I was reading Marty Stempniak's recent H&HN Daily interview with Kaiser Permanente's CEO Bernard Tyson in which he expressed a sense of urgency that, as one of the country's leading health care providers, Kaiser serves as a national model for providing high-quality, affordable (with an emphasis on affordable) care. As millions of new customers enter the market through the Affordable Care Act along with the opportunity for these customers to compare and purchase plans — oftentimes with cost as the primary differentiating factor — creating a consumer-friendly product and using technology to promote efficiency and health is becoming a key imperative, he said.
It is certainly a lofty goal, especially for a behemoth of an organization that covers almost 9 million lives, employs 17,000 physicians and 170,000 employees, and operates in nine states. On the other hand, Kaiser is ideally positioned: It is a staff model HMO and has incentives well-aligned to promote health and reduce cost. Besides, it certainly has the institutional clout to become a national model.
Health Care Is a Cause
The journey to "total health" — to promote health through clinical, educational, environmental and social services — had been a decade in the making when Kaiser's senior leaders took a bold stand stating that health was not an industry but a cause. As noted in my Aug. 10, 2010, H&HN Weekly column about Kaiser Permanente's Total Health Environments, that journey began under the aegis of the facility planners to address the built hospital environment. But it soon grew to encompass other initiatives, such as the on-site farmers markets, hospital food policy, workplace wellness and online health tools. Total Health Environments became the template for all the hospitals under construction and new management.
But Kaiser Permanente needed to go further and employ the full array of resources it has to support its members and employees to achieve their health goals where they live, work and play. It is doing this by building partnerships with local community organizations, national groups, employers and corporations, says Tyler Norris, recently hired as vice president of Total Health Partnerships.
To that end, Kaiser Permanente brought to bear four primary resources:
Clinical quality. In addition to providing high-quality care, physicians are responsible for making primary prevention in the clinical environment a major component of care along with encouraging physical activity. They call this Exercise as a Vital Sign. Physicians write "exercise prescriptions" and routinely offer referrals and resources to local community organizations with whom they have built partnerships.
Behavior change. The organization is working closely with members and corporate customers to employ strategies that help people eat more nutritious foods, be more physically active, quit tobacco and drink alcohol only in moderation.
Healthy environments. Beyond the built and physical environments, social, cultural and natural environments are crucial to ensuring that the healthier choices are the easier choices. Guidance provided to members and employees in these areas are a key component of the total health approach.
Community engagement and grant-making. In addition to providing charity care and coverage to low-income residents in the communities served by Kaiser Permanente, the organization also is investing in long-term community health initiatives. These initiatives employ evidence-informed best practices via targeted grant-making and by partnering with trusted community organizations such as community health centers, schools and after-school programs, farmers markets, YMCAs and faith-based programs.
In the short term, says Norris, two flagship initiatives are front and center — Healthy Workforce and Thriving Schools. Kaiser views promoting a healthy workplace and encouraging employees and their families to pursue and maintain healthy lifestyles as a top priority. Launched in 2010, the program features a number of innovative national programs, tools and resources focused on healthy eating, physical activity and emotional well-being — all designed to support a culture of health and a healthy lifestyle.
Thriving Schools is Kaiser's national effort to improve the health of students, staff and teachers in K-12 schools by making the healthy choice the easy choice. Thriving Schools promotes workforce health and student-focused initiatives like improving school lunches and offering more opportunities for physical activity. The Thriving Schools website offers ready-to-use tools and resources at no cost and provides a place to share ideas and success stories, as well as spark creative innovation.
Building communities of health and creating support systems that go beyond the doctor's office and outside the hospital walls are the way of the future in promoting and supporting the health of our citizens. Embracing the whole person — mind, body, spirit — and taking a total health approach is undeniably the only way we can tackle the daunting task of improving and maintaining the health of our citizens.
Sita Ananth, M.H.A.,is a Napa, Calif.-based writer and consultant specializing in complementary medicine and wellness. She is also a regular contributor to H&HN Daily.