Kaiser Permanente founding physician Sidney Garfield had good advice for his Northern California colleagues in 1974. He basically told them to stick together. “Keep your arms on each other’s shoulders and keep your eyes on the stars for innovation and change for the future.”
The executive medical directors took that sage advice in 1997 and created The Permanente Federation (the Federation) to serve the collective interests of the physicians to deliver the highest quality medical care through partnership with Kaiser Foundation Health Plan.
This year, the Federation marks the 15-year anniversary of this collaboration, which has contributed to Kaiser Permanente’s high-performing integrated care delivery system, the creation of a cutting-edge national electronic health records system, a formal sharing of best medical practices, and a shared vision for the future of health care.
In his talk to KP physician leaders 38 years ago, Garfield was speaking from the perspective of someone who had locked horns with traditional fee-for-service medicine over prepaid group practice. He understood that in order for physicians to be able to deliver the highest quality care, they need to be well-positioned to advocate for their patients.
Permanente physicians have rubbed elbows with Washington movers and shakers over the years. Here, Sidney GarfieldThe alignment of KP’s medical groups created an effective model for collaboration with the eight Kaiser Permanente regional Health Plans and Hospitals. Today, this collaboration continues to drive ongoing dialog through the Kaiser Permanente Program Group, the joint strategic leadership body, and is recognized for its balanced leadership and shared commitment to patient-centered care.
In the inaugural issue (summer 1997) of The Permanente Journal, KP’s peer-reviewed medical journal, Oliver Goldsmith, MD, first chairman of the Federation’s Executive Committee, described the need for physician alignment: “We must assure the value (of putting patient interests first) remains central and (we must) prove incorrect the creeping notion that group practice does not offer an appropriate solution to our nation’s health care problems.”
In the June 2002 issue of Managed Care magazine, former KP CEO and President David Lawrence, MD, noted that new opportunities for collaboration through the Federation represented a change necessary to KP’s continued success. “. . . We now can start to take advantage of our intellectual scale, this incredible experience that occurs across all the geographic areas with all the clinicians and all the Health Plan executives,” Lawrence told the magazine.
On the Federation’s 10th anniversary in 2007, Jay Crosson, MD, the first Federation executive director, gave his evaluation of its success: “In the areas of quality and service improvement, IT development, external relations, and other endeavors, the renewed partnership among the Federation, Health Plans, and organized labor (through the Labor Management Partnership) has been a historic contribution to maintaining KP’s reputation for excellence and superior value.”
Today, the Federation represents approximately 17,000 physicians in eight Permanente Medical Groups nationwide, caring for more than 9 million Kaiser Permanente members. Jack Cochran, MD, the current executive director, offers his perspective on the Federation’s first 15 years:
“Over the years, the partnership between the PMGs and the Federation to leverage advanced technology, create innovative ideas, and share best practices has advanced our clinical quality. Ingrained in KP’s physician culture and rooted in Sidney Garfield’s leadership and vision, is our commitment to provide excellent care through evidence-based medicine that puts the patient first, always.”
The Care Management Institute, also established in 1997, partners with the PMGs and the Kaiser Foundation Health Plan to realize Kaiser Permanente’s vision of consistent, high-quality care.
CMI works with physicians and researchers in all eight Kaiser Permanente regions to gather new epidemiological research and outcomes information and to develop evidence-based best practices to share with all KP physicians and other health care professionals.
“CMI was established to optimize care quality, to further KP’s mission in improving the health of its members, and to transform its health care culture,” said CMI’s Executive Director Scott Young, MD. “We spread clinical best practices, develop integrated care delivery models with regional partners, and support the national program by working with physicians, clinical experts and leaders throughout KP.”
In his 1997 Journal article, Dr. Goldsmith summed up the potential of KP’s partnerships: “A truly national Kaiser Permanente, with a growing Kaiser Foundation Health Plan and a growing Permanente medical practice across the United States, can be the most powerful contribution to improving American health care in our organization’s storied history.”