The OE Brief: An Open Enrollment Q&A with Kaiser Permanente

At Kaiser Permanente, your doctors, hospitals, and coverage are connected. Your health record links it all, so your care feels seamless and easier to manage. Virtual care and mental health support are just a tap away. Everything comes together in one experience — preventive, primary, and specialty care, plus pharmacy, labs, and wellness programs. Connected care can help you stay on top of your health. In fact, our members are 35% less likely to lose years of life compared to nonmembers in our communities.* That’s better health care, built around you.
*Elizabeth A. McGlynn, PhD, et al., “Using Mortality and Years-of-Life-Lost Metrics to Evaluate Health System Performance and Inform Health Care Policy,” NEJM Catalyst, October 2025.

KP Nevada
Kaiser Permanente and Renown Health announced an agreement to jointly own and operate a health plan and new outpatient care delivery system that will bring Kaiser Permanente to northern Nevada, starting with open enrollment in Fall 2026 for the 2027 plan year. Hometown Health the health plan previously owned by Renown Health will become Kaiser Permanente Nevada. Renown Health will continue as an independent, nonprofit health system. The Kaiser Permanente Del Monte and Ion Medical Offices in Reno and Sparks are now open. We’re also scheduled to open the Kaiser Permanente Fifth Street Medical Offices in Reno in 2027.

These state-of-the-art medical offices will offer primary care, on-site pharmacy, lab services, and imaging so members can take care of their health needs in one convenient place. More medical offices mean more access to care in Carson City, Douglas, Lyon, Storey, and Washoe counties, as well as in the Nevada portions of the Lake Tahoe Basin.

Other new highlights include:

• We’ve enhanced our online broker portal on business.kp.org to provide access to client/member communication including renewal letters, and view and download member ID cards (coming in October).
• We’ve expanded our IFP offerings to include a Gold and Silver HSA plan Off-Exchange in almost every state to attract ICHRA consumers.

Kaiser Permanente's integrated care model combines health coverage and care delivery into one seamless experience. We coordinate care and services across inpatient and outpatient settings, pharmacy, laboratory, imaging, and other ancillary services to help members receive the right care at the right time. When everyone is connected, care is better and far more cost-effective.

• Our care teams are rewarded for delivering the right care, not more care.

• Our providers, including doctors, receive an annual salary and are rewarded for quality and keeping patients healthy rather than for the number of patients they see and the volume of tests and procedures they order.

• Electronic health records help close care gaps, reduce waste, and share best practices — across the hall or across the country.

We look at affordability from every angle of our business because everyone at Kaiser Permanente has a role to play in achieving our mission, driving quality up and cost down to a price people can afford. At this pivotal time, Kaiser Permanente is addressing affordability challenges head-on in this changing healthcare climate. By harnessing our collective knowledge and scale, we are transforming the way we work, enhancing how we serve our members, and advancing our leadership in health care faster than ever before. We are taking decisive action to optimize our structure and operations across the enterprise. By streamlining care delivery and administrative operations, we are reducing costs, increasing efficiency, and enhancing the experience of our members, employees, and physicians.

• We’re moving care into more efficient and effective settings with a focus on member convenience and preferences through technology, automation, and improved productivity across the enterprise.
• We’re addressing social determinants of health, maintaining our focus on prevention, early detection, and total health as core drivers of affordable health care and services.

Besides improving our operations, Kaiser Permanente continues to reduce costs through industry-leading care management and member-focused programs, including:

• Pharmacy management programs that address rising prescription drug costs through effective supply chain management, evidence-based formularies, and thoughtful benefit design. We also create value by increasing the use of generic medications, reducing unnecessary opioid prescribing, and supporting medication adherence, all of which improve health outcomes while helping control costs.
• Care management programs that reduce unnecessary inpatient hospital stays through proactive, coordinated care. By helping members receive the right care in the most appropriate setting, we lower costs, shorten hospital stays, and reduce the risk of hospital-acquired infections and complications that can require additional treatment.

Our network was inherently developed to optimize quality outcomes at affordable costs and does not necessitate benefit design, such as tiered or narrow networks, to drive members to select providers based on cost or quality. Most of our members receive all their care, both inpatient and outpatient, from Kaiser Permanente physicians, creating an efficient and seamless care experience for our members. We provide our members with exclusive access to a network of providers that are recognized as high-performing by independent quality evaluators, including the Integrated Healthcare Association (IHA) and NCQA, which use nonproprietary, publicly reported metrics to measure quality.

Provider Network
Our organization includes three cooperative entities: Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the Permanente Medical Groups. The three entities work collaboratively, each with responsibilities for quality and efficient management of resources, but all with the same goal — to ensure the total health of our members. Kaiser Permanente has grown to serve over 12.8 million members across multiple states. We're teaming up to expand health care in northern Nevada. Kaiser Permanente and Renown Health are 2 nonprofits with 1 mission: making high-quality, affordable care more accessible. Our joint venture combines Kaiser Permanente‘s national expertise in value-based care with Renown's deep local presence.
Our high-performing care delivery system is available in the following regions:

• Kaiser Foundation Health Plan of Colorado

• Kaiser Foundation Health Plan of Georgia, Inc.

• Kaiser Foundation Health Plan, Inc. – Hawaii

• Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.

• Kaiser Foundation Health Plan Inc. - Nevada

• Kaiser Foundation Health Plan, Inc. – Northern California

• Kaiser Foundation Health Plan, Inc. – Southern California

• Kaiser Foundation Health Plan of the Northwest

• Kaiser Foundation Health Plan, Inc. – Washington

Empowered doctors – We empower doctors to be exceptional—with an ecosystem designed to deliver better care. Our processes, technology, and tools enable doctors to focus on what’s important—their patients.

• Fewer Barriers to Care: With few exceptions, we don’t require our doctors to have medications, non-emergency hospitalizations, or specialty medications previewed for appropriateness. We believe our doctors, in consultation with their patients, are the best judges of medically necessary and appropriate treatment.  Additionally, our doctors do not have to juggle administrative tasks that take away valuable time with patients.

• More Advanced Support: Kaiser Permanente has the largest electronic health record system that allows for fast and informed care collaboration. Innovative care and technology advanced by peers.

Local Market Strengths
Kaiser Permanente's integrated care delivery model provides members with a stable network of physicians and hospitals that remain resilient and minimally affected by market disruptions. Our physicians coordinate care across all Kaiser Permanente facilities and have seamless access to each member's electronic health record, enabling informed, connected, and efficient care delivery. When a member's clinical needs require services outside our system, our providers have the authority to recommend and arrange appropriate care to ensure the best possible outcomes.

Kaiser Permanente delivers many of the services often offered by third-party vendors through our integrated, comprehensive care delivery model. As a result, adding external solutions may duplicate services already included in our health plan rates, such as:

• Chronic condition management

• Maternity care

• Mental health services

• Specialty care

• Telephonic wellness coaching

• Virtual care and telehealth

By integrating these services within a single care and coverage model, we provide employers with a competitive health benefits solution that simplifies administration, delivers actionable care, quality, and utilization insights, and creates a seamless, easy-to-access experience for employees.

Quality & outcomes
We’re setting the national standard of care for cancer, cardiac, diabetes and MSK with the data and accolades to prove it – from HEDIS scores to recognition from leading organization and publications.

Access to Care
Kaiser Permanente prioritizes timely access to clinicians because we believe it has a greater impact on health outcomes than network size alone. Across our national footprint, we use a variety of strategies to ensure members can conveniently access high-quality care. We continuously monitor network adequacy standards and provider availability to meet regulatory requirements and maintain access for our members.

We actively manage physician panel capacity and provide real-time provider information through the Kaiser Permanente app and kp.org. When a physician's panel opens or closes to new patients, we automatically update our provider directory. Members can change their primary care physician at any time, and we ensure access to providers accepting new patients across our facilities.

Truly integrated in-person and virtual care offers your employees convenient ways to get care — and helps catch problems before they become more serious and costly. In-person and virtual teams are connected to your employees, and to each other, through our electronic health record system. Integrating in-person and virtual care, including video visits and our Get Care Now virtual urgent care, makes both modalities more effective.

With Kaiser Permanente, employees and businesses will benefit from our industry-leading integrated care. For over 80 years, our value-based model has delivered better health outcomes and helped control health care costs for employers. We work with all Individual Coverage Health Reimbursement Arrangement (ICHRA) administrators and licensed and appointed brokers. 

Kaiser Permanente focuses on treating the whole person and providing members with complete care experience. Through our integrated care model, we deliver a robust suite of disease management, wellness, and workforce health programs that help members stay healthy and organizations support a thriving workforce.

Mental Health
Kaiser Permanente provides a comprehensive, integrated continuum of behavioral health and substance use disorder services as part of its standard health plan benefits. Services are embedded within Kaiser Permanente’s coordinated care model and include specialty mental health care, psychiatry, substance use disorder treatment, integrated pain services, behavioral health clinical pharmacy support, and targeted programs for populations with unique needs, including pregnant members, adolescents/youth, rural communities, and members with higher-acuity or complex behavioral health needs. This integrated model supports early identification, evidence-based treatment, functional recovery, and coordination across medical, behavioral health, pharmacy, and specialty care teams.

Kaiser Permanente integrates mental health screening and support throughout the care experience. We routinely screen for depression, anxiety, psychological distress, and substance use concerns, with additional screening for members with chronic conditions, pregnant members, and older adults to support early identification and intervention.

To make mental health care more accessible, we integrate behavioral health services across our care delivery system. Many outpatient mental health services are co-located with primary care and specialty care settings, and mental health clinicians work alongside primary care teams to streamline referrals, improve care coordination, and reduce stigma. We also offer virtual care options that make it easier for members to connect with behavioral health professionals when and where they need support.

Digital Apps
We provide multiple pathways for members to access mental health and substance use care. Members can learn about available resources online, connect through their primary care physician, self-refer to specialty mental health services, or be identified through routine screenings. This comprehensive approach helps ensure members receive the level of care that best meets their individual needs.

For members who do not require specialty care, we offer no-cost digital self-care tools rooted in evidence-based clinical practices. Through partnerships with Calm and Headspace, members can access resources that support stress management, sleep, mindfulness, relationships, chronic pain management, and overall emotional well-being. Members can also explore online classes, self-guided programs, and wellness resources designed to help them build healthy habits and improve mental well-being.

Preventive Care
Prevention has long been a cornerstone of Kaiser Permanente's approach to health care, and we consistently rank among the nation's top health plans for preventive care. We recognize that prevention goes beyond avoiding illness. It means promoting overall well-being by supporting physical, mental, and social health. By understanding the unique needs, goals, and preferences of each member and employer group, we deliver personalized programs and resources that help people stay healthy, thrive, and achieve their best health.
We promote lifelong health through personalized screenings, preventive care, and wellness support tailored to each member's age, health status, and needs. Through shared decision-making, our care teams help members navigate immunizations, screenings, medical procedures, and mental and behavioral health services. Members can also access digital tools on kp.org, including a symptom checker and the Total Health Assessment, which provides personalized recommendations for Healthy Lifestyle Programs.

Wellness
Kaiser Permanente offers members access to a broad range of health and wellness programs, many of which are available at no additional cost as part of our integrated care delivery model. By embedding these services within our core offerings, we make it easier for members to access the support they need to improve their health and well-being.
Our Permanente Medical Groups develop clinical wellness programs that complement our comprehensive preventive care and screening services. We tailor these programs to address members' unique demographic and clinical needs, including health concerns that are prevalent within specific regions and communities.

Members can participate in classes, workshops, and support groups offered both online and at select facilities. Available programs vary by region and are listed at kp.org/classes. Members also have access to a wide range of wellness resources, tools, and programs available across all Kaiser Permanente regions through kp.org/health-wellness.

Clinical wellness programs may include:

• Nutrition counseling (such as weight loss and a healthy diet)

   

• Prenatal counseling and education

   

• Substance abuse prevention

   

• Alcohol-dependency counseling

   

• Stress reduction programs

   

• Chronic disease self-management programs

   

• Exercise counseling and cardiovascular fitness programs

   

• Violence Prevention and Anger Management programs

   

• Smoking Cessation program

   

• Health risk appraisals

   

• Injury prevention program

Virtual Care
Kaiser Permanente makes it easy for members to access care when and where they need it. Our integrated virtual care services connect members with their care teams through secure, convenient digital tools that support ongoing relationships and seamless care coordination. Because virtual visits are fully integrated with our care delivery model and electronic health record, members benefit from continuity, quality, and a connected care experience.

Members can access a wide range of virtual care services, including video visits, scheduled phone appointments, online chat, secure messaging, e-visits, remote monitoring, online physical therapy, telephone assessments, and 24/7 nurse advice, when clinically appropriate and available. For immediate needs, members can also use "Get Care Now" through kp.org or the Kaiser Permanente mobile app to connect with a clinician 24/7.

These virtual care options help members receive care in the setting that best fits their needs while improving access, strengthening engagement, supporting preventive care and chronic condition management, and enhancing care coordination.

• Video visits and scheduled telephone appointments: Members can connect with Kaiser Permanente providers through secure two-way video or scheduled telephone appointments when clinically appropriate.

   

• Chat and secure messaging: Members can chat with a clinician or securely email their care team with non-urgent questions, prescriptions, follow-up information, and care guidance.

   

• E-visits: Members complete an online questionnaire about their condition and receive self-care guidance, an appointment, or an assessment and treatment plan from a Kaiser Permanente physician.

   

• Remote monitoring: Members with diabetes, hypertension, pregnancy-related needs, or other conditions may share health data with Kaiser Permanente providers remotely using connected technology.

   

• 24/7 advice and urgent virtual access: Trained nurses and clinicians are available by telephone 24/7 to assess symptoms, perform triage, and help determine the right level of care.

Additional Member Resources
Through kp.org, members can access a wealth of health and wellness resources designed to support informed health decisions and healthy lifestyle choices. We provide educational content, videos, podcasts, self-guided tools, region-specific classes, and health improvement programs that help members manage their health, prevent illness, and improve overall well-being. Resources are available on a wide range of topics, including:

• BMI calculators

   

• Children and teen health 

   

• Class offerings on various health and wellness topics with schedules by region

   

• Complementary and alternative care (nontraditional care)

   

• Decision support/help tools for symptoms, medical tests, surgeries, treatments

   

• Chronic disease and chronic condition management

   

• Drug encyclopedia and regional formularies

   

• Emotional and behavioral health

   

• Fitness and getting active

   

• Healthy Lifestyles programs 

   

• Health education materials/brochures

   

• Kids' wellness games and activities

   

• Men's health

   

• Pregnancy, new baby, well-baby care (prenatal/postnatal)

   

• Preventive care

   

• Quitting smoking (smoking cessation)

   

• Older adults' health and aging

   

• Weight management

   

• Women's health