DELIVERY OF COMPREHENSIVE CANCER CARE AT KAISER-PERMANENTE

BACKGROUND. Kaiser Permanente (KP) is a large health maintenance organ ization (HMO) operating in 14 states and caring for 8,000,000 members in hundreds of facilities staffed by thousands of physicians and suppo rt personnel. Cancer care is provided to these KP members as part of t he health care package. METHODS. KP insures members for all their heal th care needs and provides needed services in their own facilities exc ept in rare circumstances. Professional services are provided by physi cians of the Permanente Medical Groups, locally governed groups of phy sicians contractually bound to Kaiser Permanente by capitation agreeme nts. These agreements cover the full range of services for cancer and all other diseases. KP uses evidence-based guidelines to rationalize t he provision and delivery of medical care for its members. A large inv estment in technology has allowed these guidelines to be generally ava ilable on local intranets and has facilitated the development of a com puterized medical record and linkages to multiple clinical and adminis trative databases for all providers. Several of the KP regions have st rong commitments to research in the public domain and have integrated this effort into the clinical practice of oncology, particularly in cl inical trials in cancer treatment and prevention. Research efforts als o exist in the areas of cancer epidemiology and outcomes. RESULTS. Can cer care is integrated fully into the comprehensive medical care provi ded the KP member. Health benefits cover the full range of cancer prev ention and treatment without distinction by diagnosis. CONCLUSIONS. Wi thin the broad range of health care options in the U.S., KP represents a good example of the value of a large HMO to deliver comprehensive g eneral medical and oncologic care. (C) 1998 American Cancer Society.