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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 18,090 | 23,186 | 738,592 | 818,201 | 325,563 | 1,923,632 |
| 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 | 3,944,202,954 | 4,180,613,701 | 4,467,072,552 | 4,634,650,434 | 4,739,291,518 | 21,965,831,159 |
| 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 | 3,944,221,044 | 4,180,636,887 | 4,467,811,144 | 4,635,468,635 | 4,739,617,081 | 21,967,754,791 |
| 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.) | 21,967,754,791 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 3,944,221,044 | 4,180,636,887 | 4,467,811,144 | 4,635,468,635 | 4,739,617,081 | 21,967,754,791 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 21,736,621 | 25,252,630 | 26,730,220 | 20,986,083 | 13,242,254 | 107,947,808 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 172,284 | 213,536 | 263,834 | 255,163 | 441,544 | 1,346,361 |
| c | Add lines 10a and 10b. | 21,908,905 | 25,466,166 | 26,994,054 | 21,241,246 | 13,683,798 | 109,294,169 |
| 11 | Net income from unrelated business activities not included on 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 | 277,551 | 2,014 | 279,565 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 3,966,129,949 | 4,206,103,053 | 4,494,805,198 | 4,656,987,432 | 4,753,302,893 | 22,077,328,525 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 2021 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-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| 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 | - Voting Member and Governing Body - 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 members Jeffrey Epstein and Jenny Ming have a business relationship. |
| Form 990, PART VI, LINE 6 | KAISER FOUNDATION HEALTH PLAN, INC. IS THE SOLE MEMBER. |
| Form 990, PART VI, LINE 7A | - APPOINTMENT OF GOVERNING BODY - 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 | - APPROVAL OF CERTAIN GOVERNANCE DECISIONS - 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, Executives, and other employees in roles with elevated risk are required to complete a Conflicts of Interest Disclosure (COID). 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 with 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 COID process and actions taken for Directors, Officers, Key Employees, and Executives. 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 liab $ 424,838,569 Gain/ Loss on Investments - Book (6,034,373) Gain/ Loss on Investments - Tax 7,066,242 otti losses - book (5,704,114) ------------------ 420,166,324 |
| FORM 990, PART III, LINES 4A - 4D | - EXEMPT PURPOSE ACHIEVEMENTS - I. Introduction A. About Kaiser Permanente Founded 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 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 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 12.5 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. To be our healthiest we need more than high-quality medical care - we need to improve the conditions for health and equity in the communities we serve. What does that mean? It means addressing all the factors that affect health, such as having a safe place to live, enough money to pay the bills, access to healthy meals, and meaningful social connections. Kaiser Permanente is accelerating efforts to broaden the scope of our work - and ultimately create healthier, more equitable communities for all. Through our continued focus on expanding our community health approach, however, 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 12.5 million members and the communities we serve. |
| C.Kaiser Permanentes Total Contribution | Kaiser Permanente provided $2.6 billion in 2021 to improve the health of our communities. The amounts attributable to Kaiser Foundation Health Plan of the Northwest is $83 million as follows: - Financial Assistance at cost - $23.3 million - Medicaid - $45.2 million - Costs of other means-tested government programs - $12 million - Community health improvement services and community benefit operations - $2.6 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 our participation in government programs like Medicaid and the Children's Health Insurance Programs (CHIP) and 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. |
| 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 2021, Kaiser Foundation Health Plan of the Northwest was providing coverage to a total of 75,500 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 2021, 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 2021 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 underinsured 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. 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 2021, Kaiser Foundation Health Plan of the Northwest subsidized care for a total of 16,000 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. Safety-net health care providers have a legal mandate or explicit mission to provide care for patients who have low incomes and/or are uninsured regardless of their ability to pay. 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 continue to 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. As part of Kaiser Permanente's $8.15 million commitment to COVID- 19 vaccine equity, Kaiser Foundation Health Plan of the Northwest supported Federally Qualified Health Centers (FQHC) across Oregon. Efforts focused on serving the safety net population and connecting them to vaccines and aiding equitable vaccine access across disproportionately impacted communities. Kaiser Foundation Health Plan of the Northwest's support encouraged FQHC capacity to leverage federal support for vaccines. Kaiser Foundation Health Plan of the Northwest also supported Project Access NOW's Community Care Collaborative. The program provides outcome-focused, comprehensive, community-wide solutions strategically tailored to meet the changing needs of diverse communities across Oregon and Southwest Washington. Project Access NOW has proven to be an important partner and convener for all the health systems in Portland and will continue to play a role in addressing the social needs of low-income patients. |
| 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 health and equity in communities by addressing the root causes of health, such as healthy food, economic opportunity, affordable housing, and safe and supportive schools. We screen patients for social factors influencing their health and connect them to resources when needed - both community-based programs and Kaiser Permanente-funded initiatives. 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.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 Kaiser Permanente is also deepening its efforts to get at the heart of inequities, addressing systemic racism, breaking cycles of trauma, and creating economic opportunities for communities that have endured decades of underinvestment. We are working with communities striving to overcome systemic and structural economic disadvantage and supporting the resiliency of businesses owned by Black and other historically underrepresented individuals. We recognize that it will require sustained efforts to increase access to business capital and build capacity for growth. Success for these communities requires intentional, long-term investment, and ongoing work to dismantle racist systems that create barriers to success. Kaiser Foundation Health Plan of the Northwest supported the Hispanic Scholarship Fund and United Negro College Fund Inc (UNCF) for the Health Equity Scholarship Program - a postsecondary, need-based scholarship and wrap-around services program designed to support college persistence and completion for low- to mid-incomes students. The contributions will serve African American and Latino students from communities within Kaiser Permanente's footprint. Through the delivery of college success coaching and professional development support, students in the program will be prepared to assume rewarding internship and early career opportunities within the healthcare industry. Scholars will be provided all the tools they need to do well in their course work, graduate, enter and excel in their profession. |
| B.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. The COVID-19 pandemic had a significant impact on social health needs in our communities, and people experiencing homelessness or housing insecurity were among the most vulnerable. Even in the absence of COVID-19, people experiencing homelessness face a higher risk of death than housed populations. Increasing affordable housing preserves homes that improve total health and lift residents socially and economically. Nationwide, people of color are disproportionately impacted by homelessness and housing insecurity, further exacerbated by COVID-19. The health crisis and economic fallout from the pandemic have hit low-income and communities of color hardest and threaten to widen the health equity gap in our country even further. Kaiser Permanente cannot solve the affordable housing and homelessness crisis alone. Only through innovative partnerships, strategic investments, and impactful storytelling can we move the needle for our most vulnerable communities. Kaiser Permanente will continue to drive national housing for health initiatives that create more healthy years for all. Kaiser Foundation Health Plan of the Northwest supported efforts to partner with Community Solutions International, Inc. to help accelerate efforts to end chronic homelessness in communities within Kaiser Permanente's national footprint. Our partnership with Community Solutions includes supporting their capacity and ability to successfully conduct Built for Zero work in Kaiser Permanente communities. It also supports building the evidence base for validating the Built for Zero methodology and creating other models to help communities achieve quality data, an essential piece of the Built for Zero process. New proof points and shared learning around Built for Zero's success will help build out a roadmap to help any community reduce and end homelessness. Kaiser Foundation Health Plan of the Northwest also supported several organizations to increase access to affordable and stable housing options and referrals to a case management program. This included connecting youth aging out of foster care to stable housing, education, and community services in the Portland Metro Region; and providing educational support for middle and high school students living affordable housing properties. Families living in affordable housing properties will receive technical assistance, and any necessary supplies for school, with the goal of ensuring that the graduation rate of these students living in affordable housing meets or exceeds that of their corresponding high schools. |
| C.Thriving Schools | At Kaiser Permanente, we're committed to not only delivering great health care but also creating communities where people can be healthy in all the places they live, learn, work, and play. Thriving Schools brings together Kaiser Permanente's extensive health care expertise and our partnerships with nationally recognized and trusted organizations working to support schools in becoming a beacon of health in their community. Thriving Schools takes an integrated approach to school health, curating the best thinking and guidance on how to keep students, staff, teachers, and families healthy across four dimensions of health: physical health, mental health, social health, and equity and access. Taking an integrated approach to health means supporting schools and districts in advancing their wellness and educational goals by incorporating health-related strategies into school and district improvement efforts. Like the communities in which they sit, schools often reflect a diversity of cultures, beliefs, and experiences. As such, the services and opportunities they provide must ensure that all students and staff are given the opportunity to reach their full potential. Thriving Schools' integrated approach explicitly addresses equity and inclusion, both in the assessment tools we use and in the resources we offer for school staff and district leaders. Kaiser Foundation Health Plan of the Northwest supported efforts to partner with the Alliance for Healthier Generation to advance the RISE (Resilience in School Environments) initiative, an enterprise-wide effort. RISE is 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 improve safety, connectedness, and relationships among students and staff; increase skills related to social and emotional learning for students and staff; increase mental health supports; and increase job satisfaction, including reducing staff member stress. Kaiser Foundation Health Plan of the Northwest also supported Washington State University for the Improve Social and Academic Success through Trauma-informed Schools project. This project will reach elementary students by providing educators with cultural and professional skills needed to effectively support students with trauma and enhance universal social emotional learning practice, develop effective identification, and care coordination for the most vulnerable students and families, and assure school and support services operate from a unified and sustainable plan to support students and families. |
| D.Thrive Local | Social determinants of health - the conditions in which people live, learn, work, and play - affect a wide range of health risks and outcomes. Access to quality health care is critical, but social factors, such as lack of safe housing and transportation, inadequate education or job opportunities, and poor access to good nutrition and physical activity, inevitably create barriers to health and wellbeing. While many social resources may exist in a community, they are often unknown to those most in need and disconnected from one another even when serving the same client, creating confusion and exacerbating stress for community members. Through the Thrive Local initiative, launched in late 2019, Kaiser Permanente is establishing bi-directional electronic community networks in every Kaiser Permanente service area. The networks enable health care providers, safety net clinics, social service agencies, government programs, and other participants to make, receive, and track patient and client referrals. Health care providers can refer patients to organizations that address social factors affecting their health, and social service providers can coordinate effectively among themselves to improve community-wide care delivery. Data aggregated through the network technology provides a robust source of information on local social needs and service gaps to drive collaborative community planning. Kaiser Permanente's Thrive Local contributions in 2021 facilitated growth of these community networks by funding community-based organizations to invest in change management, technology, or staffing to assist them in joining the network, as well as "anchor" social service organizations that participated in outreach to build the networks, ensuring they reflect the needs of their respective communities. Kaiser Foundation Health Plan of the Northwest continued to support organizations as part of its 4-year Community-Clinic Integration (CCI) initiative. This included engaging with several community -based organizations to facilitate their participation in the community network in Southwest Washington. This also added key services to the network to meet community needs and increased participation in the network. The organizations selected included Area Agency on Aging and Disability of Southwest Washington, Cascade Pacific Action Alliance, and Southwest Washington Accountable Community of Health. Support of the Community-Clinic Integration has expanded geographically over the life of the initiative as new networks have been launched. |
| E.Food for Life | Food for Life is Kaiser Permanente's comprehensive approach to transforming the economic, social, and policy environments connected to food so that people across the nation have access to, and can afford, healthy food. It includes increasing individual and family purchasing power; providing enhanced nutrition to vulnerable and sick members; improving access to community resources; and advancing local and national food security efforts through research, policy advocacy, thought leadership and community support. Kaiser Permanente recognizes that solving for food security goes beyond just giving people food. People's attitudes toward food, the economic tradeoffs they must make, the stigma around food assistance, and social and culture dimensions all play an important role. Food insecurity is linked to a variety of adverse health outcomes, including poor chronic disease management, developmental and mental health problems, increased hospitalizations, and higher costs of care. Kaiser Foundation Health Plan of the Northwest supported several efforts to end hunger across Oregon including supporting the Clackamas Service Center with their efforts to ending the hunger crisis and strengthening the nutrition safety net. Clackamas Service Center is an inclusive, trauma-informed service center where community members experiencing hunger and poverty can meet their basic food, health, and hygiene needs, and connect with supportive services to help them take their next steps toward stability and self-sufficiency. This project will establish a new food hub and community resources for food security in Clackamas County and ensure that low- and no-income residents of this deeply underserved region of the Portland metropolitan area, including unhoused people, BIPOC communities, immigrants (documented and undocumented) and working-class families are able to secure abundant, fresh, nutritious, and culturally relevant foods. |
| 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 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. Kaiser Foundation Health Plan of the Northwest also supported efforts to partner with the Vose River Charitable Fund, which is an organization that develops tools and collaborates with other nonprofit organizations and government health departments to support effective policies and the public health workforce. Our partnership with Vose River Charitable Fund will ensure the CityHealth initiative has sufficient staffing and consultants, policy-specific technical assistance, policy assessment research and communications support. Funding will also support a new policy menu and greater reach among cities in Kaiser Permanente's footprint. |
| B.Environmental Stewardship | At Kaiser Permanente, we believe it is our obligation as a health care provider to minimize our environmental impact. We work 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. Our mission to improve the total health of our members and the communities we serve compels us to take bold steps to reduce our impact on the climate and increase understanding of the connection between climate and health. We know one way to improve the health of the communities we serve is by improving their environmental conditions. In 2020, we became the first U.S. health system to become carbon neutral as an organization, completing the "last mile" toward this milestone through investment in carefully chosen carbon offset projects. By eliminating our carbon footprint, we have taken measurable action to improve conditions that lead to poor health, deepening our commitment to create more healthy years for all, and supporting the medical community's pledge to do no harm. In 2021, we also dedicated 26.62% of overall spending on products to items that met our Environmentally Preferable Purchasing standards and 100% of our overall operations were powered by renewable electricity. |
| 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. |
| D.Research | 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 | After two years, the COVID-19 pandemic continues to be a significant risk in our communities, especially for people who are not yet vaccinated. We rapidly rolled out vaccines, and now boosters, and administered COVID-19 tests while managing new and unpredictable variants like delta and omicron as they surfaced. 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 guidelines have a strong focus on addressing COVID-19 patients' social needs to improve their health outcomes and to prevent further transmission of the virus. 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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