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Why is Kaiser Different From Other Providers?

If you are looking at your coverage options for healthcare for the next year, you might be considering Kaiser Permanente as an option. Compared to other providers on the California health insurance exchange, and depending on your exact location, Kaiser might be showing up as one of the more expensive healthcare options both for individuals and families.

While Kaiser offers plans with many of the same benefits as other California plan providers, they are a different type of company. This is because they are considered “truly integrated” with their own healthcare delivery system both in the state and around the country. They have their own clinics, hospitals, other essential plan components, and even their own healthcare professionals within their system. While for some this could be viewed as a professionalization and a standardization across their various forms of care, it can also make things more expensive. Another benefit of being structured like this is that the company is essentially able to provide all services to each of their plan members because of this extensive system.

The downside of that is that it can be expensive to maintain such a system, even when it has bene streamlined. Careful execution of a strategy like this and advance planning are critical for the company to get the most out of this but also for insured individuals to capitalize on the strengths of their plan. Plans like this are dependent on big enrollment, because the cost of enrollment, when spread out over so many individuals, can help to keep the costs reasonable and therefore present a sensible perspective on keeping so many facilities and providers managed under the Kaiser Permanent system. It’s a delicate balance, because sudden surges in patients and enrollment could even put a strain on such a system, but too low enrollment means that it doesn’t really pay off to have such a big system built in.

It’s important to know that there are many different plan options under Covered California and that the purpose of a health insurance exchange is to give you plenty of choices to determine the best fit for you and your family. One of the advantages of selecting a plan through Kaiser is that you’ll benefit from the standards and system already developed in-house. For some families, that could be a perfect fit. Remember that you can use the health insurance exchange to shop around.