Module 3
Affordable health care and value you can measure
Kaiser Permanente is committed to helping your clients keep their costs manageable. We do this by reducing unnecessary spend and supporting long-term workforce health by proactively preventing illness or catching it before it becomes serious and costly. And by providing robust, transparent data reporting that shows your clients exactly where their health care dollars are going, we’re able to deliver value they can actually measure.
Minimizing costs, maximizing health
Kaiser Permanente is recognized as a leader in value-based care because we improve population health by delivering cost-effective, evidence-based health care.
We’re not immune to rising drug cost trends — but our cost-efficient pharmacy model helps minimize their impact.
Seamlessly integrated in-person and virtual care helps accelerate access, avoid gaps, and eliminate waste.
Robust data and reporting empowers your clients with the insights they need to get the highest return on their health care investment.
A pharmacy model with massive cost-saving potential
At Kaiser Permanente, we oversee the entire pharmacy process — enabling us to maintain excellent quality while controlling costs to protect your clients’ bottom line.
Strategic purchasing — Annual bid cycles help keep drug supplies steady and prices consistent. We also purchase and warehouse drugs ahead of impending price increases.
Adopting biosimilars — When biosimilars are available, we prescribe them 95% of the time, compared with just 25% nationally.1 In 2023, we achieved more than $300 million in savings by replacing expensive biologic Humira with the cost-efficient biosimilar Amjevita.2
Championing generics — 94% of the medications we prescribe are generics.3 That's notably higher than the national average of 90%.4
Higher telehealth utilization lowers costs
Our robust, integrated telehealth capabilities help minimize costs by getting members to the right care at the right time.
- Our members use telehealth 6 times more than the national average — and they’re 2 times less likely to need follow-up appointments.8
- 50% of our 24/7 virtual care users avoid unnecessary and costly trips to the ER or urgent care.9
- 27% of our primary care appointments happen virtually, compared with just 5% nationally.10 Since health care costs are 33% lower for employees who get regular primary care — and telehealth makes it easier for them to do that — higher utilization rates can result in substantial cost savings.11
Robust reporting gives your clients a competitive edge
Reporting from other health plans is typically limited to insurance claims. In contrast, our electronic health record lets us report clinical data that illustrates exactly what’s driving your clients’ health care costs.
Leveraging data to optimize value
Your clients can use these insights to inform their workforce wellness strategy — targeting specific areas for improvement that can help reduce costs and improve workforce health. In addition to showing how employees are interacting with care, our reports let your clients see how many employees are:13
- Up to date on preventive care and screenings
- Effectively managing chronic conditions
- Engaging in healthy behaviors
- Filling prescriptions on time, getting vaccines, and more
Learn more about what sets us apart in the market
We make it easy for your clients to get started with their health plan.
Innovative solutions for smarter, faster, and more effective care.
Expand your book of business while delivering more value.
Footnotes:
1Kaiser Permanente internal data; The IQVIA Institute for Human Data Science, January 31, 2023. Continue at 1
2“Biosimilars at Kaiser Permanente: Lessons in Successfully Reducing Spending on Prescription Drugs,” Kaiser Permanente Institute for Health Policy, July 16, 2023. Continue at 2
3Kaiser Permanente internal data. Continue at 3
4The U.S. Generic & Biosimilar Medicines Savings Report, Association for Accessible Medicines, October 2021. Continue at 4
5Kaiser Permanente Telehealth Insights Dashboard, accessed November 18, 2024; “Monthly Telehealth Regional Tracker Trending Report,” Fair Health, 2024. Continue at 5
6Mary Reed, DrPH, et al., “Treatment and Follow-up Care Associated With Patient-Scheduled Primary Care Telemedicine and In-Person Visits in a Large Integrated Health System,” JAMA Network Open, November 16, 2021; Kathleen Yinran Li et al., "Direct-to-Consumer Telemedicine Visits for Acute Respiratory Infections Linked to More Downstream Visits," Health Affairs, April 2021. Continue at 6
7Kaiser Permanente GCN Post-Visit Survey of 60,945 members, 2023. Data is from members who had an on-demand video visit. Continue at 7
8See notes 5 and 6. Continue at 8
9See note 7. Continue at 9
10“Kaiser Permanente 2023 Telehealth Update and Research Inventory,” KP National Market Research, May 2023. Continue at 10;
11“Employers are Driving Innovations in Primary Care,” Purchaser Business Group on Health, February 24, 2024. Continue at 11
12Example of a GLP-1 CAR report showing employees’ GLP-1 use over time and whether GLP-1s are prescribed for diabetes, obesity plus a comorbidity, class III obesity, or another reason. Continue at 12
13Group minimum requirements apply — 300+ California only, 200+ all other regions. Group size is determined by the number of members enrolled at the end of the reporting period. Continue at 13