Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 10,958,451 | 14,549,684 | 16,404,939 | 15,721,147 | 6,768,197 | 64,402,418 |
| 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...... | 2,587,673,738 | 2,850,877,885 | 2,982,890,216 | 3,122,130,913 | 3,412,772,584 | 14,956,345,336 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 2,598,632,189 | 2,865,427,569 | 2,999,295,155 | 3,137,852,060 | 3,419,540,781 | 15,020,747,754 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support (Subtract line 7c from line 6.) | 15,020,747,754 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 2,598,632,189 | 2,865,427,569 | 2,999,295,155 | 3,137,852,060 | 3,419,540,781 | 15,020,747,754 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 22,888,156 | 22,406,248 | 28,842,528 | 42,455,192 | 47,679,687 | 164,271,811 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 22,888,156 | 22,406,248 | 28,842,528 | 42,455,192 | 47,679,687 | 164,271,811 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 2,621,520,345 | 2,887,833,817 | 3,028,137,683 | 3,180,307,252 | 3,467,220,468 | 15,185,019,565 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 6 | Members or Stockholders: KAISER FOUNDATION HEALTH PLAN, INC. IS THE 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 15 individuals who comprise the Board of Directors of KFHP also serve as the 15 Directors of KFHP Colorado, 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. The complete tax return is reviewed and signed by a PRICEWATERHOUSECOOPERs LLP tax advisor. 4. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer. 5. A copy of the return is provided to each board member prior to filing. |
| Form 990, PART VI, LINE 12C | Compliance enforcement: A. 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: a1. 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. a2. The National Compliance Office and 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, a3. 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. B. 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: b1. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. b2. 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. b3. 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 AND THE MANAGEMENT COMMITTEE ON COMPENSATION, PRIOR TO PAYMENT, ALL PROGRAMS AND PAYMENTS TO THE 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 TO BE COMPETITIVE TO 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 18 | Available on GuideStar.org website |
| Form 990, PART VI, LINE 19 | Public Inspection Copy: Governing documents - are available from the Department of Insurance and maintained on the 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 - Tax Services Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Suite 15L Oakland, CA 94612 |
| Form 990, PART VII, SECTION A, COLUMN B | Hours for related organizations: 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 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCES: CHANGE IN CAPITAL STOCK $ 11,484 CHANGE IN OTHER COMPREHENSIVE INCOME <164,349,191> GAIN/LOSS ON INVESTMENTS - TAX <1,116,986> GAIN/LOSS ON INVESTMENTS - BOOK 1,507,978 OTTI LOSSES - BOOK <5,617,705> payment TO AFFILIATE <30,000,000> -------------------------------------------------------------- TOTAL OTHER CHANGES IN NET ASSETS <199,564,421> |
| Form 990, PART III, LINE 4A-D | 2014 Community Benefit Report Kaiser Foundation Health Plan of Colorado Kaiser Foundation Health Plan of Colorado's Commitment to the Community Kaiser Foundation Health Plan of Colorado (Colorado Health Plan or KFHP-CO) provides and arranges comprehensive health care services for members on a predominantly prepaid basis. Its contractual obligations to group and individual members are fulfilled by contracting with local hospitals and Permanente Medical Group physicians to provide health care services for its members. KFHP-CO strives for excellence in serving its members through market-leading performance in quality and service. As a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP, Inc.), membership is available without regard to age, sex, race, religion, or national origin, or to the individual's ability to pay. Colorado Health Plan members are broadly representative of the communities served. Once enrolled, a member may maintain membership regardless of health or employment status. As related nonprofit organizations, Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Health Plan of Colorado are committed to improving the health of communities beyond enrolled membership. Annual investments in a range of Community Benefit programs are a fundamental embodiment of the organizations' ongoing commitment to improve the general wellbeing within the broader community. These investments result in intentional, planned, measurable, and accountable benefits intended to address many of the health challenges faced at the individual, local, state, and national levels. In 2007, Kaiser Foundation Health Plan Inc.'s board of directors refined the focus of the organizations' Community Benefit programs and established the following four priority areas which have come to be known as "Streams of Work": A. Care and Coverage for Low-Income People - Creates and supports programs that lower the financial barriers for the under- and uninsured. B. Community Health Initiatives (CHI) - Seeks to measurably improve the health of the communities we serve. Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. C. 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. D. Developing and Disseminating Knowledge - Improves health care by sharing our knowledge - educating practitioners, advancing research, empowering consumers, and informing policymakers about evidence-based care and health. The following are details of the Community Benefit activities provided by Kaiser Foundation Health Plan of Colorado: In 2014, Colorado Health Plan served over 627,000 members and expended approximately $109.4 million (at cost, net of $59.6 million of related revenues) to support Community Benefit activities. The following summarizes many of the signature Community Benefit programs and services grouped according to the national Streams of Work. |
| A. Care and Coverage for Low-Income People | Improving health care access for those with limited incomes and resources is fundamental to Kaiser Foundation Health Plan of Colorado's mission. In 2014, Colorado Health Plan expended $88.3 million (at cost, net of $59.6 million of related revenues) 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 Kaiser Permanente facility or by a Permanente provider. A.1. Charitable Care (Medical Financial Assistance and Charitable Health Coverage Programs) Colorado Health Plan provides charity care to low-income vulnerable populations through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) programs. In 2014, the Colorado Health Plan spent approximately $25.9 million (at cost, net of $331 thousand in related revenues) to support under- and uninsured patients. A.1.1. Medical Financial Assistance (MFA) Program The Colorado Health Plan's Medical Financial Assistance program provides financial assistance for emergency and medically necessary services, medications, and supplies to patients with a demonstrated financial need. Patients must receive health care services at facilities operated by Kaiser Permanente and/or from a Kaiser Permanente provider. Eligibility is based upon prescribed levels of income to patients who have exhausted other private and public sources of support. In 2014, KFHP-CO provided $21.2 million (at cost, net of no related revenues) to under- and uninsured patients. At KFHP-CO, uninsured patients receive a discount on hospital and professional charges for emergency or other medically necessary care without application and regardless of income level. The discount is provided to ensure that an uninsured individual is not charged more for emergency or other medically necessary services than the amounts generally billed to insured individuals receiving equivalent care. Contracted collection agency practices are already aligned with the organization's social values and IRC section 501(r), which was finalized in December 2014 and becomes fully effective for the 2016 tax year. Additionally, any patient experiencing financial hardship due to high medical expenses relative to their income level may qualify for the program under special circumstances. In Colorado, the MFA program's eligibility criteria allows patients falling below 300% of the Federal Poverty Guidelines (FPG) to receive full write off of patient out-of-pocket costs. In 2014, KFHP-CO's MFA program assisted nearly 3,800 qualifying applicants, including more than 1,100 patients who were not otherwise covered by a health care plan offered by Kaiser Foundation Health Plan of Colorado. This population received full or partial forgiveness for over 14,000 outpatient visits and more than 7,400 prescriptions. Additional charity care is provided through Exempla, one of KFHP-CO's partner hospitals. Kaiser Permanente providers give care in the emergency room, in surgery settings, for rounding duties in hospitals, and in various other medical settings on the Exempla campus. Any additional follow-up care is provided in Colorado Health Plan's medical offices. Approximately $13.0 million in charity care services was provided to Denver area residents under this agreement in 2014. A.1.2. Charitable Health Coverage (CHC) Program Charitable Health Coverage is a unique approach to caring for low-income uninsured persons in the community. Eligible participants receive a regular Kaiser Permanente Health Plan membership card and access to the full range of services and providers - a much better alternative to a potentially costly emergency room visit or hospitalization. This allows Colorado Health Plan to invest in the longer term health of patients and the community. KFHP-CO's CHC programs have a long history of making a real difference in the lives of persons who might otherwise have no permanent medical home. During 2014, KFHP-CO invested approximately $4.7 million (at cost, net of $331 thousand of related revenues to support the CHC program. In order to meet the requirements of the Affordable Care Act, Colorado Health Plan's CHC program was redesigned in 2014. The new CHC program includes a separately administered premium subsidy that CHC members use for the purchase of a standard off-exchange Kaiser Permanente Individual/Family (KPIF) gold level plan. To ensure that patient cost sharing obligations do not become a barrier to care, a Medical Financial Assistance award is provided to CHC members at the time of enrollment in the CHC program. Recertification takes place about every two years to confirm that members remain eligible to participate. Prospective members are invited to apply during limited annual enrollment periods and after experiencing triggering events. A.1.2.1. Bridge Program Colorado's Bridge Program is a Charitable Health Coverage program that provides uninsured low-income individuals and families with access to health coverage. Participants must meet certain eligibility requirements. Total household income must be at or below 300% of the Federal Poverty Level (FPL), and applicants are required to be under 35 years of age. Additionally, participants must not have access to other forms of health coverage. Over 200 members were enrolled in KFHP-CO's Bridge program at the end of 2014. A.2. Participation in Medicaid and Other Government-Sponsored Programs Kaiser Foundation Health Plan of Colorado has a long history of participating in publicly financed health programs as a nonprofit organization. KFHP-CO participates in Medicaid and other government-sponsored programs depending on the State of Colorado's structure of these programs. In 2014, Colorado Health Plan provided care and services valued at $62.5 million (at cost, net of $59.2 million of related revenues) for members and nonmembers in programs sponsored by the federal and state governments. As of December 2014, Medicaid participants whose health care needs had been assigned to Colorado Health Plan surpassed 48,000. This represents an increase of 22,000 or 84% from year-end 2013. The Affordable Care Act is expected to have a far-reaching impact on the landscape of government-sponsored programs, as these options are poised to become the key source of health coverage for a significant portion of the American population. KFHP-CO has responded to this challenge by developing organizational strategies to enable individuals whose coverage is changing - due to personal or financial circumstances - to receive medical care at a KFHP-CO facility. Realized and anticipated growth in the organization's Medicaid offerings closely aligns with and supports Colorado Health Plan's core mission, tax exempt status, credibility in state and federal policy arenas, and community health needs focusing on access to care. To better cope with the expansion of KFHP-CO's Medicaid program, a new Medicaid Assistance Center (MAC) was opened for operation in early November. With an emphasis on delivering bilingual support, the representatives in this center provide specialized enrollment services by assisting callers in understanding Medicaid eligibility in their state and the qualifications to enroll in Medicaid with KFHP-CO. A proactive follow-up process has been implemented to nurture a good foundational relationship with those prospects that elect to receive communications. A.2.1. Assignment of Medicaid Participants Improving access to care for vulnerable populations is fundamental to KFHP-CO's social mission to improve the health of the communities served, and is consistent with the obligations of a tax exempt organization. As a participant in Colorado's Medicaid program, Colorado Health Plan provides primary and specialty care to Medicaid beneficiaries who have been assigned to KFHP-CO as their primary care provider. Beneficiaries have access to both primary and specialty care in Colorado Health Plan facilities as well as pharmacy. In 2014, Colorado Health Plan provided care and services to more than 48,000 beneficiaries at a net loss of $53.0 million (at cost, net of $41.9 million of related revenues). A.2.2. Medicaid Fee-for-Service Program KFHP-CO provided health care services on a fee-for-service basis for Medicaid beneficiaries who haven't been assigned to KFHP-CO as their primary care provider for the first time in 2014. Approximately $5.8 million of health care services (at cost, net of $2.9 million in related revenues) was incurred on behalf of this population during the year. A.2.3. Child Health Plan Plus (CHP+) Colorado Health Plan serves approximately 7,200 beneficiaries under this fully capitated HMO arrangement. CHP+ serves children under age 19 and pregnant women age 19 and over who are permanent legal residents with household income below 250% of federal poverty guidelines. Eligibility includes proof of household income an |
| B. Community Health Initiatives | The Community Health Initiatives (CHI) strategy aims to improve the health of individuals, families, and communities by addressing the social, economic, and environmental determinants of health. The role of the community is vital to creating the conditions of health as well as the importance of non-medical resources in communities that promote well-being and prevent disease. The central premise of this approach is that excellent medical care alone is not sufficient to create healthy communities. Evidence underscores the importance of changing community environments as a critical community health strategy. Guided by this evidence, Kaiser Foundation Health Plan of Colorado supports comprehensive initiatives that focus on policy and environmental changes to promote healthy eating and active living, community safety, economic stability, and social and emotional wellness. As obesity continues to be a significant and pervasive public health problem, Colorado Health Plan spent approximately $2 million to support community health initiatives in 2014. B.1. CHI Programs and Services Colorado Health Plan works with community-based organizations to design, deliver, and sustain long-term efforts that improve the conditions of neighborhoods, workplaces, schools, and other settings. In some cases, the community health initiatives programs have also addressed community economic development, neighborhood safety, and other key drivers of healthy communities. To reach a broader audience, Colorado Health Plan primarily focuses on the following areas through community coalitions, health activism, and community investments: - Healthy food access - Active transportation (walking and wheeling) - School health - Community-clinic integration B.2. CHI Investments in the Community In 2014, Colorado Health Plan invested $300,000 to support Colorado Coalition to End Hunger in a multi-year grant to help sustainably end hunger in Colorado. Colorado has had low participation in federal nutrition programs for children and families, while more than 16% of Coloradans faced food hardship in 2012. The goals of this grant included food resource referrals and application assistance to at least 6,500 individuals, increasing summer meals served by 3%, and adding 60 food access (snack or supper) per year . C. Note: Kaiser Foundation Health Plan of Colorado recognized no significant financial investment in the Safety Net Partnerships Streams of Work (C) during 2014: |
| D. Developing and Disseminating Knowledge | The Developing and Disseminating Knowledge Stream of Work supports activities that improve health care by sharing knowledge, educating practitioners, advancing research, empowering consumers and informing policymakers about evidence-based care and health. Kaiser Foundation Health Plan of Colorado spent approximately $11 million in 2014 to support programs and services associated with the development and dissemination of knowledge. Approximately $8.4 million of additional projects were funded by government agencies and other nonprofit organizations. D.1. Medical Research Programs At Colorado Health Plan, research is an essential part of what it means to be an evidence-based, learning organization. Achievements realized under this program are made possible through a dedicated group of researchers, the comprehensive nature of KFHP Inc.'s electronic medical record system, and access to the health data of over 9.6 million Kaiser Foundation Health Plan, Inc. members. Through studies conducted at regional and national research centers, researchers address critical issues like cancer, cardiovascular conditions, diabetes, behavioral and mental health, and health care delivery improvements by leveraging the organization's research expertise, rich data sources, and delivery system environment. Colorado Health Plan provided approximately $1.9 million for medical research projects in 2014. In 2015, Colorado Health Plan will expand its commitment to research by participating in the launch of a national biobank that will strengthen the ability to conduct cutting-edge studies nationwide. The biobank will be one of the largest non-governmental biobanks in the United States to examine the genetic and environmental factors that influence common diseases such as heart disease, cancer, diabetes, high blood pressure, Alzheimer's disease, asthma, and many others. D.1.1. National Research Program Kaiser Foundation Health Plan, Inc. has a long history of conducting health services and medical research that addresses health care policy, quality of care, and quality of life. The results have yielded findings that affect not just the practice of medicine within the organization and its subsidiaries, but also for society-at-large. D.1.1.1. Kaiser Foundation Research Institute (KFRI) The Kaiser Foundation Research Institute provides administrative leadership and support for federally funded medical research conducted at regional research centers located in Colorado and several other states. KFRI personnel are designated as the Authorized Organizational Official for all federally funded research performed by both Kaiser Foundation Hospitals and Kaiser Foundation Health Plan, Inc. and its subsidiaries. D.1.1.2. The Center for Effectiveness and Safety Research (CESR) The Center for Effectiveness and Safety Research is a national research center that leverages the expertise of Kaiser Permanente's seven regional research centers to answer important comparative effectiveness and safety questions that affect health care delivery questions by relying on collaborations within the network. D.1.2. Colorado's Research Program The principal research activities conducted in Colorado take place at the following regional research center: D.1.2.1. The Institute for Health Research The Institute for Health Research partners with KFHP-CO members, clinicians, fellow researchers, and local and national organizations with an aim to improve quality of life and reduce health disparities through patient, community, and policy-centered research. The Institute's researchers study innovative technologies to enhance the impact and sustainability of evidence-based health care. The Institute conducts research to address the Institute of Medicine's goals for a reformed health care system that is safe, effective, timely, efficient, equitable, affordable, and patient-centered. Top Research Areas: - Epidemiology - Behavioral Health Research - Health Services Key Statistics: - Number of clinical trials in 2014: 117 - Number of active studies (clinical and non-clinical trials) in 2014: 381 - Number of research papers published in journals in 2014: 97 - Number of investigators: 11 - Number of support staff: 79 D.1.2.2. Major Areas of Funded Research The following are examples of research projects conducted by investigators at the Institute for Health Research in Colorado in 2014: D.1.2.2.1. Impact of Bariatric Surgery on Cancer Incidence in Severely Obese Adults Research Area: Cancer This project is focused on assessing whether bariatric surgery affects the incidence of cancer in severely obese adults and whether any change in risk is mediated by weight loss. Primary Funding Provided by: National Cancer Institute D.1.2.2.2. Cardiovascular Benefits and Safety of Glucose-Lowering Therapies in Adults with Diabetes Research Area: Diabetes This project examines detailed clinical data from 1.3 million adults with treated type 2 diabetes over a 13-year period to quantify the impact of specific combinations of glucose-lowering agents on myocardial infarction, stroke, cardiovascular mortality, total mortality, and congestive heart failure hospitalizations. Primary Funding Provided by: Health Partners Research Foundation D.1.2.2.3. Measuring Quality of Care for People with Multiple Chronic Conditions Research Area: Health Care Delivery and Comparative Health Systems This project is focused on developing and evaluating a preliminary composite measure of care quality for populations with multiple medical conditions. Such a measure will enhance clinicians' understanding of how to provide high quality health care for patients with multiple medical conditions by permitting evaluation of system-level interventions to improve care in real-world settings. Primary Funding Provided by: Agency for Healthcare Research and Quality D.2. Educational Theatre Programs (ETP) For 30 years, the Kaiser Foundation Health Plan of Colorado has brought education to our communities through the Educational Theatre Program (ETP). Through music, comedy and drama, live theatre programs are offered to schools and communities free of charge in each of Kaiser Permanente's communities. The programs are developed by theatre professionals in collaboration with health educators, community advisory committees and healthcare providers and physicians. In 2014, KFHP Colorado invested approximately $1.7 million to entertain and educate over 170,000 people across Colorado. The 2014 productions focused heavily on healthy eating and active living, as the service region's incidence rates of adult obesity and diabetes, as well as breast and colorectal cancer, are higher than the state and national averages. One example of an ETP offering is "5210 Mainstreet." KFHP Colorado produced 91 performances of "5210 Mainstreet" at 87 schools, reaching over 23,000 children and adults. This interactive play provides children in K-2 information to make responsible choices about food and physical activity by teaching youth to live "5-2-1-0" every day: 5 or more fruits and vegetables, 2 hours or less of screen time, 1 hour or more of physical activity, 0 sugary drinks, more water and low fat milk. The Let's Go Campaign's 5-2-1-0 model is supported by the National Initiative for Children's Healthcare Quality and used by Colorado school nurses statewide. The 5-2-1-0 logo is adapted with permission from copyrighted material of the Foundation for Healthy Communities, Concord, New Hampshire. D.2.1. Youth Engagement In addition to live theatre performances, the Educational Theatre Programs also develops youth engagement projects for high school students and facilitated workshops for adults. In 2014, CHAT (Community Health Action Team), made up of 13 youth from across KFHP Colorado's service area, developed and piloted the Avatars Anonymous: a 6-step program, a health unit for high school students. This program, rooted in Colorado Academic Standards and endorsed by the Colorado Department of Education, uses 21st Century Learning approaches to equip high school students with pre-graduate competencies and empower them to research and present on health issues. SHAC (Student Health Advisory Council), made up of high school youth across the Jefferson County school district (one of the largest in Colorado), created and distributed a short video "Just Say Know" on the effects of marijuana on the adolescent brain. Along with the video, SHAC developed educational materials and a campaign and reached close to 30,000 students and teachers across their district with this educational opportunity. D.2.2. Facilitated Workshops For adult groups, facilitated workshops were provided in new settings in 2014. The Laughaceuticals workshop, which highlights the health benefits of laughter, was provided to 45 schools as part of Colorado's efforts in the Thriving Schools Initiative. The Care Equity Workshops were provided to Clinica, a significant safety net partner, to over 90% of employees acro |
| E. Other Community Benefit investments | During 2014, the Colorado Health Plan spent approximately $8.0 million to support Community Benefit activities and programs beyond the national streams of work. This included the administrative expenses of a Community Benefit department dedicated to supporting regional Community Benefit programs and services and coordinating related initiatives. The following are examples of additional programs funded within this area. E.1. Community Service Employees are actively encouraged to donate 96 hours per year in organization-funded time, energy, and skills towards approved activities in the community outside of their normal work responsibilities. With the exception of those employees whose jobs are directly classified within the Community Benefit department, organization-funded time contributed to other nonprofits is not counted towards KFHP-CO's annual Community Benefit investment. On January 20, 2014, in honor of Martin Luther King, Jr., over 400 Kaiser Foundation Health Plan of Colorado employees made it a "day on" of community service at more than 30 nonprofit organizations, representing approximately 2,800 hours of combined service. Hundreds of volunteers were deployed to interact with youth, refurbish schools and nonprofit facilities, and assemble food and hygiene kits and blankets for the underserved and victims of the 2013 Colorado floods. E.2. Tumor Board and Cancer Registry Included in the other Community Benefit spending reported above is more than $450 thousand dollars in expenses related to the State of Colorado's 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. |
| F. Environmental Stewardship | Poor environmental quality contributes to disease and economic insecurity. Kaiser Foundation Health Plan of Colorado has committed itself to protecting and improving the natural environment as a key component of its mission to improve the health of the community it serves. Although costs associated with this initiative are not included in the dollars reported as Community Benefit investments, efforts in this area contribute to advancing a broader vision emphasizing healthy people and healthy environments while also improving health care quality and affordability. To fulfill the organization's commitment to the natural environment, KFHP-CO maintains a governance structure for environmental stewardship that enables the organization to continually improve its environmental performance. This structure includes clearly defined roles, responsibilities, plans and routines, and has resulted in the following five organizational focus areas. These have been selected based on their ability to result in the greatest impact on the environmental forces that shape environmental and human health. - Finding safe alternatives to harmful industrial chemicals - Responding to climate change - Promoting sustainable farming and food choices - Reducing, reusing, and recycling to eliminate waste - Conserving water In each of these focus areas, KFHP-CO has established ambitious goals (including a target to reduce total greenhouse gas emissions by 30% by 2020, compared to a 2008 baseline), implemented initiatives, achieved measurable improvements, and regularly reported progress to the board of directors, staff, and the general public. By replacing paper medical charts and digitizing x-ray images through an electronic medical record system, Kaiser Foundation Health Plan of Colorado is also contributing to the avoidance of approximately 1,000 tons of paper waste and 200,000 pounds of x-ray film per year. F.1. Performance Metrics During 2014, key performance indicators for Kaiser Foundation Health Plan of Colorado included: F.1.1. In Colorado: F.1.1.1 Reducing total greenhouse gas emissions (metric tons CO2e) by 5.4% compared to the 2008 baseline for all facilities and assets under KFHP-CO's operational control*. F.1.1.2 Reducing KFHP-CO's energy use intensity (kBtu/rentable square foot) by 1.5% compared to the 2010 baseline year. F.1.1.3 Recycling, reusing, or composting approximately 68% of the waste generated in KFHP-CO's facilities. * Due to normal lag times in receiving and processing utility bills, performance for this indicator reflects emissions during the preceding calendar year (i.e. 2013). |
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