Improving Outcomes and Strengthening Community Partnerships with an Innovative Provider Contracting Strategy (10X)

This session will showcase Kaiser Permanente's approach to developing a 32-county network of community-based service providers across a sizable and diverse geographic landscape, providing access and capacity to serve over 1 million eligible members across 32 counties. Regulators also emphasized that these services be provided by local providers with deep community-based operations. To meet these requirements, the strategic response was establishment of a network lead entity hub that enabled Kaiser Permanente to centralize regulatory, oversight and administrative functions within the Managed Care Plan and engage community-based partners to focus solely on service delivery and reporting. The services provided by these community-based partners include enhanced care management, community health worker services and a varied menu of community supports. These services are intended to address the medical and social determinants of health. Each service has been validated to reduce hospital and emergency utilization, as well as effective alternatives to acute levels of care. The network lead entity model gives Kaiser Permanente access to over 111 community-based partners via three provider service contracts and results in a decrease in staff time, oversight obligations and administrative burdens.