Kaiser in Seattle/Tacoma?

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Kaiser in Seattle/Tacoma?

Post by duckcalldan » Mon Nov 04, 2019 11:29 pm

ACA open enrollment time. My wife and I have done the Bronze HSA-complaint plan the past couple of years, and that’s worked out really well. We’re in our mid-50s, in excellent health with minimal need for non-preventative care. Our new home in WA has 5 such plans, one of which is Kaiser. I’ve heard plenty of good things about their physicians, and most Kaiser enrollees seem pleased with the quality of their care. Not all, of course.

I’m curious if there are any Kaiser customers in Puget Sound that can chime in on their experience. I know that Kaiser is relatively new in the area, having bought Group Health in 2017, so they don’t have the history that they do in most other west coast cities. We live in Pierce County.

The other choices are Ambetter, Bridgespan, PacificSource and LifeWise. All relatively similar cost wise.

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Re: Kaiser in Seattle/Tacoma?

Post by Gnirk » Tue Nov 05, 2019 12:12 am

I was a member of Group Health Cooperative for 44 years (regular then Medicare Advantage) in Olympia, WA until Kaiser bought it and we were transitioned to Kaiser. Our doctors are very good and we can usually get care (in Olympia) within a reasonable time, though it may be with a PA or a different doctor. My husband recently needed surgery, and because of potential complications was referred to specialists at UW Medical for the surgery. Several of my husband's specialists are at the Kaiser Tacoma Medical Center, and we've been very pleased with the care they offer.

One change I've noticed, and I don't like is that it's nearly impossible to speak with an actual person : the phone tree seems to have many more branches now. :annoyed And the wait time on the phone can be long at times.

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Re: Kaiser in Seattle/Tacoma?

Post by xb7 » Tue Nov 05, 2019 12:16 pm

Our insurer (Regence) decided to stop issuing individual policies in WA state as of two years ago, and so we switched to Kaiser.

My wife and I find that we like the facilities and the care and doctors just fine. We find the administration is somewhat klunky and requires patience. For example, there is one website you go to for care-related stuff, and a completely (very completely) different one if you want to set up automatic bill pay. But to pay a non-recurring bill, you go to the care-related one. It feels like something inherited from the old Soviet system where you take a number in order to then go to stand in another line ...
This isn't normally too much of a problem, but I do on occasion run into little "we don't care to really think through the customer experience" sort of admin glitches. For example, if I have a co-pay at an automated kiosk, it seems to me that they must have explicitly disabled the ability to pay by phone. Obviously not a big deal, but bewildering. They push health through positive lifestyle, but if I ride my bike to the clinic, I have to take the elevator or walk way around, as the door to access the stairs is locked from the outside. ?!? I admit, mostly little stuff. And of course the phone tree is annoying. But absolutely every time I've interacted with a human being, they've been great, to include clearly knowing what they're doing, whether it be lab work, primary care, plus I get a more intensive eye exam once a year.

The other thing that I found was that as a new patient, it seemed like all of the doctors I could choose for primary care were all quite young. And, FWIW, I'm male but the only options at my local clinic were female doctors. This turned out just fine --- I like my primary care doctor. She carves out enough time for me and actually, really listens, and seems quite competent to me.

I'm not optimistic that they'll improve the admin "customer experience" stuff (and I know there are more things that I'm not remembering right now). Nevertheless, we're happy to stay with Kaiser. For one thing, since they have physical facilities here, it wouldn't be so easy to just pick up and say "Sorry, we're not doing plans in your state anymore". I've also heard very good things about their Medicare Advantage plan; my wife and I are in our early 60's, and so speculate that's the route that we'll go --- hopefully an easy transition.

And for some minor stuff like first aid or getting a flu shot, I can go to my really local drug store (Bartells), where they have a qualified nurse whose services for that stuff are covered by the Kaiser plan (just did that recently for a flu shot).

Overall it seems like a great organization hampered with mediocre-at-best administration support.

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Re: Kaiser in Seattle/Tacoma?

Post by Watty » Tue Nov 05, 2019 1:11 pm

duckcalldan wrote:
Mon Nov 04, 2019 11:29 pm
I’ve heard plenty of good things about their physicians, and most Kaiser enrollees seem pleased with the quality of their care.
I am in a different part of the country but I am also using Kaiser for an ACA policy at least until I get on Medicare.

When I was researching them one of the things that I heard that I really liked was that that Kaiser is good at weeding out bad doctors so you are unlikely to have a really bad doctor, which I have run into at other places.

In yet another part of the country I knew several Kaiser doctors socially and they seemed to really like working there since there was less BS and dealing with insurance companies that at many other types of practices. That is not to say that they do not have to deal with some internal Kaiser frustrations, but it is a lot frustrating than dealing with traditional billing and insurance companies.

This apparently makes Kaiser a desirable place for many doctors to work at so it is also not easy for a doctor to get hired by Kaiser. This also helps them avoid bad doctors since in most specialties they have a good number of job applicants.

When I was choosing an ACA policy I was on COBRA using Blue Cross and I was happy with my doctors. There was also an ACA Blue Cross option which was tempting but when I looked into it the network of doctors was very limited and none my current doctors were in that network. The doctors in the ACA Blue Cross network all appeared to be low end doctors who agreed to be in that network because they needed the business, and that did not inspire confidence. Very few of the primary care doctors were taking new patients so that was also a concern.

With a limited network you are also more likely to run into balance billing problems where someone like an out of network anesthesiologist is used without your knowledge.

When looking at the alternatives be sure to take a hard look at what doctors are actually in the ACA network.

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Re: Kaiser in Seattle/Tacoma?

Post by Hayden » Tue Nov 05, 2019 3:40 pm

I've had multiple people at various doctor's offices in WA tell me that Kaiser is just Group Health. To them, it is no different than GH. It's surprised me every time someone has said that to me. I guess the Kaiser branding hasn't been fully implemented.

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Re: Kaiser in Seattle/Tacoma?

Post by chemocean » Tue Nov 05, 2019 5:58 pm

My family has used Group Health/Kaiser since 1978 whenever we lived in the WA service area. I have been happy with my three primary care doctors. My present young primary physician is paired with a PA, which makes the team efficient. The PA recently examined my blood work from a annual physical and suggested a number of follow-up practices to decrease my cardiovascular failure risk. Being a HMO, they focus on preventative medicine. I understand Kaiser has infused the previous Group Health with much needed capital, which I have noticed as an improvement in the facilities. Kaiser as a whole is dedicated to family medicine. When we were in CA earlier this year, it was announced that Kaiser was opening a new medical school for family medicine and totally supporting the students from the first four years. I also have heard that they are funding family practice residency positions in the west coast, but not at our medical center.

Kaiser tends to perform routine surgery such as cataract procedures and hip replacements, but not rare procedures. When I had a complicated medical issue a number of years ago (during Group Health times), I was sent to the specialist at Virginia Mason in Seattle under the HMO. With their focus on family medicine, they are not as strong in some of specialties. I think the criticism about Kaiser is that they don't have the very, very best surgeons in the regions. If a really good specialist is with Kaiser, the wait time for an appointment is really long.

Did you know that number the number of residency position funded by the federal government has been frozen since Gingrich and Clinton kissed and made up in the fall of 1996? Only in the last few years has the number of medical students graduating from US medical schools exceeded the number of federally government residency positions. More hospitals and medical systems, like Kaiser, are funding their own residency programs.

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Re: Kaiser in Seattle/Tacoma?

Post by rick0 » Wed Nov 06, 2019 3:10 pm

My Wife and I switched over to Kaiser - via ACA - a couple years ago when our previous insurer vacated WA State & a doctor retired.

We've generally been happy. Yes, the doctors tend toward they younger side. All doctors we've been in
contact with seem competent, and are open to taking questions and explaining things. I had an urgent care visit last
year and was treated by a Nurse-Practitioner - who did an excellent job - rather than a MD. The Kaiser facilities we've
visited have all seemed up to date and clean, with competent support staff. I like that I can use their "Care Clinics" in
Bartells drug stores for simple stuff like vaccinations, suture removal, ...

I like their use of technology and use of the web. All of your records are viewable when you login to your account, and you can
make appointments, order prescription refills, email your Doctor, ... all from there. You can, for example, plot blood pressure
trends over time (or plot any other numerical test result).

I recently had an appointment in Redmond, WA and in an hour and 20 minutes from walking in the door to walking out I:
- Had an office visit with my PC Doctor
- Got some lab work done
- Picked up a new prescription
Very efficient!

We never used Group Health, so I can't comment on that.

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Re: Kaiser in Seattle/Tacoma?

Post by curmudgeon » Wed Nov 06, 2019 7:02 pm

This one is a question that has been on my mind as well, though I don't have any experience to offer. We might move up to that general area sometime in the next few years to be closer to kids/grandkids. We've been reasonably content with the Kaiser HSA plan in the SF bay area, but I'm aware that different Kaiser regions run somewhat independently. Oddly enough, for us even though the actual premium would be several $K lower in WA, the net after subsidy would cost us about $5K more per year... not enough to sway the move decision, but it does happen to more than balance out the higher other costs (income tax, property tax, utilities) we are paying in CA.

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Re: Kaiser in Seattle/Tacoma?

Post by desiderium » Thu Nov 07, 2019 12:21 am

Kaiser in the Puget Sound region is solid
As a large integrated health system, they are arguably much better and more comprehensively organized that other outfits trying to accomplish something similar. Organization does involve standardized processes for appointments, referrals, billing etc and consequently there is frequently a lack of intelligent life in processing things--obviously, not a problem unique to Kaiser. One advantage is that Kaiser is heavily invested in electronic communication through its patient portal, both to deliver care and to troubleshoot its automated activities. Patients who develop a good electronic relationship with their providers and office people, and who are not shy about pushing slow responses are generally happy and get the service they need. Like all health care systems, patients who are strong advocates for themselves and their families can protect themselves against the weaknesses of the system

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