Kasier Permanente? (Raleigh, Boone, Rex: health insurance, school, live)

[candlegirl]

For those who have been in this area for a while, did there used to be a Kaiser Permanente Medical Facility in the Raleigh area? We moved from California where we had Kaiser but the Kaiser website does not list any facilities in the area....however when we google Kaiser Permanente Raleigh a facility comes up - but the number is disconnected...kinda weird.

[VaNC]

Kaiser used to be across from Rex. The address would be either Blue Ridge Rd. or Lake Boone. Obviously, it is no longer there.

[SALUKI_LOVER]

we had Kaiser while in CA but no longer here . .

[Chatterboxishere]

Best thing to do is sign up with BCBS or Health Source. About the only two left worth a flip.

[saturnfan]

We were with Kaiser here. They left NC years ago.

BCBS is good.

[PDXmom]

Anyone know why there are not any true HMOs like Kaiser here in NC? Is there some sort of law that prevents them???

While some things are less expensive here in NC than Portland, our family health insurance through BCBS is outrageously expensive, especially when we take into account what we are getting. I think this area could benefit from a little more competition.

[saturnfan]

HMO's even flopped with the Federal Employees Health Benefit System - None in NC to select.

Perhaps the influx of newcomers made providers less willing to bargain with HMO's.

Even worse for dental plans.

Individual health insurance is beyond many families' reach. Beware of low quotes from phony plans.

[paytonc]

Originally Posted by PDXmom

Anyone know why there are not any true HMOs like Kaiser here in NC? Is there some sort of law that prevents them???

Resurrecting this thread after a search brought me here -- although I was very pleased with my Kaiser health coverage when I lived in NC, as well as today.

A very long article in a health-policy journal (it reads like an in-depth B-school case study) was written specifically on KP's failure in the Triangle, relying on interviews with many local Kaiser execs and even former Governor Jim Hunt, who had encouraged HMOs:
The Rise and Fall of a Kaiser Permanente Expansion Region

My main takeaway from the case study is that while "prepaid group practices" like Kaiser or GHC in Seattle (not to mention vertically integrated government systems like the VA) do offer tremendous cost efficiencies, they also rely on economies of scale that are difficult to set up from scratch.

The article estimates that KP's break-even point is around 100,000 members in a metro area -- which would have been a huge ask given that the Triangle's population was well below a million at that time. Below that scale, they don't have much bargaining power on the cost side, when bargaining with hospitals and specialists or bringing services in-house (the essential feature of their cost-containment model), or on the revenue side, when selling their product to employers and employees.

Now that the Triangle is bigger and denser, the health insurance market is less fragmented (partially thanks to the ACA exchanges), and more doctors have organized into group practices, "medical home" model HMOs are starting to re-emerge here. Coventry's CareLink HMO appears to work somewhat like Kaiser, using Duke's network as the in-house practice.