Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (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) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 19,040 | 18,090 | 23,186 | 738,592 | 818,201 | 1,617,109 |
| 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 | 3,724,760,440 | 3,944,202,954 | 4,180,613,701 | 4,467,072,552 | 4,634,650,434 | 20,951,300,081 |
| 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 | 3,724,779,480 | 3,944,221,044 | 4,180,636,887 | 4,467,811,144 | 4,635,468,635 | 20,952,917,190 |
| 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.) | 20,952,917,190 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 3,724,779,480 | 3,944,221,044 | 4,180,636,887 | 4,467,811,144 | 4,635,468,635 | 20,952,917,190 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 21,608,662 | 21,736,621 | 25,252,630 | 26,730,220 | 20,986,083 | 116,314,216 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | 172,284 | 213,536 | 263,834 | 255,163 | 904,817 |
| c | Add lines 10a and 10b. | 21,608,662 | 21,908,905 | 25,466,166 | 26,994,054 | 21,241,246 | 117,219,033 |
| 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 | 0 | 0 | 0 | 277,551 | 277,551 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 3,746,388,142 | 3,966,129,949 | 4,206,103,053 | 4,494,805,198 | 4,656,987,432 | 21,070,413,774 |
| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, LINE 1a | THE EXECUTIVE COMMITTEE, COMPOSED OF THE DIRECTORS THAT ARE THE CHAIRS OF THE BOARD'S OTHER STANDING COMMITTEES, HAS AUTHORITY TO ACT FOR THE BOARD BETWEEN MEETINGS EXCEPT IT HAS NO AUTHORITY TO: A. FILL VACANCIES ON THE BOARD OR THE COMMITTEE; B. FIX THE COMPENSATION OF DIRECTORS FOR SERVING ON THE BOARD OR ANY COMMITTEE; C. ADOPT, AMEND OR REPEAL BYLAWS; D. AMEND OR REPEAL ANY RESOLUTION OF THE BOARD WHICH BY ITS EXPRESS TERMS CANNOT BE AMENDED OR REPEALED BY THE EXECUTIVE COMMITTEE; E. APPOINT COMMITTEES OF THE BOARD OR APPOINT THE MEMBERS THEREOF; OR F. APPROVE ANY ASPECT OF A TRANSACTION INVOLVING THE COMPANY WHEN A DIRECTOR HAS A MATERIAL FINANCIAL INTEREST IN THAT TRANSACTION, EXCEPT AS EXPRESSLY PROVIDED BY THE LAW. Form 990, Part VI, Line 2 Family or Business Relationships Board members Eugene Washington, MD and Richard Shannon, MD have a business relationship. Board member Jeff Epstein and Corporate Officer Alfonse Upshaw have a business relationship. |
| Form 990, PART VI, LINE 6 | 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 | KAISER FOUNDATION HEALTH PLAN, INC. APPOINTS THE DIRECTORS (AND FILLS VACANCIES AND HAS AUTHORITY TO REMOVE DIRECTORS). THE SAME INDIVIDUALS WHO COMPRISE THE BOARD OF DIRECTORS OF KFHP ALSO SERVE AS THE DIRECTORS OF KFHP COLORADO, NORTHWEST, MID-ATLANTIC STATES, AND KFHPW HOLDINGS. |
| Form 990, PART VI, LINE 7B | THE FOLLOWING ACTIONS OF THE CORPORATION ARE RESERVED TO OR REQUIRE APPROVAL OF THE SOLE MEMBER: A) REMOVAL OF THE CHAIRMAN OF THE BOARD OR THE PRESIDENT, THE GROUP PRESIDENT OR REGIONAL PRESIDENT; B) NUMERICAL RANGE OF DIRECTIRS; C) AMENDMENT OF ARTICLE D, SECTION D-4 OF THE BYLAWS - ELECTION AND TERM OF OFFICE OF DIRECTORS. |
| Form, PART VI, LINE 11B | Form 990 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. Prior to finalization, the return is reviewed by an external tax advisor. 3. Once signed by an external tax advisor, the return and underlying data are reviewed by an officer or a member of management designated by an officer for signature and filing. 4. Copies are then provided to board members prior to filing. |
| Form 990, PART VI, LINE 12C | Ethics and Compliance Ongoing Monitoring and Enforcement Activities Kaiser Permanente regularly and consistently monitors and enforces compliance with the Conflicts of Interest policy in the following ways: Reporting Conflicts of Interest Concerns - The Kaiser Permanente Ethics and Compliance Hotline or Webline is available to all employees, vendors, contractors, and agents to anonymously report actual or perceived conflicts of interest. This process is managed by a third party; however, all reported allegations are provided to Ethics and Compliance for investigation, and if required, corrective action. Employees are prohibited from retaliating against or intimidating anyone who reports concerns in good faith or refuse to participate in wrongdoing. Annual Disclosure Process - Annually, Directors, Officers, Key Employees, and other employees in roles with elevated risk are required to complete a Conflicts of Interest Questionnaire (COIQ). Responses are reviewed by Ethics and Compliance, Board Services, and / or the Governance, Accountability and Nominating Committee of the Kaiser Foundation Health Plan/Hospital Board of Directors. When actions are required, they are addressed in accordance to policies and written standards. Conflicts of interest responses and actions are maintained for tracking and reporting purposes. Ongoing Disclosure Process - In addition to the annual disclosure process and in accordance with the Conflicts of Interest policy, on an ongoing basis Ethics and Compliance receives, consults, and reports conflicts of interest matters. External Audit Review of Disclosures - Annually, as a part of the Kaiser Permanente external audit, an outside certified public accounting firm reviews the COIQ process and actions taken for Directors, Officers, and Key Employees. The results, inclusive of any findings, are presented to the Kaiser Foundation Health Plan/ Hospital Audit and Compliance Committee of the Board of Directors. Awareness and Enforcement - Kaiser Permanente adheres to the following general awareness and enforcement guidelines: - Annually, the Conflicts of Interest and Corrective / Disciplinary Action policies are provided and reviewed as a part of the general ethics and compliance training. - Represented employees are subject to corrective/disciplinary action provisions outlined in the regional or national collective bargaining agreements and applicable policies. - In the event disciplinary action is required due to failure to comply with applicable legal and regulatory requirements, Kaiser Permanente policies and procedures, the Code of Conduct (Principles of Responsibility), unsatisfactory performance, or misconduct disciplinary action includes, but is not limited to: * verbal discussion, coaching, and/or warning by the employee's immediate supervisor or higher-level manager to correct the problem; * written notice, with or without final warning; * suspension, with or without final warning; or * termination of employment. |
| Form 990, PART VI, LINE 15A/B | COMPENSATION DETERMINATION THE EXECUTIVE COMPENSATION PROGRAM AS ADMINISTERED BY KAISER FOUNDATION HEALTH PLAN, INC. 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) ARE REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE MANAGEMENT COMMITTEE ON COMPENSATION. 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, BENEFITS & HUMAN RESOURCES CONSULTING FIRM. THE COMPENSATION PROGRAM FOCUSES ON OBJECTIVES IN THE AREAS OF QUALITY OF MEMBER CARE AND SERVICE, MEMBERSHIP GROWTH, FINANCIAL SOUNDNESS, AND THE COMMUNITY AND SOCIAL MISSION OF THE ORGANIZATION. |
| Form 990, PART VI, LINE 18 | Form 990 is available on www.guidestar.org. |
| Form 990, PART VI, LINE 19 | Public Inspection: Governing documents, conflict of interest policy are available upon request as disclosed to other regulatory bodies. 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 Independent Auditors' Report. To request copies contact: National Communications - RM Operations Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, 18th Floor 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 pension and other retirement lia $(119,327,517) Gain/ Loss on Investments - Book 20,212,131 Gain/ Loss on Investments - Tax (14,486,817) otti losses - book (13,417,711) ------------------ (127,019,914) |
| FORM 990, PART III, LINES 4A - 4D | - EXEMPT PURPOSE ACHIEVEMENTS - I. Introduction A. About Kaiser Permanente Founded in 1942 to serve employees of Kaiser Industries and opened to the public in 1945, Kaiser Permanente is recognized as one of America's leading health care providers and nonprofit health plans. We were created to meet the challenge of providing American workers with medical care during the Great Depression and World War II, when most people could not afford to go to a doctor. Since our beginnings, we have been committed to helping shape the future of healthcare. Kaiser Permanente has influenced U.S. health care through its innovations in these areas: - Prepaid health plans, which spread the cost to make it more affordable - A focus on preventing illness and disease as much as on caring for the sick - An organized, coordinated system that puts as many services as possible under one roof-all connected by an electronic medical record For 75 years, Kaiser Permanente has been committed to shaping the future of health and health care - and helping our members, patients, and communities experience more healthy years. We are recognized as one of America's leading health care providers and not-for-profit health plans. Since July 21, 1945, Kaiser Permanente's mission has been to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.4 million members in 8 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health. B. Kaiser Permanente's Approach to Community Health At Kaiser Permanente, we recognize that where we live and how we live has a big impact on our health and well-being. Our work is driven by our mission: to provide high-quality, affordable health care services and to improve the health of our members and our communities. It's also driven by our heritage of prevention and health promotion, and by our conviction that good health is a fundamental right. We are committed to improving the health of our communities. We do that by ensuring health access, improving community conditions for health and equity, and advancing the future of community health through innovation. We also share our financial resources, research, nurses and physicians, and our clinical practices and knowledge through a variety of grantmaking and investment efforts. As we reflect on the past year, we must recognize that our communities - and the world - are coping with unprecedented challenges magnified by the coronavirus pandemic and a renewed struggle for racial equity and social justice. Through our continued focus on expanding our community health approach, we laid the foundation for an acceleration of work to meet the challenges posed by the public health crises we now face. We dedicated ourselves to improving the social health of our 12.4 million members and the communities we serve. C. Kaiser Permanente's Total Contribution Kaiser Permanente provided $3.6 billion in 2020 to improve the health of our communities. The amounts attributable to Kaiser Foundation Health Plan of the Northwest is $94.9 million as follows: * Financial Assistance at cost - $23.8 million * Medicaid - $61.8 million * Costs of other means-tested government programs - $6.3 million * Community health improvement services and community benefit operations - $3 million In addition to our direct spend, we also leverage assets from across Kaiser Permanente to help us achieve our mission to improve the health of communities. This "Total Health" strategy includes our widely recognized activities around supplier diversity, socially responsible investing and environmental stewardship. Kaiser Foundation Health Plan of the Northwest partners with KFH to provide health care services and improve the health of the communities we serve. II. Health Access Ensuring health access means serving those most in need of health care through Medicaid, medical financial assistance, charitable health coverage, and other forms of subsidized care and coverage. It also means connecting people with wrap-around social services, healthy meals, affordable homes, safe playgrounds, and supportive schools. For many low-income people without access to health care coverage, or for those who lose their jobs and can't maintain health care coverage, an emergency room is often the only place they receive care. At Kaiser Permanente, we're working to change that with programs that lower financial barriers by providing deeply subsidized health coverage and medical financial assistance for care. We also provide information about how to access and qualify for public programs such as Medicaid and financial assistance through the marketplace to individuals who may be eligible. Kaiser Foundation Health Plan of the Northwest supports the health access needs of our communities through a combination of coverage and care programs. We provide coverage to low income populations through two key vehicles: first, via our participation in government programs like Medicaid and the Children's Health Insurance Programs (CHIP), and second, via our own Charitable Health Coverage (CHC) program, which provides a premium subsidy for Kaiser Permanente coverage for qualified low-income families and children who do not have access to public or private health coverage. Similarly, we provide care to low-income populations through two key vehicles: first, via our treatment of Medicaid and CHIP enrollees, and second, via the Medical Financial Assistance (MFA) program, which is Kaiser Permanente's traditional charity care or financial assistance program (FAP). For Kaiser Foundation Health Plan, Inc. and all of its subsidiary health plans, the main way to address health access challenges is by absorbing the cost of the coverage and care programs described above. In 2020, Kaiser Foundation Health Plan of the Northwest spent a total of $91.9 million on our coverage and care programs (at cost, net of all related revenues). A. Coverage Having health coverage means consistent access to comprehensive and continuous medical and preventative services for people to get and stay healthy, a much better alternative to episodic care at emergency departments. Coverage is good for the patient, good for Kaiser Permanente and good for the US overall because it helps people get and stay healthy and avoid costly hospital services. i. Coverage provided through Medicaid, CHIP and other government programs The Affordable Care Act has had a far-reaching impact on the landscape of government-sponsored programs, as these options have become a key source of health coverage for a significant portion of the US population. Kaiser Permanente has responded to this challenge by developing organizational strategies to enable low-income individuals to obtain and/or retain health coverage through Medicaid, CHIP or other government programs, even as their personal or financial circumstances may be changing. At the end of 2020, Kaiser Foundation Health Plan of the Northwest was providing coverage to approximately 67,000 people through these government programs. ii. Coverage provided through CHC CHC is a unique approach to caring for low-income uninsured persons in the community. The program provides a premium subsidy for a KFHP off exchange plan to low income individuals and families who are not eligible for other public or privately sponsored coverage. Eligible participants receive a regular KFHP membership card and have access to the same services and providers as other KFHP individual and family plan members. CHC members also receive cost sharing support that eliminates out of pocket costs for most covered services provided at Kaiser Permanente facilities. CHC provides individuals/families who would otherwise not have access to coverage, consistent access through the "front door" of the health delivery system, including a medical home and preventive services, better alternatives than episodic care. At the end of 2020, Kaiser Foundation Health Plan of the Northwest was providing coverage to approximately 1,000 people through the CHC program. |
| B. Care | To get and/or stay healthy, people need access to high quality care by providers they trust. This care must include preventative services and required medications so that people can avoid ending up in the emergency room or requiring more extensive services down the line. Kaiser Permanente helps low income populations gain access to this type of care by leveraging the full scope of its integrated delivery system, including not only critical hospital-based services but also outpatient primary, specialty and pharmacy services. i. Care provided through Medicaid, CHIP and other government programs Kaiser Permanente provides a wide range of health care services to individuals enrolled in Medicaid, CHIP and other government programs, regardless of whether they are assigned to Kaiser Permanente or not. In addition to the individuals who received health coverage in 2020 due to Kaiser Permanente's participation in these government programs, Kaiser Foundation Health Plan of the Northwest also subsidized care to people who are enrolled in these programs but not formally assigned to Kaiser Foundation Health Plan. ii. Care subsidized by MFA Medical Financial Assistance program (MFA) helps low-income, uninsured, and underserved patients receive access to care. The program provides temporary financial assistance or free care to patients who receive health care services from our providers, regardless of whether they have health coverage or are uninsured. The MFA program is one of the most generous in the health care industry and is available to those patients in greatest need. Eligibility is based on financial need. In general, patients whose household income is at or below 200 percent, and in some regions up to 400 percent, of the federal poverty guidelines are eligible for the MFA program. Patients who are experiencing high medical expenses as compared to their income may be eligible under high medical expenses criteria, regardless of household income. The MFA program covers emergency and medically necessary health care services, pharmacy services and products, and medical supplies provided at Kaiser Permanente facilities (i.e. hospitals, medical centers, and medical office buildings), at Kaiser Permanente outpatient pharmacies, or by Kaiser Permanente providers. Over the course of 2020, Kaiser Foundation Health Plan of the Northwest subsidized care for over 18,000 people through the MFA program. C. Safety-Net Partnerships Safety net providers are a mix of public hospitals, community-based organizations such as federally qualified health centers, and other health care organizations. In Kaiser Permanente service areas, federally qualified health centers serve the uninsured, Medicaid, and other vulnerable populations. In addition to working families, children, the elderly, and the disabled, health centers serve students, homeless people, people living in public housing, agricultural workers, and veterans. Strengthening the safety net advances our mission to improve the health of the communities we serve as well as our equity agenda. Our communities' most vulnerable populations, including a disproportionate number of low-income people of color, rely on the safety net for their health care needs. Our support ensures that communities have access to a strong safety net that can equitably meet patients' needs and improve health outcomes. As we confront COVID-19, ensuring that low-income patients and people experiencing homelessness continue to have access to high-quality health care is more important than ever. Kaiser Foundation Health Plan of the Northwest formed a partnership with OCHIN in the Northwest to expand access to social needs resources to patients served by community health centers. OCHIN is a nonprofit health care innovation center that provides EPIC electronic health records and other information technology services to Community Health Centers. Through this partnership, Kaiser Foundation Health Plan of the Northwest supported OCHIN to build and implement a social service resource locator that was integrated into the community health center's electronic health record. Kaiser Foundation Health Plan of the Northwest partnered with The Oregon Community Foundation to support the Health Systems Access to Care Fund. The fund pools resources from several health systems to support Community Supported Clinics that serve over 10,000 patients with grants to improve their model of care to increase the access to care to the uninsured and the underinsured, which is even more needed because of the COVID-19 pandemic. III. Social Health Healthy individuals need healthy communities, and healthy communities need healthy people to thrive. At Kaiser Permanente, we are working to improve the conditions for social health and equity in the community by addressing the root causes of health, such as food insecurity, economic opportunity, affordable housing, and safe and supportive schools. These improvements grow from our collaboration with each community to co-design and co-create solutions that truly make a positive impact. By engaging members, communities, our sizeable workforce, and all of our organization's considerable assets, we are working to create communities that are among the healthiest in the nation, and inspiring greater health for America and the world. |
| A. Food for Life | Rooted in the belief that nobody should go hungry in America, the nation's largest integrated, nonprofit health system is again going beyond traditional care delivery to tackle one of the most basic human needs - access to affordable, healthy food. Before COVID-19, 1 in 9 households in the United States were at risk for food insecurity, the lack of consistent access to adequate food because of limited resources. Feeding America now estimates this to be 1 in 6 adults and 1 in 4 children, with the potential to double as COVID-19 continues to unfold. Food for Life is a comprehensive approach for transforming the economic, social, and policy environments connected to food so that people across the nation have access to, and can afford, healthy food. Kaiser Permanente is supporting diverse community partners who are increasing purchasing power for food, providing meal and nutrition distribution with an emphasis on equity, and driving essential change in food system policy and research. B. Economic Opportunity Inclusive economic growth is critical to both individual and community health. When there is a lack of economic opportunity in communities, the prospects for upward social mobility are diminished, often resulting in poorer health and higher mortality rates for people living in those communities. By contrast, economic growth and opportunity provides individuals with jobs, income, a sense of purpose, and opportunities to improve their economic circumstances overtime. As a large, influential institution in our communities, Kaiser Permanente also recognizes that the way we do business can support economic opportunity in local communities through how we hire, purchase, build our facilities and partner with communities. Some ways that we're helping revitalize and grow our communities by strengthening economic opportunity include: - Providing good jobs to individuals facing barriers to employment through high-impact hiring and workforce pipeline efforts. - Pursuing a social impact investment strategy to support impact investments aimed at addressing key social issues that have a significant impact on health. - Purchasing goods and services from local minority- and women-owned businesses and encouraging good employment practices by our vendor partners. - Building new facilities with an emphasis on positive local community impact, including local construction hiring, local and diverse purchasing, healthy and sustainable design features, neighborhood revitalization, and deep community engagement. - Partnering with community organizations to grow local business capacity, increase access to good jobs, and support stable, quality, affordable housing. In June 2020, we announced a series of actions to address systemic racism and lack of economic opportunities that have persisted for far too long and prevented communities of color, and especially Black communities, from achieving total health. As a critical step toward supporting communities in overcoming systemic and structural disadvantages, we committed to providing support to businesses owned by Black and other underrepresented people across the country. The following demonstrates our key efforts in 2020 to support economic opportunity: Kaiser Foundation Health Plan of the Northwest partnered with the Inner-City Capital Connections program to support small minority and women-owned businesses in Portland to build their capacity for sustainable growth in revenue, profitability, and employment through a combination of in-person executive education, webinars, coaching, and connections to capital. ICIC's Inner City Capital Connections program is a national scaling partner selected to achieve Kaiser Permanente's economic opportunity strategy of supporting small businesses in our communities, with a focus on businesses owned by Black/other People of Color. ICCC has responded to the pressing needs of small businesses in response to the pandemic by substantially changed its signature program of free executive training to small business owners by moving to a virtual platform and is maintaining updated educational materials through webinars and its website, to support small businesses navigate the rapidly changing environment. Small businesses, particularly those in under-resourced communities, are being hit the hardest by the economic impact of the COVID-19 crisis. Now, more than ever, they require access to capital, one-on-one coaching, and capacity-building education, which are fundamental components of the ICCC program. Kaiser Foundation Health Plan of the Northwest supported the Contingent Ignite scholarship program supporting diverse Portland State University pre-health students. Students are provided with scholarships and leadership development training. The goal is to increase degree completion among Portland State University Pre-Health students and provide connections to internships and networking opportunities within Portland's health care sector. C. Housing for Health Without a safe place to call home, it's nearly impossible to focus on basic health and medical needs. Kaiser Permanente is leading efforts to end homelessness and preserve affordable housing by making strategic impact investments, shaping policy, and catalyzing innovative partnerships. COVID-19 continues to impact social health needs in our communities, and people experiencing homelessness or housing insecurity are at increased risk. Nationwide, people of color are more affected by homelessness and housing insecurity, made worse by the pandemic. The health crisis and economic fallout from the pandemic are hitting low-income and communities of color hardest, and threaten to widen the health equity gap in our country even further. As Kaiser Permanente continues to respond on the front lines of the COVID-19 pandemic, we are accelerating efforts to increase affordable housing, address homelessness, and advance equity in the communities we serve. Kaiser Permanente's multipronged approach to increase affordable housing and address homelessness helps improve the health outcomes of the people who live in the communities we serve. The following demonstrates our key efforts in 2020 to support housing insecurity and homelessness: Kaiser Foundation Health Plan of the Northwest partnered with Community Solutions International to support capacity, operational expenses, and expansion for Built for Zero's work to end chronic and veteran homelessness in communities within Kaiser Permanente's national footprint. The partnership will also ensure that every Built for Zero community in KP's footprint has the right information, thought partnership, and resourcing to adequately respond to COVID-19. Community Solutions' support for communities will contribute to preventing deaths among people experiencing homelessness, protect response system staff, and aid in conserving hospital resources by preventing unnecessary hospitalization. Kaiser Foundation Health Plan of the Northwest partnered with the Health Share of Oregon to house homeless seniors and launch the Regional Supportive Housing Impact Fund (RSHIF), a new flexible fund designed to work in tandem with other regional efforts, such as affordable housing bonds, to address the homelessness crisis. RSHIF will connect very low-income persons with complex health challenges to deeply affordable supportive housing options. RSHIF partners include the major health care providers in the Portland metro region, philanthropic partners, and the business community. Kaiser Foundation Health Plan of the Northwest partnered with seven organizations in the Northwest Region as part of the COVID-19 Prevention & Response in Homeless Systems of Care cohort. The cohort includes homeless service providers, continuum of care agencies, shelter operators, and local public health departments. The partnership will support organizations to address immediate needs of people experiencing homelessness as well as build longer-term capacity and infrastructure for a coordinated homeless system of care and a broader emergency response system. |
| D. Thriving Schools | Our efforts to support health in schools are part of how we are advancing our vision for total health - a holistic approach that emphasizes the social, environmental, behavioral, and clinical aspects that shape one's well-being. Schools are passionate about ensuring that all students succeed. They need strong partners to help them address health as part of their strategy. That's why Kaiser Permanente created Thriving Schools, our all-in engagement to improve health for students, staff, and teachers. Our vision is that every community can count on their school as a champion for good health that enables great learning. Thriving Schools is intentional about coordinating our own knowledge and existing work in school health with the good work of others. Through our valued partnerships with some of the country's most innovative organizations, we are able to provide concrete resources and pathways to health in schools. To create lasting change, we use our voice to advance local, regional, and national policies and a movement to make healthy schools the norm for everyone. Kaiser Foundation Health Plan of the Northwest partnered with the Alliance for Healthier Generation in 2020 to advance the RISE, Resilience in School Environments initiative, an enterprise-wide effort designed to empower schools and districts to create safe and supportive learning environments by cultivating practices that strengthen the social and emotional health of all students and school staff. RISE is the first national initiative of its kind specifically designed for schools and districts to increase job satisfaction, including reducing staff stress; improve safety, connectedness, and relationships among students and staff; increase skills related to social and emotional learning for students and staff and; increase mental health supports. As school communities address the twin pandemics of COVID-19 and racial equity, supporting social emotional health and resilience is more important now than ever. In fact, schools and districts have requested intensified RISE support and resources due to the significant effects COVID-19, racial injustice, and the economic recession are having on student, staff and teacher mental health. Additionally, Kaiser Foundation Health Plan of the Northwest partnered with Alliance for a Healthier Generation to expand the Health Eating, Active Living initiative to address the multidimensional health or social health needs of the school community. The initiative is designed to help schools and districts examine policies and practices to increase daily physical activity, access to nutritious food and access to and use of systems to support stable housing, food security, reliable transportation for students and school staff. The organization will leverage evidence-based strategies and best practices, including its proven six-step process to facilitate school- and district-level change and its online assessments (including the Healthy Schools Program (HSP) and the RISE Index) to create sustainable environmental change through connecting policy development and accountability at the district level to school level daily operations. Alliance for a Healthier Generation will work with the Nutrition Policy Institute to further refine and evaluate the program to ensure best practices/evidence-based strategies are deployed. IV. Policy and Systems A. Thriving Cities The places where we live, learn, work, and play - our cities and towns, our schools, our homes, our neighborhoods - have an enormous impact on our health. And how we shape those places, through public policy and the support for healthy environments, has the potential to make real, lasting impacts on our surroundings and our everyday quality of life. Through Kaiser Foundation Health Plan of the Northwest's ongoing partnerships with community organizations, municipal leaders, and public health champions, we are working to incorporate health, equity and sustainability considerations into public policy and the built environment in ways that influence how neighborhoods take shape and grow. In 2018, we joined forces with the de Beaumont Foundation, a leader in public health philanthropy, to help U.S. cities thrive through the CityHealth initiative. Created by the de Beaumont Foundation to promote practices that make cities healthier, CityHealth tracks and reports on proven policies, and works with cities to advance policies that achieve community health priorities. Through this relationship, Kaiser Foundation Health Plan of the Northwest will leverage its deep expertise in health policy, government relations, and community-based prevention to accelerate cities' efforts to improve people's health and quality of life. For Kaiser Foundation Health Plan of the Northwest, this partnership complements the organization's established approach to community health - bringing together health leaders, clinicians and community partners to help solve the social, economic and environmental health challenges facing the residents who live in the communities it serves. Policy menu includes: earned sick leave, high-quality accessible pre-Kindergarten, affordable housing/inclusionary zoning, complete streets, safer alcohol sales, Tobacco 21, smoke-free indoor air, food safety and restaurant inspection rating, healthy food procurement. B. Environmental Stewardship We believe it is our obligation as a health care provider to minimize our environmental impact. We embed efforts to be environmentally responsible throughout our organization - in how we power our facilities, purchase food and medical supplies and equipment, manage waste, and invest in our communities. We also prioritize partnerships with others to develop policies and systems that strengthen community health and protect our environment. In 2016, Kaiser Permanente adopted an ambitious set of environmental goals to guide the organization for the decade ahead. These goals have raised the bar on environmental responsibility, not just for Kaiser Permanente but for all health care organizations. Kaiser Permanente pledges that by 2025 it will: - Become "carbon net positive" by buying enough clean energy and carbon offsets to remove more greenhouse gases from the atmosphere than it emits. - Buy all of its food locally or from farms and producers that use sustainable practices, including using antibiotics responsibly. - Recycle, reuse or compost 100 percent of its non-hazardous waste. - Reduce the amount of water it uses by 25 percent per square foot of buildings. - Increase its purchase of products and materials that meet environmental standards to 50 percent. - Meet international standards for environmental management at all its hospitals. - Pursue new collaborations to reduce environmental risks to the foodsheds, watersheds and air basins supplying its communities. In September 2020, Kaiser Permanente, the nation's largest integrated, nonprofit health system, announced that it had become the first health care system in the United States to achieve carbon-neutral status. With its longstanding commitment to improving conditions that lead to poor health, Kaiser Permanente has prioritized sustainability to contribute to and catalyze a green future free of the extreme climate conditions currently harming so many Americans. This move to carbon neutrality eliminates the organization's 800,000-ton annual carbon footprint. The U.S. health care industry overall is responsible for roughly 10% of the country's greenhouse gas emissions. Climate change causes many conditions that drive poor health, including damaging extreme weather events such as wildfires, hurricanes, and droughts, increased rates of asthma and respiratory diseases, and the spread of infectious diseases such as malaria and Zika virus. Certified by the CarbonNeutral Protocol, the milestone comes as Kaiser Permanente has for decades embraced renewable energy and embedded sustainable practices throughout its business operations. In 2020, we also dedicated 23% of overall spending on products to items that met our Environmentally Preferable Purchasing standards and dedicated 41% of spending on food to items produced locally or from farms and producers that use sustainable practices, including using antibiotics responsibly. |
| C.Health Professionals Education | Our Graduate Medical Education (GME) program provides training and education for medical residents and interns in the interest of educating the next generation of physicians. The nationally acclaimed program attracts some of the top medical school graduates in the United States and serves as a national model by exposing future health care providers to an integrated health care delivery system. Residents are offered the opportunity to serve a large, culturally diverse patient base in a setting with sophisticated technology and information systems, established clinical guidelines and an emphasis on preventive and primary care. The majority of medical residents are studying within the primary care medicine areas of family practice, internal medicine, ob/gyn, pediatrics, preventive medicine, and psychiatry. In addition to GME, we provide a range of training and education programs for nurse practitioners, nurses, radiology and sonography technicians, physical therapists, post-graduate psychology and social work students, pharmacists, and other non-physician health professionals. Additionally, in January 2020, Kaiser Permanente and Service Employees International Union-United Healthcare Workers West (SEIU-UHW) partnered to establish Futuro Health, a new nonprofit organization dedicated to growing the largest network of certified health care workers. Efforts will start in California and spread throughout the nation. Futuro Health was established to improve the health and wealth of communities by investing in allied health education and skills training and retraining. Allied health care services, critical to delivering high-quality health care, are provided by a wide range of clinical, administrative, and support professionals including licensed vocational nurses, medical coders, health information technicians, radiologic technicians, and laboratory workers. Futuro Health will deliver a new education-to-work model that supports candidates through career exploration and coaching, education financing, and targeted education-to-work pathways toward their credential or licensure attainment. D. Research Kaiser Permanente has a long history of conducting health research related to both prevention and treatment of disease that benefits its members, the communities it serves and the nation. Kaiser Permanente's research efforts are core to the organization's mission to improve population health, and its commitment to continued learning. Kaiser Permanente researchers study critical health issues such as cancer, cardiovascular conditions, diabetes, behavioral and mental health, and health care delivery improvement. Kaiser Permanente's research is broadly focused on three themes: understanding health risks; addressing patients' needs and improving health outcomes; and informing policy and practice to facilitate the use of evidence-based care. Kaiser Permanente is uniquely positioned to conduct research due to its rich, longitudinal, electronic clinical databases that capture virtually complete health care delivery, payment, decision-making and behavioral data across inpatient, outpatient, and emergency department settings for its geographically and demographically diverse members. V. Pandemic Response Working together with our members, patients, communities, employees, and physicians, we can combat this virus. While the COVID-19 vaccine brings hope, COVID-19 still poses a dangerous risk, particularly for older individuals and people of any age with underlying health conditions. The virus continues to spread around the globe and within the United States. Given the continued growth in U.S. COVID-19 cases and the discovery of more contagious variants, Kaiser Permanente's infectious disease experts and clinicians agree that vaccinations, social distancing and masking remain the best way to protect yourself and others and decrease one's chance of getting and spreading the virus. Kaiser Permanente awarded grants to dozens of community-based organizations, safety net providers, and trusted messengers in every market we serve to expand public education and to create trusted messenger campaigns to increase education and to remove barriers for individuals and communities at highest risk for contracting COVID-19. Kaiser Permanente's COVID-19 Social Health Playbook provides care teams with guidance and tools for screening patients for social needs, connecting them to help, and following up to ensure their needs are met. The initial release of the guidelines has a strong focus on addressing COVID-19 patients' social needs to improve their health outcomes and to prevent further transmission of the virus. Nearly half of our outpatient care visits are now conducted virtually by video or phone call. Our teams have adjusted resources and services to meet the increased mail-to-home demand, which has gone from a third of all prescriptions before the pandemic to now half of all prescriptions we dispense. Kaiser Permanente has been part of studies to improve our understanding of COVID-19 and develop tools to prevent and treat the disease, including clinical trials to determine the safety and effectiveness of coronavirus vaccines. |
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