Kaiser Foundation Health Plans, part of Oakland, Calif.-based Kaiser Permanente, added 36,000 members in 2022, putting it at more than 12.6 million members nationwide.
Ten things to know:
1. Greg Adams is chair and CEO of Kaiser Foundation Health Plan and Hospitals, collectively known as Kaiser Permanente. He has served in the role since December 2019.
2. Kaiser Permanente comprises multiple organizations which combine health plan coverage with coordinated medical services. Kaiser Foundation Health Plans provides pre-paid coverage; Kaiser Foundation Hospitals operates hospitals and provides other infrastructure; and the Permanente Medical Groups provide or oversee care. The Kaiser Health Plans and Hospitals are nonprofit, tax-exempt entities. As physician-owned organizations, the Permanente Medical Groups are separate, for-profit, professional corporations or partnerships, which are contractually dedicated to care for Kaiser Permanente members.
3. Kaiser health plan operates in the District of Columbia and eight states: California, Colorado, Georgia, Hawaii, Virginia, Maryland, Oregon and Washington.
4. Kaiser ranked as the best U.S. health insurance company in 2023, with UnitedHealthcare and Aetna following close behind, according to Insure.com. Kaiser was also named the most trustworthy health insurer and ranked No. 1 for customer satisfaction and ease of service.
5. Five Kaiser Medicare Advantage Part D plans earned five star designations from CMS for 2023: Kaiser Foundation HP (California); Kaiser Foundation HP of Colorado; Kaiser Foundation HP of Georgia; Kaiser Foundation HP (Hawaii); and Kaiser Foundation Health Plan of the Mid-Atlantic States.
6. The payer-provider organization has about 7 percent of the commercial market share at the national level. It ranks fifth behind UnitedHealth Group (15 percent), Elevance Health (12 percent), Aetna (11 percent) and Cigna (10 percent), according to the American Medical Association.
7. Kaiser is the largest payer on the ACA exchange market in California and Washington with a market share of 38 percent and 26 percent, respectively.
8. Kaiser's integrated model, easy access to preventive care and commitment to improving outcomes and reducing health inequities are among the key reasons it earned the top spot for Medicaid, Medicare and commercial plan ratings from the National Committee for Quality Assurance in 2022.
9. As a system, Kaiser reported a net loss of $4.5 billion in 2022, down from a net income of $8.1 billion in 2021, according to its financial results. Its operating margin dipped from 0.7 percent in 2021 to -1.3 percent in 2022. Kaiser said the swing from net income to net loss reflects an increase in healthcare costs driven by inflation, high COVID-19 costs, ongoing labor shortages and a rise in care volume.
10. Founded in 1945, the organization has grown to include 39 hospitals, 23,982 physicians, 68,218 nurses and 223,735 employees.