KPS Health Plans Group Health Options « Health Insurance Advisory

KPS Health Plans Group Health Options

KPS Health Plans Group Health Options KPS Health Plans Group Health Options

Group Health provides medical coverage and care to more than 654,000 residents in Washington state and North Idaho who are covered by health plans offered by Group Health Cooperative or its subsidiaries, Group Health Options, Inc., and KPS Health Plans.  Nearly two-thirds of members receive care in Group Health operated medical facilities.

Group Health includes Group Health Cooperative (1947) and its research arm — the Group Health Research Institute (1983; formerly the Center for Health Studies), Group Health Options, Inc. (1990), Group Health Foundation (1983), and Group Health Permanente medical group (1997) — with whom Group Health Cooperative has an exclusive contract.  These organizations and their staff members share a common purpose to transform health care, working together to improve the care and well-being of members, patients, and communities.  In October 2005, Group Health Cooperative acquired KPS Health Plans, a health care service contractor in Northwest Washington.

Group Health Cooperative

Group Health Cooperative began in 1947 as a community coalition dedicated to making quality health care available and affordable.  Today it is one of the few health care organizations in the country governed by consumers.  Its 11-member Board of Trustees — all health-plan members elected by other members — work closely with management and medical staff to ensure that the organization’s policies and direction put the needs of patients first.  Group Health Cooperative, together with its subsidiary Group Health Options, Inc., operates in all or parts of 20 counties in Washington and two counties in North Idaho.  In Washington, Group Health Cooperative offers coordinated-care plans for both groups and individuals; Clear Care®, our Medicare Advantage plans; and plans for residents who qualify for Healthy Options (Medicaid), Basic Health, and the State Children’s Health Insurance Plan (SCHIP).

Care is provided by Group Health Permanente doctors and other clinicians at Group Health-operated medical facilities.  In service areas where Group Health doesn’t own facilities and for plans offering more choice, a network of nearly 9,000 community clinicians and 41 hospitals meets member health care needs.

Group Health Options, Inc.

Group Health Options, Inc., was incorporated in 1990 as a wholly owned subsidiary of Group Health Cooperative.  It offers a variety of health plans in Washington and Idaho that provide choice and flexibility to meet the needs of large and small employers.  These range from a defined physician-network plan to point-of-service plans in which members can get care from outside the network for higher out-of-pocket costs.

KPS Health Plans

Group Health Cooperative acquired KPS, a 62-year-old nonprofit health carrier based in Bremerton, Wash., in October 2005. KPS maintains a separate corporate identity.

Affiliates

Kaiser Permanente and Group Health affiliated in 1997.  Each remains independent and separate, but work together in areas such as marketing to regional and national customers, sharing best clinical practices, and full-service member reciprocity.

Fast Facts About Group Health (October 2010)

Statistics

  • Membership: 654,302*
  • Service areas: All or parts of 20 counties in Washington state and two counties in North Idaho
  • Consolidated operating revenue: $3 billion (2009)

People

  • Total staff (including Group Health Permanente): 9,365 (7,644 FTEs)*, including Group Health Permanente
  • Nurses: 1,587 (with 36 specialties and certifications)
  • Physicians: 985
  • Specialties and subspecialties: 75
  • Board certifications: Family medicine, 93 percent; Pediatrics, 89 percent; Ob/Gyn, 94 percent; other specialty certifications, 94 percent
  • Family Medicine Residency established: 1969 (affiliated with University of Washington Family Medicine Network)

Facilities

  • Hospitals: 1
  • Primary care medical centers: 26
  • Specialty care units: 6
  • Behavioral health clinics: 7
  • Eye Care clinics: 14
  • Audiology/Hear Centers: 5
  • Speech, Language & Learning Services clinics: 8

Major Employer Group Accounts

  • The Boeing Company
  • City of Seattle
  • City of Spokane
  • Comcast Corporation
  • Hanford Employee Welfare Trust
  • King County
  • Microsoft
  • Providence Health System
  • Puget Sound Energy, Inc.
  • The Puyallup Tribe
  • Seattle Cancer Care Alliance
  • Seattle School District
  • SEIU Local 75
  • Sound Health & Welfare Trust
  • Spokane County
  • Spokane School District
  • United Airlines

(Information updated as of 2011 from KPS Health Plans Group Health Options website)

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