Quality Assurance: Kaiser Permanente

Case Management Programs are More Concerned with Reducing Costs Than with Improving the Quality of Care

Rather than relying on generalized statements about case management programs, focused research on Kaiser Permanente (Kaiser) shows an egregious example of a "profits over patients" mentality in case management. By delaying, misdiagnosing, undertreating or not treating at all, Kaiser evidently save millions of dollars, until It gets caught. For example, in June 2010, the California Department of Managed Health Care (DMHC) fined Kaiser a $75,000 administrative penalty for unreasonably delaying diagnosis and treatment of autism for Andrew Arce. According to the DMHC, due to Kaiser's delays and denials, Andrew's treatment was delayed for more than a year and he did not receive needed treatment until he was damaged by Kaiser's delays and denials (Kaiserthrive.org, 2010).

Binding arbitration boards are also finding that Kaiser delays adequate treatment. For example, in November...
[ View Full Essay]