations are generally 4-6 weeks in length and are full-time (160-240 hours per externship). Students are able to have "hands-on" learning in the provision of care to our members. Pharmacy Student Introductory Experiential Program - Experiential unpaid training opportunities exist for Pharmacy students in their 2nd or 3rd year of training from Colorado and other states. Students spend time in outpatient pharmacies, or may spend time in specialty areas, to gain early experience in pharmacy services. These experiences vary between 9 to 72 hours per semester and serve the purpose of getting students early exposure, as well as possibly sparking interest in Kaiser Permanente as a future site of training and employment. Pharmacy Intern Program - Interns are pharmacy students in various stages of pharmacy school who desire to acquire "hands on" training. Interns at KPCO have a paid, structured learning experience that involves set objectives and experiences, and incorporates organized learning sessions. Interns generally work 8-12 hours per week during school and full time during the summer in the outpatient pharmacies. The "Clinical Intern" program allows a certain number of existing outpatient interns to work in Clinical Pharmacy Services, in order to broaden their exposure to all aspects of the Pharmacy Department. Pharmacy Resident Program - KPCO Health Plan offers a unique Post Graduate Year Two (PGY2) residency training program that provides the opportunity to acquire advanced knowledge and skill in ambulatory care pharmacotherapy in a managed care environment. Residents gain an understanding of managed care pharmacy practice; a practice which balances between evaluating outcomes, managing systems and providing pharmaceutical care to individual patients. Residents are paid employees, but the teaching of residents is on voluntary staff time. | |
| . | Kent M. Nelson Scholarship Program - was created to cultivate student interest in careers in clinical pharmacy. The scholarship winners are awarded monetary assistance as well as a structured program (shadowing opportunities, mentoring sessions, paid research opportunities) with the clinical pharmacy services leadership at KPCO. Pharmacy Technician Training Program - The pharmacy department continues to establish positive relationships with schools and colleges that provide training programs for pharmacy technicians. We are pleased to offer our unique resources as clinical extern sites for technician externs. The pharmacy offers unpaid experiential training opportunities to students enrolled in a pharmacy technician program. Students may complete up to 160 hours of experiential training after finishing their didactic course work. Students partner with a current Kaiser Permanente pharmacy technician to learn all aspects of the job. Various Externships, Internships, and Clinical Rotations/Clinical Internships supported by Colorado Health Plan NURSE PRACTITIONER: KPCO recognizes the growing need to train nurse practitioners as the demand for more primary care providers grows rapidly in Colorado and in the nation. We are pleased to support four very strong nurse practitioner programs including University of Colorado-Denver, University of Northern Colorado, University of Colorado-Colorado Springs Beth El, and Regis University. Students from these prestigious universities work with our talented providers and our state-of-the-art computer systems and equipment to gain knowledge and expertise in their chosen field of advanced practice nursing. In 2013, nurse practitioners will be required to have doctorates and will require more clinical rotation time. Therefore, Kaiser Permanente will continue to be a clinical site for these very important mid-level providers. LABORATORY: The Clinical Laboratory departments at KPCO continue to establish robust relationships with colleges, universities and institutes to promote the laboratory professions and to offer our resources as clinical intern sites for students. We have formed strong partnerships with Arapahoe Community College's Medical Laboratory Technician program and the Medical Technologist Program at the Center for Medical Laboratory Science at Presbyterian/St. Luke's Hospital. These programs have proven to be very successful and will create a much-needed pipeline of possible laboratory technicians/technologists in the future. Kaiser Permanente continues to donate time and equipment to keep these programs running. RADIOLOGY: The multiple Radiology department locations at KPCO also continue to establish very robust relationships with colleges, universities and institutes to promote the radiology professions and to offer our resources as clinical intern sites for students. One example of this partnering is the new Red Rocks Community College Diagnostic Medical Sonographer and Cardiac Diagnostic Medical Sonographer programs, which have been identified as a very difficult-to-fill radiology positions. All of the radiology programs are very successful and Kaiser Permanente Radiology Departments will continue to donate time and equipment to keep these programs running. SOCIAL WORK: The Palliative Care and Oncology Departments at KPCO continue to establish positive relationships with colleges and universities that provide graduate-level programs in Social Work. One example is our partnership with the prestigious University of Denver Graduate School of Social Work. We are pleased to offer our unique resources as clinical intern sites for these students. BEHAVIORAL HEALTH: According to Colorado Workforce development reports, the need for more mental health providers is growing steadily as the population grows. Kaiser Permanente Behavioral Health Department welcomes students from the University of Denver's Counseling Psychology/Couple & Family program. These masters and doctoral students serve nine-month to one-year internships at a Behavioral Health facility. Kaiser Permanente will continue to provide opportunities for these counseling students and will extend the program to include students from the University of Colorado Denver program as well. Grants and Donations for Knowledge Dissemination The Colorado Health Plan donated approximately $32,700 charitable contributions to nonprofit organizations for the dissemination of evidence-based studies, which informed the community about health care public policy and educational opportunities for individuals seeking a career as a health care provider. OTHER COMMUNITY BENEFITS The Colorado Health Plan spent approximately $1.3 million on other community benefit activities and programs beyond the national streams of work. Self-Sufficiency Programs The Colorado Health Plan spent approximately $185,000 to support 25 Undergraduate Pre-Health interns in 2011. Undergraduate Pre-Health Program (UPP): University of Colorado Denver - Anschutz Medical Campus & Kaiser Permanente KP employs 20 interns annually in the form of summer internships and supplemental education for undergraduate students interested in pursuing the health care professions of medicine, nursing, pharmacy & research. The 13-month program offers paid internships for the summer, education, training, and research experiences, and exposure to cadaver and simulation labs. Interns also attend Saturday Academies throughout the school year that included an array of topics from practicing interview skills, to writing personal statements required for application to the professional schools, and engaging in activities that focus on health disparities. Arrup Jesuit High School KP employs 6 college work study program students annually. (Arrup is a college prep school and corporate work-study program that serves underprivileged students of color.) - The corporate work-study program provides students with real world job experiences and exposure to careers while allowing them to earn 70% of their school tuition, which is an integral part of their educational experience and requires that the students are committed to high standards of responsibility and behavior. Other Grants and Donations Colorado Health Plan donated more than $169,491 to nonprofit organizations to address other community benefits beyond the national streams of work. - Denver Botanic Gardens Healthy Environments: Community Supporting Agriculture (CSA) $508,848 over three years Year 2 Summary: Impressive increases in produce grown (10,400 to 45,009 pounds), volunteer engagement (1,015 to 1,683 hours), donations of produce to local nonprofits (34 organizations for 4,188 pounds of produce), and total member "shares" sold (55 to 145). Year 2 additions include two acres of farming, nine crops grown, 25 varieties grown, two CSA internships, a Farm Camp, and four new revenue sources. Finally, project staff have provided significant technical assistance to national and local agencies about the business and technical model of a CSA. A number of additional community organizations were funded in 2011 through grants made to the Denver Foundation. The following are examples: - Health Access Pueblo Health Access: Community share of a multi-share health insurance program $50,000 in 2011 Summary: KPCO funding helped provide accessible health care to 131 working but uninsured individuals in Pueblo County. Health Access Pueblo now has 226 individuals in the plan and serves 69 employee groups. This is a three share (employer, employee, and community share) health coverage model for Pueblo's working uninsured that do not qualify for other insurance programs. - Hunger Free Colorado Healthy Environments: The Hunger Free Hotline $150,000 over two years Year 1 Summary: The comprehensive bilingual, statewide Hunger Free Hotline helps connect families to needed nutrition assistance programs and emergency food resources. The Hotline received an average of 40 calls per day. Referrals included: 4,846 households for a total of 13,090 individuals; 4,201 to food pantries; 3,988 to SNAP; 1,871 to child nutrition programs; 1,327 to soup kitchens, 609 to commodities; 220 to congregate feeding services; 98 to Meal on Wheels; and, 24 to mobile food services. | |
| . | - The Partnership for Families and Children, $5000 Support for a national conference called School Success: Best Practices in Attendance, Attachment, and Achievement on October 26th-28th, 2011 at the Omni Hotel in Broomfield. The conference which reached 500-600 participants increased knowledge of school professionals with best practice tools in : Bully prevention and intervention Prevention truancy and dropout Reduce elementary school absences Align policy and best practices Implement early warning systems Create engaging school climate Engage parents Create effective school partnerships Regional Community Benefit Operations The Colorado Health Plan has a dedicated Community Benefit Department with 32 full time employees to support regional community benefit programs and services and coordinate CB initiatives. VOLUNTEERISM Our volunteer mission is to serve the community in ways that improve the health of our members and the communities we serve and to work with nonprofit organizations when there is an existing business partnership and mission alignment. We accomplished this mission in 2011 with 1,387 employees engaged in volunteer projects. Here are some of the community partners that we worked with: Jeffco Action Center, Bessie's Hope, Boys & Girls Clubs, Habitat for Humanity, Food Bank of the Rockies, Hunger Free Colorado, MLK Jr Early College, Project C.U.R.E., Visiting Nurses Association, Marion House Soup Kitchen, Family Tree - House of Hope, Metro Community Provider Network, The Bike Depot, Urban Peak, Junior Achievement, Denver Urban Gardens, Goodwill Inc., Community Supported Agriculture (Denver Botanic Gardens), Veterans Associations. | |
| . | ATTACHMENT A 2011 COMMUNITY BENEFIT INVESTMENT - COLORADO REGION The following chart summarizes 2011 Community Benefit investments by the Colorado Health Plan. The investments in the community reflected in the chart are unaudited. REGIONAL HEALTH PLAN TOTAL CARE AND COVERAGE Charitable Care and Coverage Programs $19,260,454 Government-Sponsored Programs 31,046,268 Care & Coverage CB Operations 1,613,282 Subtotal: $51,920,004 COMMUNITY HEALTH INITIATIVES Community Health Education $322,314 Community Health Initiatives CB Operations 318,772 Subtotal: $641,086 SAFETY NET PARTNERSHIPS Grants & Donations for Safety Net Partnerships $98,810 Safety Net CB Operations 218,059 Subtotal: $316,869 KNOWLEDGE DISSEMINATION Medical Research $22,207,360 Educational Theatre Program 1,679,861 Health Care Training and Education Programs 9,860,379 Grants & Donations for Knowledge Dissemination 32,700 Knowledge Dissemination CB operations 709,393 Subtotal: $34,489,693 OTHER COMMUNITY BENEFITS Self Sufficiency Programs $185,435 Grants/Donations for other community benefits 169,491 other CB Operations 933,725 Subtotal: $1,288,651 TOTAL $88,656,303 | |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Christine Cassel TITLE:Director HOURS:7 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Thomas Chapman TITLE:Director HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Daniel P. garcia TITLE:SVP, Chief Compliance Officer HOURS:48 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:William Graber TITLE:Director HOURS:7 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Eugene Grisby III TITLE:Director HOURS:7 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:George C. Halvorson TITLE:Chairman and CEO HOURS:45 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Judith Johansen TITLE:Director HOURS:6 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Kim J. Kaiser TITLE:Director HOURS:8 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Philip Marineau TITLE:Director HOURS:6 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Jenny Ming TITLE:Director HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Edward Pei TITLE:Director HOURS:8 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:J. Neal Purcell TITLE:Director HOURS:9 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Cynthia Telles TITLE:Director HOURS:7 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:meg porfido TITLE:director HOURS:6 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Sandra Thompkins TITLE:Director HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Mitchell S.Cohen TITLE:Region Liaison HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Kathryn Lancaster TITLE:EVP & CFO HOURS:46 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Donna Lynne TITLE:Region President Colorado HOURS:32 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Thomas R. Meier TITLE:SVP, Corporate Treasurer HOURS:47 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Donald H. Orndoff TITLE:SVP, NFS HOURS:45 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROCHELLE M. Roth TITLE:SENIOR DIRECTOR,QRM HOURS:45 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Arthur M. Southam TITLE:EVP, Health Plan Operations HOURS:45 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Deborah Stokes TITLE:SVP, Controller & Chief Accoun HOURS:46 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Bernard J. Tyson TITLE:President & COO HOURS:45 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Victoria B. Zatkin TITLE:VP, Off of Brd & Corp Gov Svcs HOURS:46 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Mark S. Zemelman TITLE:SVP, Gen Counsel & Secretary HOURS:47 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Keith J. Evans TITLE:VP, MSBD - CO HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Jeffrey L. Hahn TITLE:Dir Sales & Acct Mgt HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Anne E. McDow TITLE:VP, Health Plan Admin - CO HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:James Newsome TITLE:VP, CFO - CO HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Nancy L. Wollen TITLE:SVP, Operations HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Jean L. Barker TITLE:Market & Prod Strategy Dir HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Richard Roland Lyon TITLE:VP, Region Strategy Performanc HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Virginia M. McLain TITLE:VP, Primary Care & Med Special HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Robin Sadler TITLE:VP, HR - Colorado HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:John K. Warren TITLE:Sr Sales Director HOURS:20 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Steven R. Zatkin TITLE:consultant HOURS: |
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