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Read Making a Killing

home / healthcare / in the media

AM BestWire
Jan 29, 2003

by Marie Suszynski, Associate Editor

KAISER AGREES TO DISCLOSE PHYSICIAN GUIDELINES, COMPENSATION TO SETTLE SUITS

OAKLAND, Calif. (BestWire) - Kaiser Permanente said it would post clinical guidelines and its physician compensation structure on its public Web site as part of a settlement to end lawsuits with three consumer groups. The agreement ends two lawsuits filed in 1999 by the Foundation for Taxpayer and Consumer Rights, Consumers for Quality Care and the Steven Andrew Olsen Coalition for Patients' Rights. The suits alleged that Oakland, Calif.-based Kaiser used false advertising and committed other violations of California's unfair competition law.

Kaiser, which is the nation's largest nonprofit health plan, will post guidelines developed by physicians for the treatment of conditions such as asthma and visual impairment, the company said in a joint statement with the consumer groups. The insurer will also provide information on its physician-compensation structure.

"The goal of Kaiser Permanente is to work hand-in-hand with our members to continually improve the quality of care and service," Bernard Tyson, senior vice president of Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals, said in the statement. "It is particularly gratifying to turn conflict into a productive collaboration with these important consumer groups."

Kaiser Permanente is made up of Kaiser Foundation Health Plan, Kaiser Foundation Hospitals, their subsidiaries and Permanente Medical Groups.

The 1999 lawsuit involving the Foundation for Taxpayer and Consumer Rights was set for trial last November. It alleged that Kaiser's $60-million-a-year mass-market advertising campaign that carried the slogan "in the hands of doctors" lured 500,000 new members with the false promise that only doctors, not insurance administrators, would make medical decisions.

The lawsuit also alleged that Kaiser established policies and practices that allowed monetary and profitability concerns to interfere with the medical judgment of Kaiser doctors. Kaiser contended that the lawsuit was "completely groundless and false" (BestWire, Jan. 8, 2002).

In a Jan. 23 statement, Kaiser reaffirmed that its call-center employees don't receive financial incentives to limit or deny access. The company also said it has already implemented changes that included expanding efforts to encourage members to select a personal physician; devoting resources to physician recruitment to ensure an appropriate number of qualified doctors; improving call-center operations based on surveys of members; and contributing to an ongoing study on the delivery of emergency-care services in California hospitals.

"Kaiser Permanente has set an important bar for public disclosure that other health plans should meet," Jamie Court, executive director for the Foundation for Taxpayer and Consumers Rights, said in the statement.

Kaiser Foundation Health Plan is rated B+ pd (Very Good, based on public data)
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By Marie Suszynski, associate editor, BestWeek (Marie.Suszynski@ambest.com)


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