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by abalone
2362 days ago
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This type of post is a pet peeve of mine because you use terms like “data” and “anecdotal” but it’s actually a poorly supported argument. This happens too often on HN. It’s certainly true that primary care visits improve health outcomes, but you offer no evidence that people get more primary care at Kaiser. Meanwhile the most significant rankings are not only patient opinions but rather systematic reviews of outcomes, expert analysis and objective metrics. Newsweek did one such ranking that put Kaiser behind 4 other hospitals.[1] US News puts UCSF ahead of Kaiser in many aspects and specialities.[2] When you need a brain surgery or cancer treatment, you’re definitely going to “feel better” having “choice and freedom” to go to the best. [1] https://www.mercurynews.com/2019/04/03/ucsf-medical-center-s... [2] https://health.usnews.com/best-hospitals/area/ca/ucsf-medica... |
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Here's an actual comparison of health care plans:
[1] https://www.fiercehealthcare.com/payer/ncqa-insurer-rankings...
[2] http://healthinsuranceratings.ncqa.org/2019/HprPlandetails.a...
[3] http://healthinsuranceratings.ncqa.org/2019/HprPlandetails.a...
[4] http://reportcard.opa.ca.gov/rc/HMO_PPOCombined.aspx
And here's some research showing Kaiser's outcomes quality: [1] https://www.ncbi.nlm.nih.gov/pubmed/26131607
[2] https://www.ncbi.nlm.nih.gov/pubmed/29625083
[3] https://www.ncbi.nlm.nih.gov/pubmed/30002140
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270203/
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC64512/
> It’s certainly true that primary care visits improve health outcomes, but you offer no evidence that people get more primary care at Kaiser. Again, I worked with claims data where we could analyze primary care utilization and kaiser was significantly higher than most PPOs in our systems (and high in general). We specifically built an email targeting patients who did not visit their primary care doctor in the last year and Kaiser was at the bottom of numbers because of the high usage. There is definitely a lot more research you can find studying Kaiser's integrated approach and how it related to primary care usage. Kaiser is pretty good good at preventative care, primary care usage, and some chronic care management.
> When you need a brain surgery or cancer treatment, you’re definitely going to “feel better” having “choice and freedom” to go to the best. Again, I've outlined research showing outcomes and quality metrics showing Kaiser is pretty solid. Their primary care usage is higher than other health plans, and there are quality metrics and research showing they are pretty good at preventative, primary care, and chronic care management. There are definitely gaps, but from a population level outcomes, they perform at or better than many PPOs given their costs. If you take a step further and look at the economic ROI of their plans, they definitely outclass most PPO and HMOs.
It's not like they have that much secret sauce, the main advantages they have are the same ones a nationalized system has (being integrated aligns incentives better).