Oakland, Calif.-based Kaiser Permanente has spent 81 years building an integrated care model that consistently outperforms national benchmarks on cancer mortality, cardiovascular disease and overall premature death. For most of that history, experiencing that model meant being a Kaiser member in a Kaiser market. Shelby DeCosta, senior vice president and chief business development officer, is focused on changing that.
In the past two years, Kaiser has structured three distinct partnership vehicles, each designed for a different population, a different problem and a different type of partner. But within all partnerships the organization makes an effort to extend Kaiser’s outcomes-driven approach without the constraints of organic expansion, and without asking partners to become something they’re not.
“We don’t believe every organization needs to be Kaiser Permanente,” Ms. DeCosta said. “But what we do believe is that value-based care is the right way to impact health outcomes in communities.”
Before the partnerships can work, Ms. DeCosta argues, the term has to mean something specific. She describes value-based care as healthcare delivery that is simple, affordable, evidence-based and equitable, with every incentive in the system aligned around keeping patients healthy. Kaiser’s outcomes data shows its members are 20% less likely to die prematurely of cancer, 33% less likely to die prematurely of heart disease and see 35% lower overall premature mortality compared to others in its communities.
“As we think about our partnerships, it is how do we get those same outcomes by really bringing the best of what KP has and the best of what others have,” she said. “The goal is not really to make everybody Kaiser Permanente, but it’s to figure out for each community how we can express those outcomes.”
The first vehicle is a joint venture health plan structure, piloted in Nevada. After receiving inbound interest from employers and former members who wanted Kaiser’s integrated care model in the state, the health system partnered with Reno, Nev.-based Renown Health to co-own Renown’s existing health plan, Hometown Health.
Rather than building from scratch, the two organizations mapped the full member experience and assigned responsibility for each component based on which partner was best positioned to deliver it. Renown retained all hospital care and most existing outpatient services. Kaiser brought national health plan capabilities, expanded primary care and new specialty medical offices, and the digital infrastructure Hometown Health lacked.
“While this is a joint venture plan between Kaiser Permanente and Renown Health, all of the hospital care is still provided by Renown Health,” Ms. DeCosta said.
The partnership launched earlier this year. Ms. DeCosta said interoperability work is still underway to ensure members traveling to other Kaiser regions can access care across the system.
The second vehicle came not from a new market but from a gap Kaiser identified within its own membership. Elderly members with complex needs were not receiving the level of care they required from Kaiser’s existing system. In partnership with healthcare investment firm Town Hall Ventures, Kaiser built Habitat Health, a program of all-inclusive care for the elderly operation with two centers currently live. Early results show reductions in hospital readmissions and stronger compliance with care regimens, while members maintain access to Kaiser hospitals and specialists for inpatient needs.
“We’re looking not just at new populations and new communities that we can better serve,” Ms. DeCosta said. “We’re also looking within our own membership to see what else we can do to better serve their needs.”
The third vehicle is the most structurally ambitious. Risant Health, a nonprofit formed under Kaiser, is designed for community health systems that serve all payers and want to deepen their value-based care capabilities. Danville, Pa.-based Geisinger was the first member system. Greensboro, N.C.-based Cone Health is the second. Through Risant, member systems gain access to Kaiser’s evidence-based care protocols, patient navigation tools and capabilities that have already reduced specialty and inpatient demand at early member sites — freeing capacity for patients who need it most.
“The criteria for Risant is pretty stringent and so there’s a short list of health systems where this model makes sense,” said Ms. DeCosta.
Risant is targeting five to six member systems over the next few years, prioritizing organizations that are already recognized leaders in their markets and have built across the full continuum of primary care, specialty, ambulatory and post-acute. What Kaiser brings through Risant is the connective infrastructure of payer alignment, evidence-based protocols and the tools to tie existing capabilities together under a value-based framework.
“These are the organizations that are known to be the leaders in their communities,” Ms. DeCosta said. “They’re the highest quality organizations and in many cases, they are the
Kaiser leans into local brand identity rather than overwriting it. Ms. DeCosta said the organization consistently steers away from imposing its own name and structure on partner markets, viewing the trust a health system already holds in its community as an asset.
Joint operating committees in Nevada coordinate care alignment across organizations. Risant’s structure is anchored in long-term contracts oriented around shared outcomes rather than short-term transactional value. Ms. DeCosta said the most essential ingredient in any of these models is trust.
“We really need to trust each other,” she said. “These are big decisions with the potential for significant outcomes. Having that shared accountability, knowing who’s on the other side and the type of organization — that sets us up for long-term success.”
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