Primary Care RedesignRob Ryan, MD Perm J 2016 Fall;20(4):97-063 https://doi.org/10.7812/TPP/97-063For the past several years, Kaiser Permanente has been fundamentally redesigning primary care delivery in Georgia. We have built a unique model centered on physician ownership and accountability along with incentives and compensation levels which are tied to performance and member satisfaction. Structured around small, semi-autonomous teams, this model blends the best of two worlds by leveraging the scale, structure, experience, and reputation of the nation’s largest and most respected health maintenance organization (HMO) to create and support small teams of medical professionals who manage the care of a defined panel of patients. INTRODUCTIONKaiser Permanente in Atlanta, Georgia (KP-Atlanta) began operations in 1985, and by 1992 there were more than 156,000 members enrolled. The plan had accumulated operating debt of approximately $80 million at a time when competition was intensifying. A 1993 study showed that our internal cost for delivering primary care was about 40% higher than in community practice. Our competition was delivering primary care much more efficiently, and our predictions suggested that our price disadvantage would increase. |
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