Associated Press
OAKLAND, Calif. (AP) — Kaiser Permanente and consumer activists announced a legal settlement Thursday that will require the health care giant to disclose the guidelines and financial incentives that influence the medical decisions of its doctors.
The agreement settled a 1999 lawsuit and is expected to shed light on the cost controls of health maintenance organizations.
The settlement requires the Oakland-based company to post on the Internet its guidelines for what kind of treatment patients can expect for an illness, and how doctors are compensated for their services.
The settlement applies only to California, Kaiser Permanente spokeswoman Beverly Hayon said.
The company has more than 8 million patients across the country — about two-thirds of them in California.
Hayon said she didn’t know when the information would be posted.
Kaiser Permanente is unlike other HMOs in the state because it’s a health insurance company that also has a doctors group, said Steven Fisher, deputy director of the state Department of Managed Health Care. Typically, HMOs contract with doctors.
“It’s always a victory when adversaries stop shooting at each other and come to an agreement in favor of patients,” Fisher said.
The Foundation for Taxpayer and Consumer Rights, Consumers for Quality Care and the Steven Andrew Olsen Coalition for Patients’ Rights sued Kaiser Permanente in San Francisco court on allegations that a company ad campaign inaccurately portrayed its doctors as unhampered by financial constraints on patient care.
“This is a really important step for public disclosure that every other HMO in the nation should follow,” said Jamie Court, executive director of the Foundation for Taxpayer and Consumer Rights.
Under the agreement, Kaiser Permanente will expand efforts to let patients chose a personal doctor, continue physician recruitment and take part in a statewide study on emergency care services.
The company also said its customer service employees are not receiving financial incentives to keep patients away from doctors. Kaiser Permanente had come under fire for a bonus it offered call center employees if their calls with patients averaged less than 3 minutes, 45 seconds and if they scheduled appointments for 15 to 35 percent of patients who called.
Kaiser Permanente said the bonuses were not intended to make it difficult for patients to access care, but were instead intended to reward good service. The company said it was a pilot program that has been discontinued.
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On the Net: Kaiser Permanente: http://kaiserpermanente.org
California Department of Managed Health Care: http://www.hmohelp.ca.gov
Foundation for Taxpayer and Consumer Rights: http://www.consumerwatchdog.org
