2022 Environmental, Social, and Governance Summary
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Message From Our Chair and Chief Executive Officer
Kaiser Permanente’s mission is to provide high-quality, affordable
health care services and to improve the health of our members,
patients, and the communities we serve. As the nation’s largest
nonprofit health care and coverage organization, we strive to deliver
on our mission every day, just as we have for the past 78 years.
Healthy people need healthy communities in which to live and
work, and we know that if we hope to create and sustain healthy
communities, we need a healthy planet. We also believe that
everyone deserves the chance to live a healthy life, so throughout our
history we have been committed to providing equity and inclusion
for all and respecting and representing the diverse communities we
serve. In these very real ways, our mission drives our efforts to ensure
equitable care, healthy communities, and a more sustainable world.
Just as we strive to deliver equitable care to our members and
communities, we also actively work to cultivate an inclusive, diverse,
and equitable culture within our organization. This makes us — a
multicultural, multiracial organization — better able to deliver our best
to our richly diverse patients, members, and communities.
We also know that people in marginalized populations are most
impacted by unhealthy conditions.
The health care industry continues to be engaged in climate
change challenges in many ways, from the industry’s impact on the
environment to the threats climate change poses to our communities,
to the health conditions it causes in our patients. Kaiser Permanente
is committed to minimizing our own environmental impact, as well
as addressing the upstream factors of social and economic drivers of
health. This work too is part of our mission.
Indeed, the strategies and outcomes outlined in this Sustainability
& Responsibility Report are a direct result of our commitment to
our mission. We hope that sharing this report serves as an incentive
to our industry partners to continue doing our part to make this a
better world.
Greg A. Adams
Chair and Chief Executive Officer
Kaiser Permanente
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Message From Our Chief Health Officer
We are called on by our mission to improve the health of our
members and communities. That starts with delivering high-quality
care and services and extends to supporting equitable health
outcomes across our communities. It starts with offering affordable
health care coverage and extends to investing resources that
improve conditions for health and equity in our communities —
from driving more sustainability around energy, water, waste, and
other environmental stewardship efforts to expanding access to
safe affordable housing, healthy food, and economic security, and
supporting health and wellness in our schools.
Our 2022 Sustainability & Responsibility Report highlights our
strategies and accomplishments toward improving the health of
all our people and communities, supporting a thriving planet, and
leading a mission-driven and responsible enterprise. Every part of
our organization contributes in some way to the work included here,
because every part of our organization plays a role in how we deliver
on our mission.
We believe in leveraging our voice, our resources, and our
community connections to drive changes to the policies, systems,
and environments that can drive or thwart good health. In order to
protect the health and safety of our members, communities, and
employees, we must also help address one of the single greatest
threats to human health: climate change. We know that climate
change is a public health and health equity crisis, which is why we
support initiatives that increase the understanding of the direct links
between climate change and health, while continuing to drive to
net-zero emissions in our operations.
As we put the emergency phase of the COVID-19 pandemic
behind us, we are strengthening support for the nation’s public
health system and partnering to tackle the most significant health
risks of our time — from poverty and hunger to homelessness and
gun violence.
Kaiser Permanente is pleased to share the work we’re doing to
improve health and health equity, build healthier communities, and
create a more sustainable world. We invite you to review this report
to gain a deeper understanding of our work.
All these efforts and more are part of how we deliver on our
mission of improving health. Individually and collectively, each
accomplishment helps build a better world.
Bechara Choucair, MD
Senior Vice President and Chief Health Officer
Kaiser Permanente
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Kaiser Permanente
Overview
Kaiser Permanente’s mission is to provide high-
quality, affordable health care services and
to improve the health of our more than 12.6
million members and the more than 65 million
people who live in the communities we serve in
8 states and the District of Columbia. Founded
in 1945, Kaiser Permanente is recognized as one
of America’s leading health care providers and
nonprofit health plans and is the largest and
most complex health care organization of its
kind in the nation, with more than $95 billion in
revenue in 2022, and a hospital and care delivery
system with 39 hospitals and 737 medical offices.
We also operate one of the largest pharmacy
distribution services in the country, are a
leader in home health, and serve as a major,
independent medical research organization.
8
States and D.C.
12.6 M
Members
24,000+
Physicians
Largest
civilian health
record system in U.S.
737
Medical offices
39
hospitals
Data from Kaiser Permanente 2022 Annual Report
Care for members and patients is focused on their total health and
guided by their personal Permanente Medical Group physicians,
specialists, and team of caregivers. Our expert and caring medical
teams are empowered and supported by industry-leading
technology advances and tools for health promotion, disease
prevention, state-of-the-art care delivery, and world-class ongoing
disease management. Kaiser Permanente is dedicated to care
innovations, clinical research, health education, and the support of
community health.
Providing accessible, affordable, high-quality health care is at the
heart of Kaiser Permanente’s mission — and has been throughout our
history. Our leadership in prevention, diagnosis, and treatment is
how we help our members live healthy, engaged lives.
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68,000
Nurses
24,000+
Physicians
213,000
Employees
Kaiser Permanente is accountable both for providing the most
appropriate and necessary care to each individual member and
for serving as a steward of resources on behalf of our entire
membership. This accountability aligns incentives to keep people
healthy, rather than seeking to generate revenue when they are
sick. Our approach enables our physicians and other caregivers
to practice person-centered, high-quality care that embraces the
latest innovations in medicine, which in turn enables them to make
decisions with the best interest of the patient in mind. This leads to
more effective and efficient care for our patients and members, and
better health outcomes.
Our mission defines what we do, our model enables us to do it
effectively, and our people are our greatest resource: Their inspiring
commitment, industry-leading expertise, and extraordinary work
every day make a real difference in people’s lives. Our organization
combines the skills of more than 213,000 employees, including over
68,000 nurses, who work with nearly 24,000 physicians, representing
all specialties, to serve our members and communities. Our shared
purpose inspires and drives us.
Kaiser Permanente’s commitment to improving conditions for health
in our communities extends beyond the delivery of health care
and is another foundational part of our mission. Central to Kaiser
Permanente’s model is a focus that extends beyond our members
into the communities where they live, work, and play. We are a leader
in recognizing that healthy individuals need healthy communities,
and healthy communities need healthy people to thrive. That is why
we are working to improve the economic, social, and environmental
conditions for health and equity in our communities by addressing
the root causes of many health issues. We target social drivers of
health such as economic opportunity, access to quality and nutritious
food, affordable housing, safe and supportive schools, and a healthy
environment. We invest significantly in the states and regions where
we operate by supporting community organizations and providing
social health resources. Through these efforts we are working to
create communities that are among the healthiest in the nation.
Thriving Planet:
How we drive inclusive environmental
stewardship to protect and promote
a sustainable world for health
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Thriving Planet
Environmental stewardship
Climate change is a public health crisis.
Our highest commitment at Kaiser Permanente is protecting the
health and safety of our members, communities, and employees.
Our work in community health extends this commitment beyond
patient care to comprehensively support the total health of over 68
million people who live in the communities we serve.
Kaiser Permanente knows that climate change poses a public health
and health equity crisis. Climate change is impacting our patients, our
communities, and our operations today. Our physicians and nurses
treat patients experiencing health challenges caused or worsened
by our changing climate, while our operations teams continuously
monitor and respond to climate threats in our service areas.
Our holistic approach
As employees for one of the nation’s leading health care providers
and nonprofit health plans, we at Kaiser Permanente recognize our
obligation to steward the environment in which we live, work, play, and
deliver care. Our foundational approach to stewardship is anchored in
protecting and promoting the health of our communities.
In 2016, as part of our focus on total health, we committed to a
comprehensive set of ambitious 10-year environmental goals around
energy, water, waste, our built environment, and environmentally
preferable purchasing. Our performance against each goal is
explored in this report.
We know that our work to eliminate our greenhouse gases directly
benefits the health of our patients and our communities while
reducing health disparities.
In 2020, we became the first U.S. health care organization certified
as carbon neutral, and have continued to maintain our certification
annually. In 2022, we publicly stated our goal to reduce greenhouse
gas emissions by 50% by 2030 and our aim to reach net-zero
emissions by 2050. We continue to reduce the health risks associated
with climate change and other environmental factors through our
efforts to reduce emissions. We lead health care in the U.S. in our
commitments and real-world results — from how we power our
facilities, purchase medical supplies, and manage waste to how we
support our communities and partner with leaders in developing
policies and systems that strengthen community health and protect
our environment. Our 3-part environmental stewardship approach
puts health and health equity at the center of everything we do.
Leadership and
engagement
Low-carbon, su
stainable
operations
Healthy,
equitable, and
sustainable
communities
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Climate change
Climate change
Vulnerability
Social and behavioral context
• Age and gender
• Race and ethnicity
• Poverty
• Housing and infrastructure
• Education
• Discrimination
• Access to care and
community health
infrastructur
e
• Preexisting health conditions
Exposure pathways
• Extreme weather events
• Heat stress
• Air quality
• Water quality and quantity
• Food security and safety
• Vector distribution
and ecology
Environmental and
institutional context
• Land-use change
• Ecosystem change
• Infr
astructure
condition
• Geography
• Agricultural
production and
livestock use
Climate-sensitive health risks
Health outcomes
Injury and
mortality
from
extreme
weather
events
Heat-
related
illness
Respiratory
illness
Water-borne
diseases
and other
water
-related
health
impacts
Animal-
borne
diseases
V
ector-
borne
diseases
Malnutrition
and
food-borne
diseases
Non-
communicable
diseases
Mental and
psychosocial
health
Health systems and
facilities outcomes
Impacts
on health
care
facilities
Effects
on health
systems
Adaptation of World Health Organization and Environmental Protection Agency graphic
Overview of climate-sensitive health risks, their exposure factors, and social/behavioral and environmental/institutional context.
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Sustainable operations
The health imperative of climate action
The World Health Organization’s Special Report on Climate Change
and Health has recognized climate change as the single greatest
threat facing humanity, and that the public health benefits from
implementing ambitious climate actions far outweigh the costs.
Additionally, common greenhouse gases have a direct impact on
human health conditions, including asthma, chronic obstructive
pulmonary disorder, and autoimmune disorders. Kaiser Permanente
also recognizes that the health impacts of climate change occur
inequitably in historically underserved communities. We believe
urgent, equity-centered action is needed to help mitigate climate
change and build capacity for adaptation and resilience in our
changing climate.
Kaiser Permanente has historically worked to reduce our greenhouse
gas emissions and lower our carbon footprint. We committed to
becoming carbon neutral to reduce our contribution to climate
change and its impact on our communities. We achieved this goal
in 2020 through a successful combination of energy use reduction,
improved energy efficiency, investment in large-scale wind and
solar energy, and third-party verified carbon offset projects,. We
are now certified as carbon neutral across scopes 1 and 2 as well as
select scope 3 emissions. We were the first major U.S. health care
organization to achieve this milestone.
In June 2022, we expanded our climate action by publicly
committing to becoming net zero across all our emissions by
2050, with a mid-term target to reduce our absolute emissions
by 50% by 2030.
Our energy approach
allows us to obtain all
our electricity from
renewable sources, such
as wind and solar.
In 2022, 107 of our facilities
hosted on-site solar panels.
The Richmond Medical
Center microgrid is the
first microgrid at a hospital
in California.
In 2022 51% of Kaiser
Permanente’s nonhazardous
waste was reused, recycled,
or composted. We have a
goal to reuse, recycle, or
compost 100% of our waste
by 2025 (excluding medical
and hazardous waste).
More than 32% of
our purchased products
met our environmentally
preferrable purchasing
criteria in 2022, exceeding
our goal for the year.
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Responsibility across Kaiser Permanente
As of 2022, 72 of our facilities hosted over 700 electric
vehicle charging stations, and powered over 6 million EV
miles — nearly double the amount from 2021.
Stewardship in action
Solar excellence
As of 2022, 106 of our facilities have on-site solar arrays.
Anesthetic emissions reduction
Between 2014 and 2022, Kaiser Permanente achieved a 78%
reduction in emissions associated with our use of halogenated
anesthetic agents.
Green building
Our LEED-certified (by the Leadership in Energy and Environmental
Design program) and zero-energy health care facilities continue
to play an essential role in our ability to reach our goals for safer
products, water and energy consumption reduction, and emissions
reduction. Our design standard is to deliver major facility projects
that achieve a minimum of Gold level certification. With 71 projects
totaling more than 7 million square feet certified under 8 rating
systems, we have the most LEED-certified health care square footage
of any health care organization in the country.
Innovation
In 2018, we began operating California’s first hospital-based
renewable microgrid at our Richmond Medical Center. Paired with a
250-kilowatt solar installation, the microgrid can store 1 megawatt
hour of renewable energy to help power the facility when it’s needed
most, helping to reduce energy intensity by up to 50%.
Procurement collaboration
As part of our work to reduce our emissions by 50% by 2030,
we carefully select new suppliers based on their environmental
commitments. We also work with our existing suppliers on their
greenhouse gas reduction goals, innovations, and process
improvements to drive action and accountability.
2021 emissions
GHG
down
Scope (GHG Protocol) Metric tons of carbon dioxide
equivalent (MTCO2e)
Scope 1 emissions 267,841
*
Scope 2 emissions Market-based: 50,402
1
Location-based: 447,380
2
Scope 3 2019 third-party assessment
*
: 3.8 million
Thriving Planet
*
Note: Emissions figures have been reviewed with limited assurance by an accredited
third party.
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Scope 2
Indirect
Purchased energy emissions
Scope 1
Direct
On-site emissions
Scope 3
Indirect
Other value chain emissions
BANK
CO
2
SF
6
CH
4
NFC
S
PFC
S
N
2
O
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Climate action aims:
• Achieve third-party verification of our carbon neutral status
annually, in line with the CarbonNeutral Protocol.
• Reduce greenhouse gas emissions by 50% by 2030 and aim
to reach net-zero emissions by 2050.
Strategies for impact
Managing our energy use
We have invested in enterprise energy monitoring and
management capabilities with a formalized process to
routinely evaluate and improve energy performance
across all our regions and facilities.
Electrification
Our scope 1 and 2 decarbonization tactics will
continue to emphasize electrification across
our buildings and fleet vehicles as well as a
transition to renewable, low-carbon sources
of energy.
Strategy definition
In line with our environmental stewardship
governance model, our teams are
committed to develop and implement
our strategies to reduce our emissions.
Our commitment
In alignment with our net-zero goals, we are examining every aspect
of our operations, including energy usage, water management,
built environment, natural environment, waste management,
impact spending, and procurement. Recognizing the substantial
commitment we’ve undertaken, we are dedicated to integrating
these goals across Kaiser Permanente.
Energy
Climate and health imperative
According to the Environmental
Protection Agency, inpatient health
care is the second-largest commercial
energy user in the U.S., and health
care facilities consume close to
10% of the total energy used in U.S.
commercial buildings.
4
The U.S.
Department of Energy’s National Renewable Energy Laboratory
found that states that reduced fossil fuel energy production
through new renewable energy systems saw health benefits
and savings.
5
The full life cycles of fossil fuels include extraction,
processing, storage, transportation, and use, each with significant
climate, health, and equity impacts.
We have long recognized that one of the most important
ways we can serve our local and global communities is to
improve our emissions footprint by improving our energy
efficiency and transitioning to no- and low-carbon renewable
energy sources.
Thriving Planet
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Stewardship in action
Carbon neutral for scopes 1 and 2 and select scope 3 emissions
We maintain this certification annually through improvements in
energy efficiency, on-site solar energy generation at our facilities,
the purchase of renewable energy, and the purchase of third-party-
verified carbon offset projects.
Energy efficiency
Through 2022, we reduced our energy use intensity by 5.9%
compared to 2015 levels. We had an energy use intensity in 2022 of
155.8 kBtu/RSF (total usage per rentable square feet).
Solar power
We have installed solar arrays at 106 Kaiser Permanente sites. We’ve
also invested significantly in zero-emissions energy, purchasing
683,000 megawatt-hours of wind and solar electricity in 2022.
Grid resilience
In 2018, we installed the first hospital-renewable microgrid at our
Richmond Medical Center. Across Kaiser Permanente, we have over
100 megawatt-hours of battery storage, and we’ll be adding battery
storage to many of our solar projects to reduce demand on the
power grid, save money, and increase resilience.
Facility engineer training and engagement
We instituted our utility optimization program, an energy and water
management community of practice, to educate and drive action
across regions and locations.
Recognition
We were awarded Energy to Care awards from ASHE, the American
Society for Health Care Engineering, at 71 facilities across 7 of our
regions in 2022.
Energy Star ratings
We have 23 Energy Star Certified medical centers — including 1 (our
Vallejo Medical Center) — with a perfect score of 100 and 48 Energy
Star Certified buildings in total including 5 newly certified buildings
in 2022.
LEED-certified
With 71 projects totaling more than 7 million square feet certified
under 8 rating systems at the end of 2022, we have the most LEED-
certified health care square footage of any health care organization
in the country and the largest number of certified projects in the
health care category.
Internationally acclaimed
The International Federation of Healthcare Engineering awarded our
Vallejo Medical Center its Best in Country and Best in World awards
for the facility’s 13% reduction in energy usage in 2021. In total, 153
of our facilities were recognized by the federation in 2022 for energy
reductions of 5% or 10%.
Electrifying travel
As of 2022, 72 of our facilities hosted over 700 electric vehicle
charging stations, dispensing about 2,147,285 kilowatt-hours, the
equivalent of over 6 million EV miles driven in 2022, nearly twice the
amount from 2021.
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2022 energy metrics
Type Electricity
use (MWh)
Percent
electricity use
Grid electricity (owned) 1,169,694 72
Estimated grid electricity
(leased buildings)
103,926 6
Fuel cell electricity 282,892 17
On-site solar 76,154 5
Total electricity 1,632,666 1
00
We aim to:
• Reduce our energy use intensity
• Grow investment in on-site solar energy
• Expand fleet electrification
Strategies for impact
Measuring what matters
We use smart energy analytics to drive energy conservation
and efficiency in our buildings and optimize distributed energy
resource performance.
Employee training and engagement
We leverage our Utility Optimization Program to educate, inform,
and inspire our enterprise wide energy management community
of practice.
Accountability
We establish and enforce energy efficiency targets in our design
standards to drive reductions through our capital investments. We
strive to make every project an energy project.
Smart shifts
We improve the energy efficiency of our equipment and our systems.
Zeroing in
We focus our energy efficiency and carbon reduction investments on
our highest-energy-consuming facilities.
Low- and zero-carbon energy
We expand the use of clean and distributed energy to further reduce
grid dependency.
Financial sustainability
We optimize energy costs through rate optimization activities, such
as direct access procurement.
Water management
Climate and health imperative
Water scarcity will continue to grow.
By 2030, the United Nations predicts
a shortfall of 40% in our global water
supply.
5
In the U.S., hospitals account
for approximately 7% of water usage
in all commercial and institutional
facilities.
6
By keeping pollutants from entering our oceans,
groundwater, and reservoirs, as well as conserving water wherever
possible, serious adverse health effects can be prevented.
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Concerned with growing water scarcity, water quality risks, and
increasing water costs, we’ve stepped up our efforts to conserve
water. Our goals include helping to reduce our water use intensity
and improve water quality in the communities we serve.
In 2014, we instituted a national water policy to reduce our water
use and support long-term access to quality water supplies in all
our communities.
We aim to:
• Reduce our water use intensity
• Protect the water supplies of the
communities we serve
Stewardship in action
We reduced our water use intensity by 16% between 2013
and 2022.
2022 water use metrics
2022 water use intensity
7
averaged across all facilities
Water use intensity (total gallons per rentable square foot) 44.6
Strategies for impact
Spread best practices
We identify and spread best practices across Kaiser Permanente,
including our approaches to innovative technology and creative
employee engagement.
Employee engagement
We use our internally developed Utility Optimization Program to
educate and inform our enterprise water conservation community
of practice.
Smart metering
We use our smart water metering technology to fix leaks more
quickly, gain a better understanding of our water usage, and validate
conservation measures.
Flow optimization
We optimize water flow in our fixtures to reduce water usage without
increasing maintenance requirements or Legionella risk.
Minimize irrigation
We minimize irrigation by reducing
d
emand (for example, with the
use of xeriscaping, or using
native, drought-tolerant plants in
landscaping), efficiently delivering
water (including using drip or
bubbler sprinkler systems),
eliminating waste (such as leaks
and overspray), and smartly
controlling irrigation schedules.
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Efficiently heating and cooling water
We maximize the water efficiency of our cooling towers and heating
systems to safely condition our facilities with the least amount of
water needed.
Water-efficient medical equipment
We invest in water-efficient medical equipment and processes.
Built and natural environment
Climate and health imperative
The way we design our sites to interact with adjacent
neighborhoods, plan our facilities to support our members and their
communities, and construct our buildings can have a huge impact on
the environment in which those structures are located. By prioritizing
an environmentally conscious strategy for all building and upgrade
projects, we can reduce greenhouse gas emissions and eliminate
potentially harmful effects of our day-to-day facility operations. By
recognizing the link between the health of the environment and
human health, we have sought to make our health care facilities
among the most sustainable. As a result, Kaiser Permanente has
played a key role in developing nationally recognized green building
strategies for the health care sector.
Kaiser Permanente currently tops LEED ratings for health care
facilities, demonstrating our longtime dedication to improving
community health and protecting the environment. Leveraging
existing development and density, designing for efficient water and
energy consumption, including building commissioning in project
scope, providing on-site renewable energy, purchasing green power
and carbon offsets, prioritizing low emission vehicle and bicycle
parking, selecting sites with access to public transportation, selecting
products and materials that
minimize environmental
impacts, using low-emitting
materials to maximize indoor
air quality, and implementing
environmentally friendly
building cleaning
programs are just some
of the considerations that go into the planning and construction
of a sustainable building. These practices are very much top of
mind at Kaiser Permanente as we work to improve the physical and
environmental health of the communities we serve.
Stewardship in action
In 2022, we were recognized by LEED as the top health care
organization in the world for our number of LEED-certified buildings.
We’re also number one in the U.S. in terms of LEED floor space, with
7.4 million certified square feet as of 2022.
Leading the way
In 2022, we were recognized by LEED as the top health care
organization in the world for our number of LEED-certified buildings.
We’re also number one in the U.S. in terms of LEED floor space, with
7.4 million certified square feet as of 2022.
Lowering emissions
By building to LEED standards, our buildings are able to contribute
up to 50% less greenhouse gas emissions due to water consumption,
48% less greenhouse gas emissions due to solid waste, and 5%
less greenhouse gas emissions due to transportation, compared to
conventionally constructed buildings.
9
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Verified results
153 of our buildings have been recognized by the International
Federation of Healthcare Engineering as of December 2022, and 71
of our medical facilities received ASHE Energy to Care awards
in 2022.
Impactful collaboration
In partnership with the California Energy Commission, we led an
advanced heating, ventilating, and air conditioning technology
demonstration project to reduce natural gas use in medical facilities.
Ventilation research
Our outcomes-based ventilation project demonstrated a safe and
effective variable air volume conversion. It also provided natural gas
savings of up to 29% over baseline and electricity savings of up to
36% over baseline.
Mercury elimination
Kaiser Permanente has worked with suppliers to virtually eliminate
the use of products and equipment that contain mercury.
Environmental responsibility
We work to reduce and eliminate chemicals of concern when
sourcing medical products and building materials.
Resiliency through microgrids
We improve our enterprise resilience in climate-related emergencies
by installing microgrids. These microgrids, which are functional and
operate all the time, are designed to be “backups to the backup” if
diesel generators (which operate only in emergencies) fail during
a power outage. In 2018, we installed the first California state-
approved solar microgrid, which helps reduce most purchases from
electric utilities. We are committed to expanding this innovation into
more of our facilities.
Built environment metrics
• Energy Star Certified buildings as of 2022: 48
• LEED-certified buildings as of 2022: 71
• Over 100 of our buildings hosted on-site solar panels in 2022
We aim to:
• Achieve minimum LEED Gold certification
for all major construction projects
• Use our strategies for sustainable facilities
to protect our patients, our employees, and
the environment
Our strategies for impact
Building an accessible toolkit
Working with architects, engineers, and public health care
advocates, Kaiser Permanente helped design and test strategies
for Health Care Without Harm’s
Green Guide for Health Care,
which is the first quantifiable and sustainable design, construction,
and operations toolkit customized for the health care sector.
We also worked with Health Care Without Harm to create
“The Path to Carbon Neutral,” a guide that was made publicly
available in 2020.
Expanding our innovation
We increase our organizational resilience through expanding
innovative infrastructure and protection against grid outages.
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19
Waste
Climate and health
imperative
On average, U.S. hospitals
generate over 29 pounds of
waste
10
per bed per day, adding
up to almost 6 million tons of waste each year. In addition to waste
products such as paper, cardboard, bottles, cans, and compostable
organic waste, health care generates unique waste streams —
including medical waste (such as items contaminated with blood
or other potentially infectious materials, sharps, and nonhazardous
pharmaceutical items), hazardous waste (lab solvents, cleaners,
disinfectants, and some pharmaceuticals), and universal waste (such
as batteries and electronic equipment).
Reusing, recycling, and composting waste uses less natural
resources, water, and energy to manufacture products compared
to manufacturing using virgin materials. Recycling, reusing, and
composting waste also emits less pollutants than manufacturing
with new materials, and avoids emissions of pollutants from landfills.
Overall, proper collection and management of waste is important for
the health of our environment and our communities.
We are committed to reducing and recycling our waste, motivated by
our 2025 goal to ensure 100% of all nonhazardous waste is diverted
from landfills through reduction, reuse, recycling, and composting.
We are also committed to advocating for proper waste management
among the entire health care sector.
Stewardship in action
Reduced landfill waste
Just over half — 51% — of our nonhazardous waste was collected for
recycling, reuse, and composting in 2022, including:
• More than 39,000 tons of waste collected for recycling
• More than 2,700 tons of organic waste collected for
composting, a 55% increase over 2021
• More than 3,200 tons of cardboard waste collected for
recycling
• More than 1,375 tons of electronic waste collected for reuse
or recycling
In addition, over 1,290 tons of plastic waste was avoided by our use
of reusable sharps containers.
Recycled content
We decreased nonrecyclable packaging and increased recycled
content in our procured products.
Safe community collection
We have collection processes
in place to help our members
dispose of unused medications and
used sharps. We aim to provide
responsible disposal processes
for these items to reduce the risk
of diversion and improper use of
medications, and to reduce the risk
of sharps injuries and needlesticks
in the community.
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2022 waste metrics
Waste Type Weight (tons) Disposal
Nonhazardous,
nonmedical waste
51% Collected for composting,
recycling, or reprocessing
Medical waste 29,100 81% autoclaved and then
landfilled; 19% incinerated
We aim to:
• Reuse, recycle, or compost 100% of waste
(excluding medical and hazardous waste)
• Reduce the toxicity of waste
• Enhance the use of recycled materials
Strategies for impact
Waste reduction
We drive waste reduction and increase recycling rates via integration
with cost savings and regulatory compliance initiatives.
Optimize waste streams
We identify new opportunities for waste streams that can be
recycled or composted.
Organic waste
We enhance the collection of organic waste for composting.
Standardize waste management
We’ve standardized waste bin labeling and waste bin placement
to make it easier for staff and members to choose the appropriate
waste bin. We also provide annual training for all Kaiser Permanente
staff on waste disposal procedures and requirements.
Real-time analysis
We are piloting the use of data analysis to identify opportunities to
reduce compactor and dumpster pickup frequencies, and to identify
underperforming sites with opportunities for improvement.
Reuse and reprocess
• We reduce waste volumes by reusing and reprocessing items
when feasible.
• We utilize reusable sharps containers, which are emptied and
then sterilized by our medical waste vendors, enabling the
containers to be reused in our hospitals.
• Single-use clinical devices are collected and safely reprocessed
and remanufactured by a third-party vendor for resale.
• When possible, IT and other electronic equipment is
refurbished by a third-party vendor and then redeployed within
Kaiser Permanente or resold by a third-party vendor.
Procurement collaboration
In addition to thoughtfully managing our waste, we also focus on
how we can work upstream by employing sustainable sourcing
strategies. Our supply chain and impact spending teams collaborate
with key suppliers and distributors to identify opportunities to:
• Decrease nonrecyclable packaging and increase recycled
content in products
• Implement product stewardship, or take-back, programs
• Support product designs that advance reprocessing and
purchase reprocessed single-use items
• Assess the toxicity of materials that will become waste to
reduce hazardous waste
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Responsible procurement and impact spending
Climate and health imperative overview
What we buy matters. Without responsible procurement,
purchased goods and services can lead to larger carbon
footprints, unnecessary waste, and adverse risks to human
and environmental health.
As part of our mission to improve the health of our members and
t
he communities we serve, Kaiser Permanente developed and
implemented a set of Environmentally Preferable Purchasing
guidelines, which comprise a holistic set of environmental criteria
aligned with our commitment to promote cleaner energy, safer
chemicals, resource conservation, and waste reduction.
We are committed to applying the Environmentally Preferable
Purchasing principles to all our major, strategic, and critical
purchasing decisions and evaluating the full life-cycle impacts of our
purchased goods and services.
Stewardship in action
Eliminated harmful ingredients
More than 20 years ago, we began eliminating
the use of soaps, lotions, and sanitizers
containing triclosan and triclocarban.
Since 2012, we have worked with our suppliers
to keep polyvinyl chloride, or PVC, and
diethylhexyl phthalate, or DEHP, out of our
IV solution bags.
Prohibited harmful materials
Beginning in 2004, we prohibited the purchase of building products
containing PVC in our furnishings, including flooring, carpet, carpet
backing, cove bases, corner guards, wall protection, handrails,
bumper guards, perimeter edging on tables, signage (vinyl lettering),
and above-ground piping. We also prohibited the purchase of fabric,
furniture, finishes, and building materials containing fluorochemical
additives or treatments and the purchase of upholstered furniture
containing chemical flame retardants.
Procurement excellence
Every year since 2014, Kaiser Permanente has received the Electronic
Product Environmental Assessment Tool Purchaser Award for
excellence in the procurement of environmentally preferable
electronic equipment.
Access to fresh, local food
Starting in 2003, we began hosting facility
and community based farmers markets. We
have hosted more than 50 seasonal markets
and farm stands at our medical facilities and
in our communities across the country.
2022 impact spending metrics
• Product purchases meeting
Environmentally Preferable Purchasing
criteria: 32.38%, a significant (23.5%)
increase in EPP purchasing since 2021
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Our commitments
• Use our purchasing power to support
diverse suppliers to address economic,
racial, and environmental disparities that
impact the health of our members and the communities
we serve
• Increase the proportion of purchased products
and materials that meet our environmental standards
to 50%
Strategies for impact
Eliminate hazardous waste
We work to ensure products do not create hazardous waste, are
made of 10% or more post-consumer recycled content, and are
commercially recyclable.
Prioritize recycled materials
We work with suppliers to encourage the use of primary packaging
that contains more than 10% post-consumer recycled content and
secondary packaging that contains more than 30% post-consumer
recycled content. We also communicate that paper-based packaging
should be Forest Stewardship Council-certified, recyclable, and
labeled with consumer-friendly recycling information.
Utilize purchasing power
We support impact investments aimed at addressing key
social issues that have a significant impact on health. We also
purchase goods and services from local businesses owned by
underrepresented groups and women to improve the economic
health and well-being of the communities we serve and contribute to
their success and resilience.
Encourage awareness and action
As part of our work to reduce the greenhouse gas emissions
associated with health care, we work with our major suppliers on
their greenhouse gas reduction goals, product innovations, and
process improvements.
Holistic cost analysis
As part of our Environmentally Preferable Purchasing Initiative
evaluation process, we look beyond the up-front costs of a product
or service and calculate the total cost of ownership.
Resilient communities
Our mission reflects the belief that the
environments in which we live, work, learn, and
play have a meaningful impact on our health
and well-being. Kaiser Permanente’s national
community health strategy is dedicated to improving the health of
the communities we serve. We seek to address the root causes of
health inequity by supporting economic opportunity, affordable
housing, health and wellness in schools, and a healthy environment.
We are committed to environmental stewardship beyond our walls.
We strive to improve the conditions for health in our communities,
advance our mission, and create healthier and more equitable
communities through partnerships and philanthropy. By listening
to our communities, we can make impactful investments and
increase innovations that advance the future of community health
and equity.
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Our publicly shared Community Health Needs Dashboard, which is
used across our service areas, highlights place-based environmental
impacts on health. Through meaningful partnership and place-based
engagement, we work with our communities to build resilience and
reduce the health impacts of climate change and environmental
hazards. Here are some highlights from our 2022 investments.
We supported initiatives to
address air quality, extreme heat,
and water security.
In Northern California, we
supported the Madera Coalition
for Community Justice’s Campaign
for Asthma Awareness, Action, and
Advocacy. This initiative focused
on outreach to youth, parents, and
community residents to increase understanding how air quality
affects asthma, respiratory infections, and chronic health conditions.
The program promoted preventive care measures and facilitated
civic participation to improve air quality.
In the San Joaquin Valley, we funded the Central Valley Air Quality
Coalition to provide resources and information to environmentally
burdened communities about how to protect themselves from
air pollution and engaged the same communities on air quality
measures with the California Air Resources Board.
In Denver, Colorado, we supported the Urban Forest Initiative
with Denver Civic Ventures. Funding was used to support the
enhancement and expansion of downtown Denver’s urban tree
canopy to reduce the urban heat island effect and mitigate residents’
exposure to extreme heat.
In California, funding for the Community Water Center supported
efforts to advocate for safe, accessible, and affordable drinking
water for communities impacted by contaminated water and
extreme drought worsened by climate change.
We supported Self-Help Enterprises to build water management
capacity and expertise of rural community leaders, to empower
these leaders to influence regional groundwater management
and implement climate-resilient water management policies
and practices throughout the San Joaquin Valley and the state
of California.
We invested in essential workforce development and readiness
for climate change.
We supported the Central California Environmental Justice
Coalition and North Bay Jobs with Justice to improve farmworker
safety and readiness in the face of environmental hazards, including
exposure to wildfire smoke and heat waves.
We enhanced youth career development in climate-ready careers,
including essential efforts to support adaptation efforts. We
funded Faith in the Valley to provide job training in areas such as
electric vehicle industries, reforestation, and forestry in the Central
Valley of California.
In Sonoma County, California, we supported Sonoma County
Parks Foundation to provide work experience, job training, and
career exploration for young adults in low-income communities.
Participants engaged in climate change mitigation, adaptation, and
resilience projects in coastal parks, such as installing composting
equipment and reducing wildfire fuels.
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We provided support to advance equitable climate responses,
promote environmental justice, and drive systematic change.
In California, our support of The Greenlining Institute provided
strategic guidance to funders on investment opportunities in
communities of color to promote climate resilience. The project
aimed to provide insight and analysis on statewide climate action
opportunities and community-based partnerships in local regions
including Oakland, Stockton, San Diego, and Los Angeles. The
project also supported efforts to build climate equity in Oakland
and the San Gabriel Valley.
In Colorado, we supported the Colorado Health Institute to
develop strategic recommendations for health care systems and
philanthropic organizations regarding how to make meaningful
investments in climate-related community resilience. CHI conducted
an analysis of climate and health vulnerabilities and engaged
with community stakeholders to summarize recommendations in
the categories of patient and clinician education, advocacy and
leadership, adaptation to environmental hazards, and support for
research and data collection.
Leading and engaging
Solving the climate crisis and prioritizing health
equity requires collective action. No single
organization, business, or sector can solve this
alone. We catalyze change through our leadership and engagement
with stakeholders, partners, and collaborations.
Connecting for collective action
In June 2022, Kaiser Permanente declared our commitment to radical
decarbonization and hosted “Getting to Net Zero: The Health Equity
Imperative.” This event focused on why the health care sector must
commit to net-zero emissions to improve health and advance health
equity. HHS Assistant Secretary for Health Admiral Rachel Levine,
Emerald Cities Collaborative President and CEO Meishka Mitchell,
IHI President Emeritus and Senior Fellow Don Berwick, and Kaiser
Permanente physician Colin Cave, MD, joined Kaiser Permanente Senior
Vice President and Chief Health Officer Bechara Choucair and Executive
Director, Environmental Stewardship Seema Wadhwa for a LinkedIn Live
conversation as they discussed why the health sector must address the
climate crisis to protect the health of patients and communities.
In September 2022, we hosted a roundtable of key global private
sector, health care, and government leaders on the relationship
between climate change and health and the disproportionate
health impacts of climate change on low-income communities and
communities of color. Our discussion, hosted in partnership with
the World Economic Forum and Deloitte at the United Nations
Climate Week in New York City, helped to identify key priority areas
for action and insights to further embed health equity into climate
action in private sector business and community engagement goals
and practices.
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Partnering for impact
Our decades of experience and lessons learned in environmental
stewardship give us the ability to build coalitions and lead the health
care industry in decarbonizing operations and building health
care resilience. Through our partnerships with community-based
organizations, we’ve forged crucial relationships that help us listen
and respond to community challenges and opportunities.
We also work across industries and sectors to broaden
collaborations and spark insights and strategies that center health
and health equity in the climate narrative and our collective
action. Our environmental leadership has allowed us to cultivate
strong, long-lasting relationships with diverse groups of partner
organizations, including:
• Practice Greenhealth — This nonprofit membership
organization was founded on the principles of positive
environmental stewardship and best practices by organizations
in the health care community. Practice Greenhealth has been
instrumental as a source for information tools, data, resources,
and expert technical support on our sustainability initiatives.
• Health Care Without Harm — This organization works to
transform health care worldwide so that the industry reduces
its environmental footprint and becomes a community anchor
for sustainability and a leader in the global movement for
environmental health and justice. Along with our Health Care
Without Harm partners around the world, we share a vision
of a health care sector that should do no harm and promote
the health of people and the environment. We are working
alongside Health Care Without Harm to achieve the goal of
implementing ecologically sound and healthy alternatives
to health care practices that pollute the environment and
contribute to disease.
• California Health Care Climate Alliance — Launched in
collaboration with Health Care Without Harm, the alliance
is a leadership body of California health care organizations
committed to protecting the public from the health
impacts of climate change, becoming anchors for resilient
communities, and contributing to meeting the state’s
climate goals.
• Health Care Climate Council — The council is a leadership
body of health systems committed to protecting their patients
and employees from the health impacts of climate change.
Member health care organizations are committed to being
anchors for resilient communities. We learn from other Health
Care Climate Council members through sharing innovative
climate solutions, providing inspiration and support to act,
and using their trusted voices and purchasing power to move
policy and markets that drive the transformation to climate-
smart health care.
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• Greenhouse Gas Protocol — This organization established a
comprehensive, global, standardized framework that we use
to measure and manage greenhouse gas emissions from our
operations, value chains, and mitigation actions.
• RE100 — As a global corporate renewable energy initiative,
RE100 brings together hundreds of large and ambitious
businesses committed to 100% renewable electricity. We
are united with other conscientious businesses that are just
as passionate about lessening fossil-fueled grid reliance and
achieving 100% renewable, clean energy for our operations.
• Healthcare Anchor Network — More than 70 leading
health care organizations are part of this growing national
collaboration working to build more inclusive and sustainable
local economies. As a member and signatory of the Impact
Purchasing Commitment, Kaiser Permanente is committed to
making sure our institutional and operational resources are
aligned with their clinical mission of tackling the structural
determinants of health.
• Ceres — This think tank focuses on advancing leadership
among investors, companies, and capital market influencers
to drive solutions and act on the world’s most pressing
sustainability issues.
• National Academy of Medicine — The academy launched the
Climate Grand Challenge, a multiyear global initiative that aims
to communicate the climate crisis as a public health and equity
crisis; develop a roadmap for systems transformation; catalyze
the health sector to reduce its climate footprint and ensure
its resilience; and accelerate research and innovation at the
intersection of climate, health, and equity. We are excited to be
a part of this challenge as its goals align with the core purpose
of Kaiser Permanente’s environmental stewardship mission.
• Clean Production Action — This nongovernmental organization
designs and delivers strategic solutions for green chemicals,
sustainable materials, and environmentally preferable
products. Kaiser Permanente partnered with CPA on the
development of our Environmentally Preferable Purchasing
standards. We also participate in the CPA BizNGO Working
Group for Safer Chemicals and Sustainable Materials, a unique
collaboration of business and environmental leaders working
together to define and implement the leading edge in safer
chemicals and sustainable materials.
Review California AB 1305 compliance disclosureson our greenhouse gas emissions reduction efforts.
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1
A market-based method reflects emissions from electricity that companies have purposefully chosen (or their lack of choice). It derives emission factors from contractual instruments,
which include any type of contract between 2 parties for the sale and purchase of energy bundled with attributes about the energy generation or for unbundled attribute claims.
Greenhouse Gas Protocol Scope 2 Guidance, World Resources Institute, 2015, p. 4, ghgprotocol.org/sites/default/files/Scope2_ExecSum_Final.pdf.
2
A location-based method reflects the average emissions intensity of grids on which energy consumption occurs (using mostly grid-average emission factor data). Greenhouse Gas
Protocol Scope 2 Guidance, World Resources Institute, 2015, p. 4, ghgprotocol.org/sites/default/files/Scope2_ExecSum_Final.pdf.
3
David Blumenthal, Shanoor Seervai, “To Be High Performing, the U.S. Health System Will Need to Adapt to Climate Change,” Commonwealth Fund, April 18, 2018, www.common
wealthfund.org/blog/2018/be-high-performing-us-health-system-will-need-adapt-climate-change
-
.
4
“Examining Supply-Side Options to Achieve 100% Clean Electricity by 2035,” National Renewable Energy Laboratory, 2022, www.nrel.gov/docs/fy22osti/81644.pdf.
5
“Half the World to Face Severe Water Stress by 2030 unless Water Use is “Decoupled” from Economic Growth, Says International Resource Panel,” UNEP, March 2016, https://www.
unep.org/news-and-stories/press-release/half-world-face-severe-water-stress-2030-unless-water-use-decoupled.
6
“Saving Water in Hospitals,” EPA, November 2012, www.epa.gov/sites/default/files/2017-01/documents/ws-commercial-factsheet-hospitals.pdf.
7
Water use intensity refers to the rate at which water is used in a given area. It is an indicator of how much water a building requires during its occupation and informs sustainable
water allocation.
8
“Quantifying the Comprehensive Greenhouse Gas Co-Benefits of Green Buildings,” October 2014, https://escholarship.org/uc/item/935461rm#main.
9
“Waste,” Practice Greenhealth, https://practicegreenhealth.org/topics/waste/waste-0.
Thriving Planet
Equitable Care:
Improving health for members,
patients, and communities
2022 Environmental, Social, and Governance Summary
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At Kaiser Permanente, our mission is to provide high-quality, affordable
health care services and to improve the health of our members and
the communities we serve. Our definition of health refers to physical,
mental, and emotional well-being — more simply put, it’s total health.
Total health goes beyond the doctor’s office. It goes deep into our
communities where people live, work, learn, and play.
Our priority is always the health and safety of our patients, members,
communities, and employees. Our care teams — empowered
to collaborate seamlessly within Kaiser Permanente’s model of
integrated care and coverage — have a shared commitment to
preventing disease, healing illnesses and injuries, managing complex
and chronic conditions, and improving mental health. Our front-line
employees, clinicians, and labor partners all work to meet the health
needs of our members and communities and continue to be an
industry-leading voice for advancing evidence-based care. We seek
to lead the nation in delivering person-centered care that is safe,
effective, timely, efficient, and equitable.
We are proud of the work we did to deliver high-quality care and
coverage to our members and communities in 2022. We also
recognize that more needs to be done to push ourselves and others
in health care to improve health in our country by making high-
quality care more accessible, coordinated, and affordable.
Care and health equity
At Kaiser Permanente, we are committed to providing health care
equitably and strive to eliminate disparities in health outcomes for
all. We believe that all members and patients, regardless of their
physical, mental, or socioeconomic status, have the right to equitable
health outcomes and a personalized, high-quality care experience.
We’re a recognized leader in eliminating care disparities and we
continue to drive progress by seeking to address care gaps among
underserved populations. Health equity is rooted in our mission. We
take equity into account when we evaluate the quality of the care we
provide and the outcomes we deliver to our members. This helps us
identify and eliminate disparities in care and outcomes as we strive
to provide the best care possible.
Measurement
In 2022, we committed to examining all our quality metrics through
the lens of equity by looking at results by race, ethnicity, and social
drivers of health. This applies to the measures of quality required by
regulators and accreditors as well as to a new set of clinical outcome
measures we have begun to collect across our enterprise. Our focus
on both process and outcome measures demonstrates how we’re
holding ourselves accountable for both equal treatment and equity.
We believe that equitable care does not simply mean making the
same services available to all. It’s about providing the care needed
to maximize each member’s health potential. The purpose of these
measurements is to identify and inform the success of interventions
designed to eliminate inequities in health care delivery and
outcomes across different population groups.
Equitable Care
Equal medical care is not
enough to end disparities
in health outcomes. We
are working to achieve
health equity.
2022 Environmental, Social, and Governance Summary
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Even with the challenges we faced, we continued to achieve high
ratings in quality assessments. Our member satisfaction scores
and quality of care ratings continued to be among the nation’s
highest, as determined by multiple, independent organizations.
We were again among the highest-rated health plans in the
nation, according to the 2022 National Committee for Quality
Assurance report. Our Medicare and commercial health plans
were rated highest or tied for highest in every geographic region
we serve.
Alongside these important third-party assessments, we are
deeply engaged in exploring new ways of creating accountability
around quality and quality improvement. Through a collaboration
with the Institute for Health Metrics and Evaluation, we’ve taken
an important step in modeling how we might create and share
the types of quality measures that really matter to our members.
Our analysis found that Kaiser Permanente members are
significantly less likely to experience premature death due
to cancer (20% less likely) and heart disease (33% less likely)
compared to nonmembers in their community.
We have demonstrated success in addressing health disparities
for hypertension control, diabetes care, and colorectal cancer
screening. While we’re proud of this progress, we’re committed
to doing more to deliver equitable health outcomes for our
members. With the help of equity workgroups that include our
internal experts from our Quality, Community Health, Member
Services, and Human Resources departments, as well as the
Permanente Federation and Permanente Medical Groups, we
are creating a health equity framework to guide our approach to
identifying and addressing care gaps.
81
Quality measures in
which we are rated first
in the nation by NCQA
(National Committee for
Quality Assurance)
39
Hospitals rated “high
performing” in U.S. News &
World Report
12
Consecutive years
earning Pharmacy
Quality Alliance
“Excellence in Quality”
Award (Medicare
Advantage Drug Plans)
$345M
Funding for
research
1. 7 M
Cervical cancer
screenings
100M
Prescriptions
filled
2,16 0
Studies (including
clinical trials)
2.2M
Colorectal cancer
screenings
1M
Mammograms
118K
Babies born
4
Consecutive
years all KP
Medicare and
commercial plans
rated highest or
tied for highest
by NCQA in
each region
or state that
we serve
8
26
We lead the nation in 26 HEDIS® effectiveness-of-care measures
Kaiser Permanente vs.
our closest competitor
Equitable Care
2022 Environmental, Social, and Governance Summary
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As part of this work, we established the Health Equity Advisory
Council, a senior executive oversight team that is advancing
our institutional equity and health equity commitments — and
specifically the elimination of inequities — through education,
leadership subject matter expertise, and counsel. The council
is an organizational steward and bold disrupter for sustainable
and equitable change by reviewing our current organizational
structures and operations to identify and eliminate anything that
might enable or perpetuate racism or inequities.
Workforce
We are dedicated to delivering culturally responsive care with
multilingual outreach. Our call center staff members are fluent in
more than 140 languages, and our medical facilities are uniquely
focused on the needs of specific communities. For example, several
medical facilities are home to Culturally Competent Care Centers of
Excellence serving Latino, Chinese, Black, Armenian, Vietnamese,
and LGBTQ+ communities. Member communications are printed
in various languages, and translators are available to help patients
and their families. See the Responsible Business
Training
As a leading health care provider
and mission-driven organization, it’s
particularly important that we address
racial inequities resulting from what
we do or don’t do, and from how we
design our systems and processes.
Only then can we achieve our mission and truly create a better
health care organization for everyone.
Kaiser Permanente is committed to addressing racism through
ongoing work in care delivery and community and social health
as well as within our workforce. We are a
multiracial and multicultural organization
serving communities with great diversity.
Our membership represents more
than 260 ethnicities and speaks over
100 languages. Our workforce, most
of whom are also members, are highly
representative of our membership, with
over 69% being people of color. This
diversity enables us to best meet the
unique needs of each of our members
if we can fully understand and embrace
the power of our diversity. We all benefit
from racial equity, regardless of the color
of our skin.
But racism — both interpersonal and structural — affects care
experiences and outcomes for our diverse members, physicians,
and employees and is a barrier to fully realizing our mission.
Our mission can’t be fulfilled unless our care is equitable and
inclusive. We are working to reduce the barriers to racial equity t
hat exist for our workforce in our systems and processes, as well
as individual thoughts and actions. Removing bias in how we
recruit, develop, and advance people helps us build the most
diverse, engaged, innovative, and satisfied workforce at all levels,
with high retention.
Adhering to our equity principles and gaining a common
un
derstanding of bias and racial inequities helps us identify and
eliminate bias in our thinking and actions, as well as inequities in
our systems and processes.
Equitable Care
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We understand that health equity cannot be achieved without
workforce equity. Having a diverse, inclusive, engaged workforce
is a necessary ingredient to optimize culturally responsive
experiences and the care we provide to our members and
communities. We must equip our workforce to disrupt bias
and address structural and system racism. To support this, we
introduced Belong@KP, a culture transformation initiative to
embed inclusion and social justice into everything we do. Learn
more about how we’re creating an inclusive and psychologically
safe environment in our Responsible Business section. We also
provide education and training for our workforce to increase their
skills in providing culturally sensitive care. For example, Talking
to Members About Social Health uses principles from trauma-
informed care to help clinicians feel more comfortable and
confident talking to patients about their personal circumstances in
addition to their health.
Leading the national dialogue
The Joint Commission and Kaiser Permanente came together
in 2021 to establish the National Award for Excellence in Pursuit
of Healthcare Equity. This annual award recognizes health care
organizations and their partner institutions for leading initiatives
that achieved a measurable, sustained reduction in one or more
health care disparities. It honors the memory of our late chair and
CEO, Bernard J. Tyson, who worked tirelessly to address the health
care disparities that plague the U.S. health care system.
Care innovation
Alongside expert physicians and highly rated care facilities, our
robust research capabilities help advance care, improve our
members’ experience, and identify solutions to improve the health of
our members, patients, and the communities we serve. Our
research and clinical practices are integrated to promote continuous
improvement and leading-edge care delivery.
705M
Visits to kp.org
7.4M
Video visits
42.8
Prescriptions
filled online
4 4.1M
Secure messages
sent to providers
11.1M
Appointments
scheduled online
97. 3 M
Lab results
viewed online
8 5.1%
Members with
digital access
10.5M
E-visits
Our research teams are at the forefront of examining how innovations
in care delivery can address disparities and inequities. Our large,
diverse, and long-term membership enables us to study groups of
people who are often underrepresented in research.
FEB
12
Equitable Care
2022 Environmental, Social, and Governance Summary
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Equitable Care
Our physicians connect our patients to clinical trials that offer
cutting-edge treatments, such as immunotherapy and precision
medicine for the care of patients with cancer, cardiovascular disease,
and other major life-threatening illnesses. Our research on the
coronavirus and COVID-19 contributed to the rapid development of
vaccines, treatments, and other therapeutic strategies that helped
save millions of lives across the country.
We opened the Kaiser Permanente Bernard J. Tyson School of
Medicine in 2020. There, we teach future physicians about the
social and environmental factors that affect the health of patients
and populations that are under-resourced, underserved, and
culturally diverse. Students learn in an environment that reflects the
changing demographics of America and the multifaceted health
care issues our country faces. Among the inaugural class of 2024,
36% of students self-identify as being from a racial or ethnic group
underrepresented in medicine. That rose to 40% in the class of 2025.
The school ranked as the 5th most diverse medical school in the
nation — and the 2nd most diverse in California — in the U.S. News &
World Report 2023 Best Medical Schools study.
Students also have the opportunity to learn from the physicians and
care teams in Kaiser Permanente’s integrated health care system. By
reimagining how physicians are trained, the school aims to create
outstanding physicians who will be skilled advocates for their patients
and communities and drive change in the health care profession.
As a part of our mission, we’re always working toward making it
easier and more convenient for members to get high-quality care and
service. We invested in technologies to enable safe and convenient
care that helped meet the increased demand for virtual care offerings
during 2022. As we continue to invest in new and leading technology,
equipment, care facilities, and more, we do so with a member- and
patient-first approach. As part of this effort, we address digital
inequities: Currently, only about 85% of our members have digital
access.
The need for telehealth and remote care remained high throughout
2022. Kaiser Permanente focused on more than just meeting the
need for increased safety and convenience for our members. We
also expanded our virtual care to include preventive care as well as
advanced treatment of complicated and chronic health conditions.
Kaiser Permanente provided an average of 27,500 video visits per
weekday in 2022. Our teams also filled 100.2 million prescriptions,
42.8 million of which were ordered online. Our technology helps our
members access care and manage their health, including enabling our
members to view 97.3 million lab results online.
In 2022, we expanded our effort to make 24/7 virtual care available
to members with Get Care Now on kp.org. It provides another
personalized way for our members to talk with a clinician and get
convenient, high-quality care. During each phone or video visit, a
Kaiser Permanente clinician can access the member’s electronic
health record and use the person’s medical history to help inform care
decisions, order prescriptions, schedule follow-up procedures, or
make a referral to a specialist.
Remote patient monitoring helped
Alicia Saunders care team keep tabs
on her blood pressure — and ensure
a safe pregnancy for her and her
rainbow baby. Read more about how
virtual care brings peace of mind.
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In 2022, we launched a new nationwide collaboration with Evernorth
Health Services and Cigna Healthcare, to allow Kaiser Permanente
members to get in-person urgent and emergency care from Cigna
Healthcare’s preferred provider network of physicians, hospitals,
and urgent care clinics while traveling outside of states where Kaiser
Permanente operates.
COVID-19 response
The third year of the COVID-19 pandemic brought continued threats
to the health of our members and communities. The year began
in the middle of the COVID-19 omicron variant wave of infections.
Fortunately, by that point, many people had been vaccinated against
COVID-19. Severe illnesses and death caused by the virus were less
common than in the first 2 years of the pandemic.
During 2022, our care teams treated 1.8 million patients with
COVID-19, including 53,000 who required hospitalization. We
performed nearly 7 million COVID-19 PCR tests at Kaiser Permanente
facilities and provided more than 14.2 million COVID-19 home antigen
tests to our members. COVID-19 was not the only public health threat
in 2022. We also saw outbreaks of RSV, or respiratory syncytial virus,
and higher rates of the flu than we’ve seen in the past 2 years.
Kaiser Permanente was among the first health care organizations
to administer vaccinations when the COVID-19 vaccine became
available at the end of 2020. Our teams administered more than
5 million vaccine doses, including boosters, to members and
nonmembers alike during 2022.
The pandemic and events since 2020 have brought to light the
health inequity, social injustice, and racism that persist in our country.
A disproportionate percentage of COVID-19 illness and deaths
has occurred within Black, Latino, and other underrepresented
communities. These inequities and injustices were also evident
in the drive for COVID-19 vaccinations, with underrepresented
communities having limited access to health care and resources,
along with a lack of trust in the health care system.
When the COVID-19 vaccine became available to the public, we
designed, built, and adjusted outreach campaigns to increase
overall vaccination rates. We also helped ensure fair and equitable
administration of vaccinations in communities most affected by
COVID-19. Kaiser Permanente partnered with cities, states, community
and religious organizations, and federally qualified health centers to
distribute vaccinations safely and equitably in these communities.
We set up community clinics to make it easier to get a vaccination.
We helped deliver messages and information to millions of people
from trusted voices, leaders, and organizations that have consistently
served our communities in need.
We developed and freely shared our Vaccine Equity Toolkit — which
provided our equitable vaccine administration approach and best
practices — with other care delivery organizations, health plans, and
state and local governments. The toolkit continues to help deepen
our existing partnerships and supports ongoing opportunities for
mutual learning.
Our vaccine equity toolkit
offers approaches to help
addr
ess equitable vaccine
administration for communities
hit hardest by COVID-19.
Equitable Care
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Social health
Kaiser Permanente’s longstanding commitment
to eliminating health inequities and delivering
high-quality care includes addressing all of the
factors that affect health, including having a
safe place to live and access to healthy meals.
In 2022, we surveyed our members to ask about their general health
and ability to meet these and other basic needs. We learned nearly
two-thirds of our members have at least 1 social factor affecting their
health and well-being. Many had more. More than 60% of members
with social needs said they would welcome assistance from us
addressing these needs.
While membership surveys provide informal yet important insights
into the social vulnerabilities our members face, standardizing social
health screenings as a routine part of delivering care and services is
another important step in improving health equity and outcomes.
We screened more than 2 million members for social needs in
2022, asking standard questions about their ability to buy healthy
food and pay for housing and transportation, in the same way
we screen for clinical conditions like diabetes, heart disease, and
cancer. We introduced new ways to administer these social health
screenings, using digital tools including online questionnaires
emailed securely to members prior to a virtual or in-person health
visit to prompt members to complete screenings and to link those
who need it to support services.
We reached out to members broadly and with more focused
campaigns in 2022 to raise awareness of the social health support
services Kaiser Permanente offers and to encourage enrollment in
vital programs that support self-sufficiency and well-being.
A social media and direct messaging campaign in 2022 promoted
our online community resource directory and phone line to 7
million Kaiser Permanente members. The campaign ran from
October through December on Facebook, Twitter, and by email
and text message to members. It generated 550,000 visits to the
directory during those months alone and increased call volume by
nearly 300%. Anyone can search the directory for resources in their
community 24/7 at their own convenience at kp.org/community
resources or call a toll-free number during business hours to talk to
a specialist for help finding nearby programs that help with food,
housing, childcare, and more. Both services are offered at no cost.
Outreach to those at risk
We created campaigns to reach smaller groups of vulnerable
members and address prevalent conditions, such as food insecurity
and financial stress. These included:
• Extreme heat relief: Responding to record-breaking
temperatures in the Pacific Northwest during the summer of
2022, Kaiser Permanente sent text and email messages offering
support to low-income members with health conditions that
put them at risk during the high heat. Working with local
community partner Project Access NOW to order and deliver
air-conditioning units, we were able to provide over 300 free air
conditioners to members in the region.
• Get Your Refund: A similar text outreach campaign in 2022
helped low-income members connect to free tax-filing services
offered through GetYourRefund.org to increase access to
tax refunds and tax credits, including the earned income tax
credit, child tax credit, and stimulus payments from the 2021
American Rescue Plan Act. We reached out to over 550,000
members during this campaign and put an estimated $625,000
directly into the pockets of members.
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• Medical-legal partnerships: Working with local legal aid
organizations, our care teams connected 980 patients with
housing concerns to free legal support in 2022, including
representation, consultation, and advice.
Food Is Medicine
The connection between nutrition and a person’s
health and well-being is clear. So, we work to
ensure our members and communities have
access to, and can afford, healthy food. We
propelled this work in 2022 through community
investments, innovative partnerships, coalition-building, and
contributions to the national evidence base for food- and nutrition-
security interventions in health care.
A leading proponent of the national Food Is Medicine movement,
Kaiser Permanente shares our learnings and experience on the
ground with high-profile coalitions and task forces around the
country to shape key decisions on nutrition within health care and
raise awareness about the powerful impact of food on well-being.
We participated in the White House Conference on Hunger,
Nutrition, and Health in September 2022 and pledged to invest
$50 million between 2022 and 2030 in programs that reduce
hunger, improve nutrition, and prevent diet-related diseases for
our country’s most vulnerable populations. These investments
will include grantmaking to community organizations providing
evidence-based food and nutrition security interventions and to
advocacy organizations that are influencing the national dialogue on
nutrition. In addition to improving food- and nutrition-security in our
communities, we supported additional programs and partnerships
to improve nutrition and health outcomes among our members. In
2022, these programs included:
• SNAP and WIC: In 2022, we reached out to over 1 million
members to offer help applying for the Supplemental Nutrition
Assistance Program and the Special Supplemental Nutrition
Program for Women, Infants, and Children.
• Produce RX: We provided nutrition education and over
7,500 healthy food boxes to members with diabetes facing
challenges getting enough healthy food.
Kaiser Permanente’s longstanding commitment to working with
local community partners to increase applications for federal
nutrition programs like WIC and SNAP earned us a Community
Advocate award in 2022 from San Francisco Bay Area-based
nonprofit Project Open Hand. Learn more about our work around
social health.
Health care access and affordability
Equal access to care is an important part of our mission to provide
high-quality, affordable health care services to the communities
we serve.
Available 24/7 with no appointment,
e-visits offer our members quick,
convenient online care for many health
concerns such as flu or COVID-19
symptoms. Learn more about our
fastest path to care.
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We recognize that we have a responsibility to provide our members
with better value through a combination of high quality, access, and
affordability. We provide care and coverage together and share
medical and financial responsibility for our members’ health care. That
shared responsibility means we don’t benefit when our members get
sick. With traditional fee-for-service care delivery, providers get paid
more when they submit more claims. In contrast, our clinicians strive to
meet clinical quality benchmarks, which means members get the right
care and have better outcomes. We use our scale and connectivity
to maximize efficiency while continuously improving quality. As a
nonprofit health plan and care delivery organization, net income
goes back into the organization to serve our members. The superior
outcomes of our coordinated and connected model show that high-
quality, affordable care and coverage — and the promise of total health
— are possible for the communities we serve.
In our communities, improving access to care for people with limited
resources is a more complex and critical component of affordability
and our mission. For many people with low incomes and without
medical coverage, an emergency room is the only place they can get
the care they need. We’re working to change that — with programs
that lower financial barriers, provide free or deeply subsidized health
coverage, and improve access to public health care programs in
underserved communities.
Through our Medicaid, Charitable Health Coverage, and Medical
Financial Assistance programs, we deliver high-quality care and
coverage, and we improve health care access for people with limited
incomes and resources. In 2022, we served nearly 1.4 million Medicaid
and Children’s Health Insurance Program participants.
In 2022, we also provided health care coverage through our Charitable
Health Coverage programs to nearly 12,000 people with low incomes
who don’t have access to other public or private health coverage. And
we provided more than $433 million in medical financial assistance to
more than 319,000 patients in need in 2022.
Through our community health grants, we provide more options for people who need help to get care.
Telehealth access grants
Fund community organizations
to increase virtual care services
for people with low incomes
Transportation support
Partner with local groups
that provide rides to vaccine
sites and clinics
Convenient mobile clinics
Bring care to the communities
and people who need it
Equitable Care
Healthy Communities:
How we create equitable opportunities
and conditions for health
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Equitable Care
Kaiser Permanente was founded on a commitment to keeping
our members healthy and restoring them to health after injury or
illness. Since our inception we have also had a larger goal — based
on our belief that high-quality health care should be accessible and
affordable to all — to improve the health of our communities.
At Kaiser Permanente, an important part of our mission is to
improve the health of our members and communities. One way
we do this is by providing high-quality health care. But, to achieve
better health, people need more. They need to be able to meet
their daily needs. They need a safe place to live, enough money
to pay the bills, and access to healthy meals. And they need
healthy communities. We invest in our communities to improve the
conditions for health and equity. Our community investments and
partnerships address all the factors that impact health and well-
being. In 2022, as the world turned the corner on the COVID-19
pandemic, our community health investments built on partnerships
established and lessons learned to improve health for individuals,
for communities, and for the public at large.
As the health effects and economic toll of the COVID-19 pandemic
continued throughout the year, our accelerated efforts broadened
the scope of our care and services to address all factors that affect
people’s health.
Equity and COVID-19 response
During each phase of the pandemic, our response rapidly evolved
to meet changing community and social health needs, keeping
equity at the core of our efforts. Throughout 2022, the third year
of the global COVID-19 pandemic, Kaiser Permanente continued
outreach campaigns to encourage vaccination. We also continued
to support community organizations, such as churches and
barbershops, in their work to encourage vaccination. We know that
people are more likely to hear and understand messages delivered
by people they know and trust.
We also developed guidance on when it’s best for people to use
COVID-19 home antigen tests versus in-person PCR lab tests. We
shared this guidance with community partners, so they could help
spread the word.
During the COVID-19 pandemic, we’ve seen what can be
accomplished when public, private, for-profit, and nonprofit
organizations come together to protect and improve the health
of communities. But the pandemic also exposed significant, long-
standing gaps in our nation’s public health system. These include
an underfunded and patchwork infrastructure, a rapidly shrinking
workforce, and growing distrust of health institutions.
Investing in the resilience of our public health system is critical to
promoting health equity and improving health and well-being in
our communities. We worked closely with community partners to
rebuild trust in public health, in part by strengthening public health
communications capacity. In addition, we joined national leaders
across the health care, public health, academic research, and nonprofit
sectors to outline ways to bolster the public health system. The result
is a shared public health agenda, focused on 3 critical areas:
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• Public health and health care: We’re working in collaboration
with AHIP, the Alliance of Community Health Plans, the
American Hospital Association, and the American Medical
Association to ensure that our nation’s health care and public
health systems have the tools, knowledge, and working
relationships needed to respond together effectively in the
event of a crisis.
• Public health and community-based organizations:
Community organizations provide essential services to
communities. They play a critical role in ensuring that
community voices and needs guide public health responses.
We’re working with the CDC Foundation to identify and
spread best practices for making and maintaining connections
between public health agencies and community organizations.
Improved partnerships will ensure people receive better
resources and care.
• Public health and research: Our nation urgently needs better
data on the impact and effectiveness of public health services.
We’re supporting AcademyHealth as it develops a new public
health research agenda. Our shared goal is to find ways to
improve our public health system.
Read: Supporting
equitable COVID-19
vaccine education
Economic opportunity
Financial inequality and financial insecurity have direct consequences
on health, particularly mental health, and chronic stress. How much
money a person can earn or save determines how well the person can
manage unexpected expenses or a sudden loss of steady income, and
whether it’s possible to take a break from work to recover from illness
or take time off to support a family member in need.
We know that people with low incomes are more likely to face food
i
nsecurity and housing insecurity, which bring their own health-
related consequences. Studies are also beginning to demonstrate
connections between poverty and cognitive development.
It’s hard to be healthy when you don’t have enough money to pay
t
he bills. The COVID-19 pandemic impacted the financial well-
being of many U.S. households. Lower- and middle-income families
suffered most. Then, 2022 brought record levels of inflation, causing
the prices of everyday goods and services to soar. To strengthen
economic opportunities, especially for those most in need, we
focused on 4 key areas.
Offering resources to strengthen household finances
In 2022, we supported 410 organizations that are helping people with
l
ow incomes improve their household and business finances.
• Our Financial Health Initiative supported over 230,000 people
with interventions to support financial goal setting, navigate
public benefits, manage debt, and access safe financial
products. We also supported more than 4,200 entrepreneurs to
improve personal and business finances. The initiative also
helped people take advantage of credit-building opportunities,
such as rent reporting. Rent reporting is the reporting of on-time
rent payments to major credit agencies.
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Providing direct support to diverse small businesses
in our communities
Through partnerships and policy activities in 2022, we provided
9,169 entrepreneurs with technical assistance and business coaching.
And we improved their access to capital through our community
partnerships. Since starting these efforts in June 2020, we have
helped more than 24,629 entrepreneurs — 78% of whom are people
of color. These entrepreneurs helped retain or create over 27,000
jobs in our communities.
Using our purchasing power to support diverse small businesses
and promoting employee ownership
Small businesses are critical to the success of our communities. So,
when we need to buy supplies for our hospitals or other goods and
services, we buy from diverse small businesses, as often as possible.
In 2022, we spent $3.49 billion to support diverse-owned businesses.
In addition, we disbursed $11.1 million to nonprofit organizations that
help diverse-owned businesses. We specifically seek out businesses
with missions and business practices that align with our own.
We further supported small businesses and their employees by
launching the Business Resiliency Through Employee Ownership
initiative. Employee ownership is a business arrangement in
which no one person has a majority of shares or control over an
organization. In many cases, it means a company grants its workers
stock shares.
Our initiative has educated over 1,000 Kaiser Permanente suppliers
about the benefits of employee ownership. So far, 2 of those
businesses (representing 194 employees) have transitioned to
employee ownership. Employee-owned companies report faster
growth, less turnover, and greater recession resilience. Employees
who share ownership in their company report greater income
and wealth.
Expanding access to educational and career pathways
Earning a degree, starting a new career, or advancing in your current
role can be life-changing financially. But to get there, you have to
know the right steps to take. We support programs and initiatives
that provide clear educational and career pathways, especially for
people of color, who have historically faced gaps in income and
earning potential.
• In 2022, our Futuro Health initiative helped 1,006 professionals
graduate into allied health careers — 90% of graduates were
people of color and 52% of graduates are bilingual.
• We awarded 12 fellowships to help launch the careers of
diverse, early-career professionals who are committed to
achieving health equity for all.
• We provided local grants to support more than 40,000 people
in accessing opportunities for higher education and job
training programs.
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Food and nutrition security
About 1 in 4 adults in the United States doesn’t have access to
enough nutritious food on a regular basis. It’s called food insecurity.
People with food insecurity have an increased risk of health
conditions, such as diabetes, obesity, and heart disease. The wide-
ranging chronic health issues driven by hunger are estimated to
increase the cost of health care by $160 billion each year.
We work to ensure the people in our communities have access
to, and can afford, healthy food. We do this by investing in our
communities and forging innovative partnerships.
In 2022, we participated in the White House Conference on
Hunger, Nutrition, and Health. To help the federal government
with its plans to evolve the country’s food and nutrition policy, we
shared how our programs and practices address food and nutrition
insecurity. We also
pledged to invest $50 million over the next
several years in programs that help vulnerable people meet their
food and nutrition needs.
Our $50 million multiyear investment will support Food Is Medicine,
a national movement that recognizes the potential of food to
help prevent and manage ongoing health conditions. In 2022, we
supported 2 Food Is Medicine programs — medically tailored meals
and produce prescriptions.
Medically tailored meals are prepared meals delivered to people
living with severe illnesses. The meals are designed to meet the
unique health needs of each recipient. The aim is to improve
people’s health and keep them out of the hospital.
Produce prescription programs allow doctors to treat diet-related
diseases with fruits and vegetables. Patients who receive produce
prescriptions can “fill” them using vouchers at participating sites,
including grocery stores and farmers markets.
Housing for health
Access to affordable housing continues to be a major need in our
communities. Chronic homelessness can have devastating effects
on a person’s long-term health — and it’s a troubling reality for far
too many people. In 2022, we continued to lead efforts to preserve
affordable housing and end homelessness. We invested in solutions,
shaped public policy, and
formed innovative partnerships.
Affordable housing supports
economic development and
stability in our communities while
improving conditions for health
and equity on a broader scale. We
created our Thriving Communities
Fund in 2018 with $200 million
in impact investment to create and preserve affordable housing units
in our communities, resulting in the construction and preservation of
nearly 10,000 units. In 2022, we expanded our Thriving Communities
Fund to $400 million, with the goal of creating or preserving 30,000
units before 2030. The expansion also advances inclusive economic
development in communities to address the systemic disadvantage
and discrimination that underpin the housing crisis.
We also continued our partnership with Community Solutions, a
nonprofit working to end homelessness. Of the 30 communities
and 2 states where we partner, 14 communities have seen sustained
reductions in homelessness. And, 4 communities have achieved
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functional zero homelessness, meaning they’ve essentially ended
homelessness.
Addressing homelessness is about more than finding
housing for people in need. It’s also about finding ways to support
people as they manage health conditions. Medical respite programs
do just that. They offer short-term housing and medical care for
people who are too ill or frail to recover from an illness or injury on
the streets but not ill enough to be in the hospital. In partnership with
the National Institute for Medical Respite Care, we partnered with the
Stout Street Recuperative Care Center in Denver as part of a larger
effort to support medical respite providers in our communities. We’re
proud to have connected over 180,000 people without housing to
medical respite care programs, virtual and telehealth care, and other
services that address their mental, physical, and social health needs.
Thriving Schools
Schools are dedicated to ensuring
that all students succeed, but they
can’t address the health of their
employees and students alone.
Kaiser Permanente created our
Thriving Schools initiative to allow
our organization to serve as a valuable partner in health to schools
and school districts across the country.
Our groundbreaking 1998 research about ACEs, or adverse
childhood experiences, made us one of the first organizations to
recognize the link between childhood trauma and health. This work
has been core to Kaiser Permanente for decades.
Our Thriving Schools initiative supports K-12 school systems in being
equitable, healthy, and vibrant places for all. We partner with schools
and districts across the country, helping to ensure that teachers,
staff, and students have the support they need to thrive — in learning
and in health.
Our comprehensive approach, which includes the Resilience in
School Environments initiative (RISE), continued to help schools and
districts identify opportunities for supporting the mental health and
well-being of students, staff, and teachers. In 2022, we delivered
support to over 4,000 existing school and district partners and
engaged 1,135 new schools to adopt strategies and practices that
foster positive and healthy school environments.
Our Educational Theatre Program served over
125,000 students
and adults in 2022, offering no-cost theatrical programs that engage
and inspire students, teachers, and staff to make healthy choices.
These award-winning virtual performances and workshops address
important health topics that activate our comprehensive approach to
social health, mental health, and resilience.
We advanced our work with the National Healthy Schools
Collaborative by providing grant support to key national school
health partners to activate on collective physical, mental, and social
health priorities. This work is essential because it allows us
to expand and innovate policies and best practices that transform
K-12 education.
Advocating for good health policy
As a leader in health care, Kaiser Permanente engages in active
policy advocacy at the federal, state, and local levels. We work on
issues related to affordable health care, universal coverage, drug
pricing, public health, tobacco use, gender equality, racial justice,
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voting rights, mental health care access, and reduction of mental
health stigma.
For more information on Kaiser Permanente’s work to help shape
policy, read Community Drivers of Health: Policy Paper Series on our
Institute for Health Policy site.
CityHealth
Through Kaiser Permanente’s ongoing partnerships with community
organizations, municipal leaders, and public health advocates,
we are working to incorporate health, equity, and sustainability
considerations into public policy and the built environment in ways
that influence how neighborhoods take shape and grow.
CityHealth, Kaiser Permanente’s collaboration with the de Beaumont
Foundation, advances a package of tried and proven policy solutions
that help millions of people live longer, better lives in vibrant,
prosperous communities. CityHealth’s policy recommendations are
supported by experts and have a track record of bipartisan support.
In its annual policy assessment, CityHealth rates the nation’s 75
largest cities on best practices in prevention-oriented policies that
benefit health, well-being, and quality of life — and issues medals to
cities that go above and beyond to support their communities. For
2022, 37 of 75 cities (49%) earned an overall citywide medal — either
bronze, silver, or gold. Of those, 2 exemplary cities, Boston and
Denver, earned citywide gold medals. Nearly 39 million people live
in a city that’s earned a citywide medal. And, in areas where Kaiser
Permanente provides care and coverage, 70% of cities earned a
citywide medal.
CityHealth’s policy package includes recommendations for
affordable housing trusts; street planning, design, and maintenance;
earned sick leave; eco-friendly purchasing; flavored tobacco
restrictions; green spaces; healthy food purchasing; healthy rental
housing; high-quality, accessible pre-K; legal support for renters;
safer alcohol sales; and smoke-free indoor air.
We’ll continue to partner with CityHealth in 2023 to help more cities
achieve gold medal status, benefiting their residents’ health and
well-being.
Addressing intergenerational trauma
In 2021, Kaiser Permanente announced it was providing financial
support to 13 organizations across the United States whose work
focuses on ending the generational cycles of trauma caused by
structural racism and injustice experienced by Black Americans
and other communities of color. The organizations provide services
such as safe housing and counseling for teen mothers, violence
prevention and social-emotional learning programs, trauma-
informed and resilience-focused skill building for caregivers, and
approaches for healing racial stress for families in Los Angeles.
Trauma often manifests in situations and actions that hurt children by
causing adverse childhood experiences, known as ACEs, which have
negative lifelong consequences for health and well-being. Original
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research by Kaiser Permanente and the Centers for Disease Control
and Prevention in 1998 established that ACEs such as abuse, neglect,
and household dysfunction are associated with a long-lasting stress
response that has been linked to risky health behaviors and chronic
health conditions.
Evidence from subsequent studies shows that experiences such as
discrimination, community violence, death of a parent or guardian,
bullying, or separation from a primary caregiver may also lead to a
harmful toxic stress response. Kaiser Permanente has committed
to doing more to address social inequity and systemic racism and
to help end the generational cycles of trauma experienced by
communities of color.
Preventing firearm injury
In the U.S., firearm injuries are the leading cause of death among
children and teens. And gun violence is one of the top causes of
premature death for people 1 to 44. In 2021, firearms claimed more
than 45,000 lives.
Gun violence is a public health crisis. At Kaiser Permanente, we’re
taking steps to prevent gun violence and educate people on its
health implications.
In 2018, we established the Kaiser Permanente Task Force on Firearm
Injury Prevention. Through this task force, we supported research
studies and the testing of firearm screening tools and counseling
interventions. These approaches focus on how physicians and
clinicians can help prevent firearm injuries.
In June 2022, we launched a new Center for Gun Violence Research
and Education. The center’s goal is to reduce gun violence, including
intimate partner violence and suicide. Through the center, we’ll
develop, test, and spread public health and health care solutions to
address gun violence, including:
• Research efforts focusing on promising solutions and
interventions to gun violence, and the long-term psychological
consequences of these incidents which need additional
evidence
• Education efforts addressing the need to inform the public,
health care stakeholders, businesses, policymakers, and
community-based organizations about the role they can play in
reducing gun violence and the consequences of gun violence
• Innovation efforts focusing on novel public health and health
care processes, policies, and intervention models to prevent
gun shootings, including those that are self-inflicted and
between intimate partners
To advance these efforts, the center also will collaborate with other
health care organizations, community-based organizations, and
businesses with a shared interest in gun violence prevention. We
initially funded the center with $1.3 million. In December of 2022,
we approved a major investment of $25 million for gun violence
research and prevention work over the next 5 years. Together with all
health care organizations, we must do more to prevent gun violence.
We believe our knowledge, experience, and passion can help solve
this critical public health challenge.
Equitable CareHealthy Communities
Read: Systemic racism and trauma spur action
for healing
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Safety net support
Kaiser Permanente is committed to building partnerships with
community institutions that play a critical role in delivering health
care for the uninsured and underserved, often referred to as
the health care safety net. Ensuring health access means that
we recognize the importance of the health care safety net for
connecting people with wraparound support like social services,
housing, oral health care, and support for mental health and
addiction treatment.
Safety net clinics are essential community partners in our shared goal
of improving the health of individuals and communities. Community-
funded clinics, rural health clinics, free clinics, school-based health
centers, and federally qualified health centers are vital parts of the
health care safety net, providing quality care for the country’s most
under-resourced populations.
To help protect vulnerable communities, Kaiser Permanente provides
grants and other resources to help close gaps in care.
We launched the Virtual Care Innovation Network to bring together
safety net organizations across our communities to redesign care so
virtual care models continue to thrive and improve access after the
pandemic abates.
Our Safety Net Vaccine Equity Initiative grants awarded flexible
funding to health care safety net clinics working to increase access to
vaccinations. These funds supported mobile vaccination operations,
safe transportation to vaccination sites, language services, and
adequate staffing at clinic sites.
Read: Virtual Care Innovation
Network — supporting access
to telehealth
Our health research
At Kaiser Permanente, our researchers make discoveries that
improve health and well-being for all. Research is a vital way we
strive to improve the health of our communities.
We’re uniquely positioned to conduct research due to our large
member base and powerful electronic health record system. Our
electronic health records allow our researchers to track many of
the same members’ health over years and even decades. Our
researchers can better understand health risks, improve patient
outcomes, and inform policies and practices. In 2022, we engaged
in 2,160 active studies (including 650 clinical trials) and published
more than 1,980 journal articles.
Equitable CareHealthy Communities
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Graduate medical education
We’re planning for the future by offering training opportunities to
medical residents and interns. Our programs attract medical school
graduates from across the United States. Residents and interns get
cutting-edge academic training and exposure to the benefits of our
integrated model, which combines care and coverage.
Residents and interns also get the chance to work with a large,
culturally diverse patient base in a setting with established clinical
guidelines. They get to experience our connected care model, in
which all our care teams are connected — to our members and each
other — through our electronic health record system. Our medical
residents are studying within the primary care medicine areas of
family practice, internal medicine, ob-gyn, pediatrics, preventive
medicine, and psychiatry.
Employee volunteering in our
communities
We are proud of our workforce’s commitment to
actively engage in improving our communities.
Employee volunteering programs enable our
employees and physicians to help put inspiration
into action.
KPCares.org provides an easy way to find,
share, and participate in volunteer activities in
communities where our workforce lives and works.
Staff members can post a new project and recruit
the volunteers needed. They can also match
appropriately skilled volunteers for disaster relief,
indicating the needed medical specialties, languages spoken, and
certifications. During 2022, 55,829 volunteer hours were logged in
KPCares by our employees and physicians.
At Kaiser Permanente, Martin Luther King Jr. Day is honored as a day
of service, an annual opportunity to serve our communities across
the country. During the pandemic, MLK Day of Service continued
those efforts as a week of service with opportunities to volunteer
virtually. During the week of January 17, 2022, nearly 2,000 Kaiser
Permanente employees volunteered in over 90 service projects.
Close to 3,000 volunteer hours were served, which benefited over
17,000 people. Volunteer projects included blood drives, food
donation drives, letter- and card-writing campaigns, compassion
calls to senior citizens, resume review workshops, and making
blankets, assembling hygiene kits, and stuffing teddy bears.
Environmental stewardship
We strive to improve the physical and environmental health of the
communities we serve and are committed to being environmentally
responsible throughout our organization — in how we power our
facilities; purchase food, medical supplies, and equipment; manage
waste; and invest in our communities.
In 2022, we continued to take a leadership role in protecting the
environment. Climate-related impacts on health are significant. So, our
actions to slow climate change and limit its effects are an important
way we promote the health of our members and communities.
Our work also supports health equity. While climate change poses
a health threat for everyone, people of color and people who live in
low-income communities are at greater risk.
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New York Times story: How Hospitals Can Help
Patients and the Planet
Throughout the year, we extended our climate leadership by
partnering with key stakeholders in many industries, including
finance, business, energy, conservation, education, and public policy.
We committed to significantly reducing our greenhouse gas
emissions. Greenhouse gases trap heat in our planet’s atmosphere
and contribute to climate change. We’ve been carbon neutral since
2020, and by 2030, we’ll reduce our emissions by 50%. We’re aiming
to reach net-zero emissions by 2050. As part of this commitment, we
signed onto the Department of Health and Human Services’ climate
pledge, which was launched to encourage the health sector to take
action to reduce emissions.
We also convened key leaders to discuss climate change and its
impact on disadvantaged communities. We were proud to host
Admiral Rachel Levine, MD, assistant secretary for health for the U.S.
Department of Health and Human Services as part of our “Getting
to Net Zero: The Health Equity Imperative.” The event focused on
why the health sector must commit to net-zero emissions to improve
health and advance health equity.
We also convened a roundtable of private and public sector leaders
during New York City Climate Week to discuss prioritizing health
equity in our actions to combat climate change. And we were
recognized as the eighth-largest U.S. corporate solar user by the
Solar Energy Industries Association.
Learn more about our strategies for environmental stewardship in
our Thriving Planet section.
Review California AB 1305 compliance disclosureson our greenhouse gas emissions reduction efforts.
Responsible Business:
Inclusive, equitable, and responsible
business for positive impact
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Kaiser Permanente’s high-quality,
affordable health care and coverage
are powered by our core business
functions including human
resources, procurement, real estate
and facilities, and treasury and
investments — all of which operate at
the highest levels of business integrity
and ethics. We seek to optimize the social
value provided by our business beyond simply the health care we
provide. We understand that advancing social and economic justice
starts with how we run our business.
We strive to align our business practices to advance equity, integrity,
and access to opportunity in our industry, our business and clinical
operations, and our communities. We activate our business assets to
protect and promote the health of our communities.
A history of equity, inclusion, and diversity
at Kaiser Permanente
At Kaiser Permanente, we believe in equity and inclusion for all.
Equity is at the heart of our mission, and we will pursue this vision
until everyone has the opportunity to lead a healthy life. To make
equity, inclusion, and diversity a reality for our workforce, members,
and communities, we value each other equally. We weave equity and
inclusion into the fabric of everything we do. Equity at KP is integrated
into our organizational strategy so the business leads as an equitable
organization. Through our equity, inclusion, and diversity strategy, we
strive for the following achievements in our workplace, through our
care delivery, and in our communities.
• Workforce: All people of Kaiser Permanente have the equal
opportunity to reach their full potential benefiting from an
inclusive, psychologically safe workplace.
• Health equity: Equity in health outcomes and experiences will
be achieved through the elimination of systemic barriers such
as racism and other forms of oppression in health care.
• Community: We engage, influence, and invest in community
capacity to address the impacts of systemic barriers to health
and economic opportunity.
Long-standing commitment
Kaiser Permanente began in the shipyards, where women and men
of all races, ethnicities, and abilities worked side by side as peers. In
the 1940s, when many hospitals were segregated, we had integrated
wards, built diverse teams of employees and physicians, and treated
all our patients equally, regardless of race. Today, equity, inclusion,
and diversity continue to be elevated to Kaiser Permanente’s highest
level of strategic priority.
Kaiser Permanente commits to playing a significant role in creating
equity for all and addressing all barriers that are unjust, unequal, and
preventable. We will change foundational systems and processes
using our voices, resources, and influence to help disrupt bias
and racism, and correct oppressive systems in our society. We are
owning and addressing areas that need more focus and are key to
building an inclusive, psychologically safe workplace where everyone
feels included and has an equal opportunity to reach
their full potential.
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For over 45 years, Kaiser Permanente has hosted an annual event
to highlight current barriers and opportunities to advance equity,
inclusion, and diversity. Our National Equity, Inclusion, and Diversity
Conference continues to bring together and inspire physicians and
employees across the enterprise to provoke and activate change that
leads to equity, inclusion, and diversity for all.
Inclusive and psychologically safe environment
Achieving our mission can only be accomplished by fully including
and engaging all people and leveraging diverse backgrounds and
different ways of thinking among our workforce, all focused on
doing our best for the people we serve. We are building a highly
inclusive, engaged, and psychologically safe workplace where all
our physicians and employees have equal opportunity to use their
diverse perspectives and strengths to support our mission.
Responses to our semiannual workforce engagement survey, People
Pulse, are organized into 10 key topic areas, or indices, that measure
critical aspects of our work environment. Our inclusion and speaking
up indices allow us to track and measure employee sentiment around
inclusive climate and psychological safety. We
also use equity, inclusion, and diversity listening
sessions across the organization to hear directly
from our employees and physicians about
their experiences and opportunities at Kaiser
Permanente. These 2 data inputs as well as
participation in workforce related EID external
benchmarking, give us insights into continued
opportunity and improvement areas. We
introduced a number of tools and initiatives that
help equip our managers and workforce.
• Leader guide on our racial equity and social justice actions
— Action guides help people managers increase awareness,
education, and engagement throughout the organization on
the issues of racial equity and social justice.
• Equity principles — Our equity principles define the
expectations and accountabilities for the people of Kaiser
Permanente in promoting individual actions to uphold the
racial, health, and workforce equity standards that reflect
our mission, values, and history. These principles are being
integrated into our code of conduct and into our core talent
programs.
• Integration of sexual orientation and gender identity into
our HR information system and our recruitment application
platform — This enables our LGBTQ+ communities to
voluntarily identify so we better understand opportunities to
improve employee experience and outcomes.
• Belong@KP — This transformational program combats bias,
racism, and social injustice and promotes an environment
where all our physicians and employees feel they are valued
and treated fairly, and that they belong. It is designed to help
participants understand bias and systemic racism, build new
habits to disrupt bias, and make decisions with a lens for
identifying and eliminating bias and inequities. More than
120,000 employees and physicians have taken the disrupt bias
learning modules. Initial survey results indicate that 90% of
participants changed how they approach coworkers or patients
and 62% agreed Belong@KP Disrupt Bias improved their
ability to connect with coworkers or patients. In 2022, Belong@
KP Reexamine Racism immersive training was rolled out to
our top 400 executives and over 800 employees. The survey
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results show 93% of participants self-report an improvement in
their ability to understand and explain racial inequity and the
relationship to health disparities.
• Health equity portal — This repository offers internal and
external resources to employees and physicians to advance
equitable care.
• Equity-centered design — This holistic approach to problem-
solving is based on equity, humility-building, integration of
history and healing practices, addressing power dynamics,
and cocreating with our workforce, members, and community.
We use this approach to improve equity across our systems
and practices.
Our diversity
Our organization reflects the
ethnic, racial, and cultural
diversity of the communities
we serve. Nearly 70% of our
employees are members of
racial, ethnic, and cultural
groups, and 74% are women.
Percentages as of December 2022; data
represents Kaiser Foundation Health Plan and
Hospitals employees and does not include
physicians.
0.4
28.3
12.5
18.1
2.3
30.5
7. 9
American Indian/Alaska Native .04%
Asian 28.3%
Black/African American 12.5%
Hispanic/Latino 18.1%
Native Hawaiian/Pacific Islander 2.3%
White 30.5%
2 or more races 7.9%
74
26
Female 74%
Male 26%
7. 5
28.2
30. 3
23. 2
10.7
0.1
Under 20 0.1%
20 to 29 7.5%
30 to 39 28.2%
40 to 49 30.3%
50 to 59 23.2%
60 and over 10.7%
Responsible Business
Improving ethnic, racial, and culturally
diverse representation
We’re committed to advancing diversity at every level of our
organization.
Our efforts to improve diverse representation include the
implementation of equitable and inclusive practices across the
employee life cycle. Our intent is to identify, recruit, develop, mentor,
assess, and retain diverse talent. These efforts include:
• Engaging external experts to help us reduce bias in talent
recruitment and selection, job descriptions and structure,
performance management, and compensation programs
and policies
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• Providing formal sponsorship opportunities and exposure to
high potential leaders, with strong emphasis on diverse talent
• Creating common job structures across the organization to
ensure fair job leveling and enable pay equity analysis
• Tracking diversity statistics through each step of the executive
search process to ensure we’re being inclusive throughout our
hiring process
• Automatically sharing all external job postings across hundreds
of niche diversity job sites to cast a wide net for candidates and
increase awareness of openings
• Tracking and monitoring workforce equity progress with
senior leaders to drive accountability and help make informed
decisions during annual core talent activities. This effort will
lead to key talent actions in hiring, promotion, and retention
that will improve diverse representation in our management
ranks and improved inclusion across our workforce.
Business resource groups
• Since 1989, our business resource groups have brought people
with shared life experiences together to foster a culture of
belonging, support our mission, and advance equity and
inclusion for all.
• Today, we have 10 business resource groups creating
experiences and opportunities that reinforce our organizational
values and priorities for our workforce, members, and
communities.
• Our business resource group program is expanding our focus
on intersectionality — or the way in which different facets of a
person’s identity combine to create unique life experiences — to
more deeply understand how identifying with more than one
group shapes our interactions at work and our life experiences.
• Over 15,000 of our employees and physicians are members of
a business resource group.
Building and strengthening our
dedicated workforce
At Kaiser Permanente, we have robust facilities, deploy leading-
edge technology, and develop and follow evidence-based medical
practices. But it is our people who make our mission come to life and
truly set us apart. We are committed to responsible and inclusive
practices in who and how we hire, and in access to development and
advancement opportunities for our incumbent workforce.
We are a partner in the largest, longest-running private labor-
management partnership in the country. The Labor Management
Responsible Business
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Partnership leads organizational change, creates an environment of
continuous learning and improvement, and involves the workforce in
decision-making.
Investing in workforce development
and advancement
Kaiser Permanente’s is industry-leading, and helps tens of thousands
of employees earn credentials, access professional coaches, and
secure higher-earning positions every year.
We understand the value of beginning a career at Kaiser Permanente
and we are committed to ensuring that everyone in our communities
has equitable access to those opportunities.
Our development programs increase access to education, and
exposure to skill development, job experiences, and employment
opportunities. Several of our health care workforce development
programs are joint initiatives with our labor partners. Through
these programs, we strengthen workforce pipelines and provide
opportunities for people
already in the health care
workforce to grow and advance
in their careers.
Kaiser Permanente invests in
workforce development directly
and through contributions
to trust funds managed in
partnership with our labor
partners, including the Ben
Hudnall Memorial Trust and the
Service Employees International Union-United Healthcare Workers
WestJoint Employer Education Fund. These efforts provide tools and
resources to help front-line employees gain new skills and advance
in their careers. Resources provided include coaching, training, and
apprenticeship programs, scholarships and tuition reimbursement
for degree and certification programs, and computers and mobile
hot spot devices for qualifying students.
In 2022, nearly 22,000 Kaiser Permanente employees, representing
31.8% of those eligible, accessed programs through Ben Hudnall
Memorial Trust and SEIU-UHW Joint Employer Education Fund.
Our approach to workforce well-being
Kaiser Permanente’s workforce well-being program aims to foster a
culture of workplace wellness and give all employees the tools and
resources they need to achieve and reinforce total health — a state
of physical, mental, and social well-being. Total health encompasses
all that we do at Kaiser Permanente, where well-being is an integral
part of our work, because when we thrive, so do our members, our
communities, and our organization.
We believe in helping our employees
thrive by encouraging wellness,
supporting balance, and empowering
action so that everyone can be their very
best self. Our work helps accelerate a
culture of workplace health and well-
being through a collaborative effort with
multidepartment partnerships across
the organization. Our well-being model
includes 6 key areas of focus.
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1. Physical health and safety
2. Mental health and wellness
3. Healthy relationships
4. Community involvement
5. Career wellness
6. Financial wellness
These elements of well-being are interrelated, so the programs and
activities offered to our workforce intentionally touch on all 6 areas to
provide holistic support.
Programs and activities
Kaiser Permanente created Rise&Renew in 2021, an enterprise-
wide initiative to support the mental health and well-being of our
workforce, with resources that focus on addressing burnout and
impacts of the pandemic. The program supports leaders, managers,
physicians, and employees through training and activities that
educate about the key drivers of burnout, help to facilitate new work
norms, and provide monthly team activities that support employees
on a variety of well-being topics.
We are also committed to eliminating the stigma of mental health
conditions in the workplace and are taking action to address this
challenge. An online training was developed to give all employees
access to information about mental health conditions and how
to care for their mental health, reduce stigma in the workplace,
foster a supportive environment, and find available resources.
More than 68,000 employees completed the online mental
health training by the end of 2022. We also
offer the Kaiser Permanente Employee and
Physician Assistance Program for confidential
assessment, short- term counseling, and
referrals by licensed, trained clinicians for all
Kaiser Permanente physicians, employees,
and their dependent family members. A
national Mental Health Advocate network
was launched to increase support from
employees who are particularly interested
in spreading mental health and wellness
education to their local departments and
areas. Advocates have access to tools,
resources, and activities they can share
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with their teams to create a supportive, stigma- free workplace
environment — normalizing the conversation about mental health.
The advocate role is voluntary, and at year-end 2022, 582 advocates
had joined the effort across Kaiser Permanente.
In response to lifestyle changes caused by the pandemic, we
placed renewed focus on physical health, featuring new Go KP
campaigns “Worldwide Wellness” and “Walktober.” The campaigns
promote walking and outdoor activities as ways to increase fitness,
support mental health, and build connections with co-workers by
participating on teams. In 2022, 17,400 employees participated in
physical activity campaigns.
Leader and manager development and training
Our workforce well-being program incorporates leadership
development and training for senior leaders, managers, and front-
line staff to become leaders in health and well-being. We offer
managers a series of training sessions on how to create a culture
of health, along with an evidence-based playbook for supporting
health and well-being in the workplace.
Unit-based teams health and safety champions
Through the Labor Management Partnership, the Unit-Based Teams
Health and Safety Champion program was created to embed health
and well-being activities into the workplace through a network of
3,000 volunteers. The champions lead employee-powered well-
being projects across the organization. In 2022, 2,418 well-being
and safety-related projects were initiated across the organization.
National well-being policies
Kaiser Permanente believes in making the healthy choice the easy
choice and has implemented several workforce well-being policies
to help support our employees. These include a campuswide no-
smoking policy, a healthy catered food policy for company- sponsored
meetings and events, a lactation support policy for new mothers
returning to work, and a healthy workplace activities policy that
encourages physical activity and mental wellness during the workday.
Kaiser Permanente strives to foster an environment that supports
health and well-being, including psychological safety, enabling
our workforce to thrive. These programs also equip our workforce
to embed inclusive and equitable practices into how we identify,
recruit, develop, mentor, assess, and retain diverse talent.
Employee engagement
Kaiser Permanente’s mission to improve health requires the full
engagement of our people. By sharing their voices about their
work experiences, employees can drive change that makes Kaiser
Permanente an even better place to work. People Pulse, our
employee engagement survey, helps us understand our internal
strengths and opportunities for improvement, and guides actions so
employees can continue to contribute to achieving our mission.
Responsible Business
Higher Culture of Health Index scores
correlate with 79% fewer workplace
injuries and 84% fewer lost workdays.
Employees who are engaged in well-
being through their unit-based teams show
consistently favorable health outcomes as
well in health screenings, blood glucose
test results, and fewer lost sick days.
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In 2021, we significantly expanded our capacity to measure the
well-being of our employee population through the launch of
our Employee Well-Being Questionnaire. This self-reported
questionnaire asks a set of validated questions on well-being status,
burnout, and social health needs. In 2021, the questionnaire enabled
the organization to target support to highly impacted areas during
the pandemic, and provided managers a tool to assess the current
state of their team’s well-being so that targeted solutions and actions
could be implemented.
Across the organization, a link has been established between high
scores on Kaiser Permanente’s People Pulse Culture of Health Index
and better performance on certain business outcomes.
Workplace safety
Kaiser Permanente prioritizes the health and safety of its workforce
and has a comprehensive approach to managing workplace safety
across all administrative and clinical settings. We believe that an
injury-free workplace is an essential ingredient of high-quality,
affordable patient care. We have set the goal of eliminating all causes
of work-related injuries and illnesses to create a workplace free from
harm. Through the Labor Management Partnership with the Coalition
of Kaiser Permanente Unions and the Alliance of Healthcare Unions,
Kaiser Permanente established and maintains a strong workplace
safety program and strategy with a structure based on 4 key pillars:
leadership and employee engagement, safety management systems,
risk reduction, and performance management.
The workplace safety program is led by Kaiser Permanente and
labor leaders at the national, regional, and medical center levels,
and is highly visible. Reports are provided regularly to the Kaiser
Foundation Health Plan and Hospitals Boards of Directors. Kaiser
Permanente sets goals and benchmarks its performance against
Occupational Safety and Health Administration recordable injury
data published by the U.S. Bureau of Labor Statistics, incorporating
the Total Health Care and Social Assistance industry codes in the
North American Industry Classification System. Each quarter, the
Workplace Safety Scorecard provides a broad audience at Kaiser
Permanente with a summary of progress toward goals and targets,
areas of highest risk, and mitigation strategies.
Kaiser Permanente maintains policies that promote consistent practices
in compliance with federal, state, and local laws and regulations to
support a culture of health and safety and to protect the environment
of the communities in which we provide services, operate, or are
the building owner. This includes policies to provide clear roles,
responsibilities, and requirements for staff and managers who work
directly in the clinical care and transport of patients and members.
We take preventive measures to provide a safe environment for
everyone on our premises and in our working environments and
expressly prohibit acts or threats of violence or intimidation that
involve or affect work or that occur on Kaiser Permanente premises.
Over 90 employee safety training modules covering a broad
range of topics from blood-borne pathogens to ergonomics to fire
safety are maintained in Kaiser Permanente’s enterprise learning
system, KP Learn. Regulatory-required training is monitored for
compliance. Additional, nonregulatory-required employee safety
training modules specific to employees’ roles, responsibilities, and
interests are available and accessible to all our employees. Kaiser
Permanente’s online resource application, SafetyNet, provides
centrally accessible information about employee safety programs,
resources, and contact information.
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Other employee benefits
Our employees work hard every day to support our mission.
In return, we offer market-leading compensation and benefits,
comprehensive health coverage with little to no cost share,
retirement programs, and robust time-off policies designed to help
our employees and their families stay healthy, meet their financial
goals, and generally thrive in and beyond work. Financial assistance
for higher education is offered to employees through several
programs that offer scholarships to employees, and a tuition
reimbursement program that provides up to $3,000 a year.
Kaiser Permanente implemented special temporary programs
to support our front-line staff who were caring for our patients,
members, and communities during the COVID-19 health crisis.
The pandemic presented significant, unprecedented challenges
for employees at work while they faced managing sudden and
traumatic changes in their daily and family lives. A set of temporary
supplemental COVID-19-related benefits and pay programs to
help these employees and their families included additional time
off, grants to pay for child care, and short-term housing near our
medical offices for certain situations.
Access to economic opportunity:
Our anchor strategy
As one of the nation’s leading health care providers and integrated
nonprofit health plans, we employ over 220,000 individuals, we
purchase tens of billions of goods and services annually, and we have
billions of dollars in assets under management, including our more
than 750 hospitals, medical offices, and administrative buildings.
We recognize that we have tremendous economic power and can
influence local economies, and we strive to contribute to inclusive
economic opportunity in the communities we serve. We believe that
this approach will provide mutual, sustainable benefit to our business,
our employees, our business partners, and our communities.
At Kaiser Permanente, we consider ourselves an anchor institution
in all the communities where we provide coverage and care. Per
the National Academy of Medicine: “Anchor institutions are large,
usually nonprofit organizations tethered to their communities, like
universities, medical centers, or local government entities. They
have significant economic and social impact on their communities,
and they also have an economic self-interest in making sure these
communities are healthy and safe.”
Anchor institutions are place-based, mission-driven entities such
as hospitals, universities, and government agencies that leverage
their economic power and their human and intellectual resources to
improve the long-term health and social welfare of their communities.
We understand that income-earning and wealth-building
opportunities are foundational to healthy communities, supporting
access to health care and education, housing stability, and
food security.
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Underrepresented communities, including low-income communities
and communities of color, face disproportionate barriers to
economic opportunity, impeding good health and intergenerational
economic mobility. In line with our foundational institutional
commitment to racial equity, our anchor strategy seeks to
intentionally benefit people of color, people with disabilities, people
who identify as LGBTQ+, veterans, and other groups that have faced
sustained structural economic disadvantage in America.
Our anchor strategy encompasses commitments to:
• Responsible sourcing and supplier diversity
• Responsible and mission-aligned investment
• Responsible and inclusive hiring, development, and
advancement
• Facilities planning, design, and construction
Our approach recognizes that real-world, systemic change is best
catalyzed and reinforced through partnership. Kaiser Permanente’s
industry leadership has allowed us to cultivate strong, long-
lasting relationships with partner organizations. For example, in
2016 we helped found the Healthcare Anchor Network, a national
collaboration of more than 70 leading health care systems to build
more inclusive and sustainable local economies.
Kaiser Permanente participated in Healthcare Anchor Network
Policy Day 2022 to advocate for affordable housing and workforce
development policies and programs with health systems across the
United States, representing more than 800 hospitals in 48 states and
Washington, D.C.
Responsible and inclusive hiring, development,
and advancement in our communities
The many programs and initiatives at Kaiser Permanente to recruit,
hire, develop, and advance our employees are also an element of
our anchor strategy. In addition to the comprehensive work already
described, we undertake additional initiatives designed to develop
talent in the communities we serve.
We believe that building and supporting a more stable, diverse
public health and clinical workforce is a critical part of how we can
create economic opportunity for communities of color and be better
prepared to meet the needs of our communities.
We are working to empower people from all backgrounds to achieve
academically and gain the skills needed to improve their access to
quality, well-paying jobs.
In 2018, we launched a formal strategy called High-Impact Hiring,
a talent-sourcing and workforce planning strategy to create career
pathways for our most vulnerable unemployed and underemployed
community members. High-Impact Hiring strategies seek to increase
diversity, support local employment, and improve community health.
In 2022, our talent acquisition teams engaged over 3,250 candidates
from schools, colleges, and universities and community-based
workforce development programs to support people with
disabilities, people who identify as LGBTQ+, people of color, women,
and veterans to pursue career pathways in health care and explore
careers at Kaiser Permanente.
We hosted just over 1,100 nonclinical interns across the enterprise,
37% converting to full-time jobs.
Responsible Business
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In 2020, KP helped found Futuro Health, a nonprofit organization
that delivers an education-to-work model that supports candidates
through career exploration and coaching, education financing, and
targeted pathways to help students obtain allied health credentials
or licenses. Futuro enrolled 3,332 Futuro Health Scholars in tuition-
free allied healthcare education during 2022. Futuro Health fully
graduated 1,006 students in 2022. 90% of graduates were people of
color and 52% bilingual.
In partnership with The Hispanic Scholarship Fund and The United
Negro College Fund, the Kaiser Permanente National Health Equity
Scholars program awarded 435 scholarships to low-income
students of color.
Responsible procurement and supplier diversity
Health care organizations purchase a wide range of supplies and
services, such as uniforms, furniture, housekeeping equipment and
supplies, linen services, waste disposal, and translation services.
Kaiser Permanente leverages our purchasing power to promote
economic opportunity for diverse small businesses and to support
healthy, diverse, equitable, and sustainable economies. Our annual
procurement spending generates substantial economic impact in local
communities by supporting jobs, generating indirect income, and
contributing to federal, state, and local taxes. $21 billion in procurement
in 2022 is estimated to have supported 172,151 jobs and generated
$11.6 billion in income and $3.4 billion in federal, state, and local taxes.
In 2014, Kaiser Permanente joined the Billion Dollar Roundtable, a
network of companies that each annually spend at least $1 billion
with diverse suppliers. Each year, we increase our spending with
businesses owned by people of color, women, veterans, people with
disabilities, and people who identify as LGBTQ+. In 2022, we reached
$3.96 billion in spending with these diverse suppliers.
Along with other members of the Healthcare Anchor Network, Kaiser
Permanente is a signatory to the Impact Purchasing Commitment to
improve supplier diversity, environmentally sustainable sourcing, and
procurement-driven job creation. The signatories of the commitment
pledge to collectively increase purchasing by at least $1 billion by
2025 with local, employee-owned businesses and businesses owned
by women or people of color.
In addition to influencing purchasing decisions, Kaiser Permanente
offers support to our suppliers. In response to the COVID-19
pandemic, we created an online Supplier Restoration & Resilience
Toolkit for developing business continuity plans to recover and
rebuild after major disruptions. We also launched the Thriving
Leaders Program to help our diverse suppliers strengthen their
mental well-being and support their emotional resilience through
facilitated group workshops and peer support circles.
At Kaiser Permanente, we know that health, economic opportunity,
and wealth are linked, and small businesses create vital jobs and
thriving local economies. We are helping suppliers convert their
businesses to employee ownership, through partnerships with
Project Equity and the Obran Cooperative. Employee-owned
companies increase opportunities for employees to build wealth and
are often more resilient than other businesses.
In 2022, Kaiser Permanente celebrated the finalization of the
conversion to employee-ownership for Courier Corporation
for Hawaii and Apollo Home Healthcare through The Business
Resiliency through Employee Ownership (BREO) pilot initiative.
(Businesses interested in learning about employee ownership can
work with our partners, Project Equity and Obran.)
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Case Study: Courier Corporation of Hawaii
Nick Smallwood, owner and founder of Courier Corporation of
Hawaii (CCH), a logistics company, always wanted his legacy to
reflect his values. Specifically, he wanted to leave his business to his
employees. However, in logistics, margins are tight and in Hawaii
expenses are high. So Nick knew employees could not afford the
price tag, let alone the 20% down payment for a transition loan.
That changed when he received a call from an Obran Corporate
Development Representative.
Over the next 6 months, Obran realized that in this Kaiser
Permanente vendor they had found a business primed for employee
ownership and a leader who was excited about scaling ownership
across Hawaii and the United States. Ultimately, Obran leveraged
their bespoke capital facility, Obran Acquisition Fund I, along with
seller financing in order to acquire CCH, bring on 33 new employee-
owners, and employ Nick as the new head of Obran Logistics.
Since the acquisition in March 2022, their main focus has been on
building relationships with the new employee-owners and creating
redundancies for business systems. Obran deployed a rigorous
financial education program to make sure all new employee-owners
understand CCH’s business model.
Responsible Business
“ As an entrepreneur, if there is a legacy I can leave,
it’s that my employees, their families, and my
community as a whole are thriving because of what
we built. Enabling my employees to become owners
of our business will make us stronger.”
— Nick Smallwood, CEO and former owner of Corporation
of Hawaii (CCH)
In addition, wages increased 1% for all employees at the time of
acquisition and 1% for the employee owners when they elected to
become members of the cooperative. Obran also supplied CCH with
working capital and a part-time business consultant who has helped
the business grow by finding hidden efficiencies and increasing the
number of clients.
1000+
suppliers
educated
66
suppliers
advised
2
businesses
transitioned
to employee
ownership
194
employees
impacted
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Responsible and mission-aligned investment
Kaiser Permanente investment assets funds are invested in a
combination of equity, fixed income, alternative investments, and
cash designed to deliver long-term returns that satisfy or exceed
plan liabilities to participants and beneficiaries.
We embrace responsible investment practices as a way of
conducting our investing program, key factors that can have a
material positive impact on risk and outcomes, and creating and
preserving capital. The Kaiser Permanente investment funds
currently have specific investment exclusions around tobacco
and retail firearms manufacturers. As part of our long-standing
commitment to addressing the climate crisis, we have invested for
over 10 years in renewable energy.
We believe that equity, inclusion, and diversity, as attributes in
how investment teams are managed, increase our capability to
improve long-term returns. By integrating these approaches in the
full process of managing investments, our investment program is
informed by, a wide range of perspectives, ideas, and opinions,
ultimately producing better investment outcomes. We expect all
our managers to develop and promote talented women, people of
color, veterans, people who identify as LGBTQ+, and people with
disabilities as investment management professionals.
Further, we expect that our investment managers will pursue and
encourage equity, inclusion, and diversity in their leadership ranks.
In 2018, Kaiser Permanente established the Thriving Communities
Fund, an initial $200 million allocation from our general balance
sheet specifically set aside for impact investments — investments
that directly seek to proactively invest in drivers of health in Kaiser
Permanente communities while also attaining financial returns
(ranging from below market to market rate). In particular, the fund
focuses on affordable housing and advancing economic opportunity,
in alignment with Kaiser Permanente’s mission to improve length
and quality of life, as well as equity of health outcomes in Kaiser
Permanente communities. The Thriving Communities Fund’s impact
investment strategy seeks to promote sustainable, systemic change
for our communities’ most underserved populations.
The commitment to be a leading impact investor has only grown,
and we increased the Thriving Communities Fund allocation to $400
million in 2021.
Responsible Business
The Economic impact of our procurement spending
Our 2022 procurement dollars
drove economic impact by
supporting jobs, generating
indirect income, and contributing
to federal, state, and local taxes.
$21B
2022
Kaiser Permanente
procurement
=
172,151
Jobs
supported
+
$11.6B
Income
generated
+
$3.4B
Federal and
state taxes
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As of 2022, the Thriving Communities Fund had committed
$260 million to affordable housing and $30 million in economic
opportunity investment funds, with over $225 million fully
deployed by those funds in Kaiser Permanente communities. Over
10,500 affordable and permanent supportive homes have been
preserved and produced, and more than 1,200 high-quality jobs
have been created in communities of color with the deployment
to date. We committed $70 million in 2 new affordable housing
investments, with Community Solutions and Avanath.
Highlighted Investment: Baldwin Village
Apartment Complex, Los Angeles
•
This 669-unit naturally-occurring affordable housing
complex less than 1 mile from the Kaiser Permanente
medical office is at risk of converting to market-rate
development at point of sale.
•
Our investment partner is Avanath, a Black-owned,
mission-aligned private equity firm.
•
Our investment helped Avanath secure the financing to win
the bid, preserving the units’ affordability for 55+ years.
•
Rents will be secured at $1,200 to $1,400 per month
compared to market-rate rents for comparable units in the
area at $3,000 per month (or more).
•
Avanath also hopes to add 100 to 120 units to the property
to further increase housing stock.
•
98 units will be saved for people experiencing
homelessness (Section 8 voucher holders).
Facilities planning, design, and construction
Since 2017, we have had a new way of thinking about how we plan
and build new facilities. With close to $3 billion spent annually
on constructing, renovating, and maintaining facilities, the
opportunity to do this in a way that confers value to the community
is tremendous.
By working with the community in deeper ways to understand
n
eed, connecting people who face barriers to employment to jobs
in construction and health care, addressing neighborhood blight
through land redevelopment, and increasing access to meeting
spaces and Wi-Fi, we can meaningfully improve communities.
When building new facilities, we follow a set of requirements
i
ntended to engage local communities and maximize economic
benefits extended to them from our facility development.
These include:
• Diverse purchasing requirements determined by project
size and applied to general contractors and their vendors
• Diverse and local trade hiring requirements institutionalized
in individual contracts
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• Data analysis (including Community Health Needs
Assessments, Neighborhood Deprivation Index, and Kaiser
Permanente aggregated member health data) and community
engagement to identify needs and opportunities and to
determine what the building can contribute
• Sustainable building materials
• Major construction projects achieving LEED, or Leadership
in Energy and Environmental Design, Gold or Platinum
certification
• Engagement of local artists for facility decoration
As of 2022, Kaiser Permanente had 75 LEED-certified facilities.
By certification level: 12 Platinum, 31 Gold, 22 Silver, and 10
certified. Our renewable energy program has installed more than
60 megawatts of solar generation at 107 hospitals and medical
buildings throughout California. And we are contracting the energy
output of off-site wind and solar projects. All of these initiatives are
a large part of our overall sustainability strategy, described in the
Thriving Planet section.
We are committed to supplier diversity and to supporting the growth
of minority-owned businesses in the construction industry. In 2022,
we spent $210 million in Tier 1 and $165 million in Tier 2 spending
with diverse suppliers for design and construction services. We
also hosted multiple informational events to build minority-owned
construction firm capacity to work directly with Kaiser Permanente or
subcontract on our projects.
We are also working with our union and general contractor partners
to promote careers in the construction and building industries.
We had 179 apprentices working for Kaiser Permanente as of year-
end 2022. We worked with the Construction Industry Education
Foundation (CIEF) to give 3,800 young people from low-income
backgrounds exposure to the construction and building trades.
Their experiences included both Trades Day, a construction career
exploration, and Design Build, a 2-day competition for high school
students and probation departments.
We donated $20,000 to CIEF NCAL/SCAL to support Trades Day and
Design Build competitions and facilitate mentorships. We sponsored
the CIEF Women in Construction conference, which had 100 high
school students among the 900-plus attendees.
Responsible Business
Steady employment can improve a person’s
health. Read more about our work to connect
young people to in-demand jobs.
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Creating and preserving trust through
an ethical culture
More than ever, people care not only about what companies do,
but also about why and how they do it. Organizations that lead with
ethics do well by doing good. The people of Kaiser Permanente,
from leadership to front lines, are collectively dedicated to holding
themselves and others accountable for doing the right thing. Our
ethics and compliance program creates and protects the trust that
our customers, employees, partner organizations, government,
and communities place in Kaiser Permanente. We strongly believe
it also enables Kaiser Permanente to have a greater impact in the
communities we serve.
Code of conduct
Kaiser Permanente maintains a code of conduct that provides
guidance on the expectation that employees, physicians, dentists,
contractors, and agents of the organization conduct themselves
ethically and honestly. It emphasizes that compliance is everyone’s
responsibility and directs them to resources to help resolve any
questions regarding appropriate conduct in the workplace. The code
is provided upon hire, presented annually as a part of Ethics and
Compliance Training, and made available to all employees on the
Kaiser Permanente intranet.
The Kaiser Foundation Health Plan and Hospitals Boards of Directors
have adopted the code of conduct and are accountable for adhering
to it The code centers on the organization’s mission, includes the
foundation of the organizational values and expectations, and serves
as a framework to help exercise good judgment and make ethical
decisions.
Periodically we review the code, and any necessary enhancements
are recommended to the board-designated committee for adoption.
Our core values and guiding principles include, but are not limited to:
• Doing the right thing by integrating ethics and compliance into
the work we do every day
• Preserving the trust of our members, patients, and customers by
keeping our data confidential, private, and secure
• Striving to make Kaiser Permanente the best place to work by
respecting one another and being recognized for our equity,
diversity, and inclusion
• Making objective and fair decisions by understanding and
acting with integrity without conflict
• Knowing how to get help by providing a number of avenues to
report concerns and promoting a psychologically safe speak-
up culture
The ethics and compliance program
Our ethics and compliance program is designed to provide
awareness and to monitor and promote an ethical environment in
compliance with laws and regulations. Kaiser Permanente maintains
the program by leveraging guidance from the United States
Department of Health and Human Services Office of Inspector
General, the Centers for Medicare and Medicaid Services, and
the United States Sentencing Commission’s Federal Sentencing
Guidelines, and applicable state guidance. The program is intended
to provide added assurance that Kaiser Permanente:
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• Satisfies conditions of participation in health
care programs funded by state and federal
governments, the terms of its contractual
arrangements, and applicable requirements
associated with Centers for Medicare and
Medicaid Services models
• Detects and prevents fraud, waste, and abuse, or
other forms of misconduct by our employees,
contractors, and agents who work on our behalf
• Develops procedures that allow prompt,
thorough investigation of alleged misconduct by
the organization and timely, appropriate
corrective action
To support the effectiveness of the ethics and
compliance program, the Kaiser Foundation Health Plan
and Hospitals Boards of Directors set forth a charter
establishing a governance and structure designed to
facilitate oversight by the boards while maintaining
sufficient independence from business operations.
The organization designates a chief compliance
and privacy officer and an Executive Compliance
Committee responsible for implementing and
monitoring the program. The work is structured to
support the independent governance and overall
effectiveness of the program across the organization.
It consists of functional, regional, and market
compliance teams.
Responsible Business
PRINCIPLES OF RESPONSIBILITY
KAISER PERMANENTE’S CODE OF CONDUCT
DO THE
RIGHT
THING
Know and follow the
laws, regulations,
and policies that
apply to you in
your job.
ONE
TRE
AT
ANOTHER
WITH DIGNITY &
RESPECT
Foster a culture that
values diversity and
inclusion, and is free of
harassment, and do not
retaliate against anyone
who reports a compliance
concern in good faith.
SPEAK
UP
Talk with your chief
or supervisor, or
consult one of the
many resources at
Kaiser Permanente if
you have compliance
questions or concerns.
Report compliance
issues and concerns
anonymously
through the Kaiser
P
ermanente
Compliance Hotline
or Webline.
RESPECT
CONFIDENTIALITY,
PRI
VACY,
AND SECURITY
Double-check
names and addresses
before sending
communications
containing sensitive
information.
AVOID
CONFLICTS OF
INTEREST
Follow applicable
policies regarding
gifts, meals, or
business courtesies
offered by vendors
and potential vendors.
FOCUS
RESOURCES
ON MEMBER AND
PATIENT
CARE
Detect, prevent,
and report
fraud, waste,
and abuse.
RESPECT
CONFIDENTIALITY,
P
RIVACY,
AND SECURITY
Access patient
or member
information only
if you need it to
do your job.
PROTECTOUR
ASSETS
& INFORMATION
Use only approved
software. Do not
download or
run software not
approved by Kaiser
Permanente IT.
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Scope and responsibilities of the ethics and
compliance program
Kaiser Permanente seeks to be in compliance with all applicable
federal and state laws and organizational policies, including in 8
key areas:
• Fraud, waste, and abuse
• Privacy and security of protected health information
• Member, patient, and student rights
• Regulatory requirements impacting care delivery
• Regulatory requirements impacting human subject research
• Regulatory requirements impacting the operation of our health
plan products, particularly government programs
• Documentation, coding, charging, and billing
• Adherence to the organization’s compliance policies and code
of conduct
Policies, procedures, and workflows across
our organization
Kaiser Permanente develops and maintains enterprise, national,
regional, facility, and department policies and procedures to support
business and care delivery operations. The policy and procedure
repository is accessible to all employees, physicians, dentists, and
contractors. Policy development is monitored to validate approval
of policies and procedures, prevent conflicting policy requirements,
avoid redundancy, and comply with licensing and accreditation
requirements.
Kaiser Permanente also develops policies that establish compliance
expectations and accountabilities across the organization. Centered
by our code of conduct, these ethics and compliance policies
address expectations around topics including non-retaliation;
conflicts of interest; business record retention; compliance training;
reporting to regulators; privacy and security; and fraud, waste,
and abuse.
Ethics and compliance training and education
Kaiser Permanente requires both general and specialized ethics and
compliance training. As a condition of employment, employees are
provided ethics and compliance training upon hire and annually
thereafter. They are requested to review and attest to the code
of conduct and encouraged to share ideas or matters of concern
to their supervisor or compliance officer, or through the Ethics
and Compliance Hotline. Targeted training is also provided for
employees, and for contractors and agents, as determined by job
function. It focuses on laws, regulations, and ethics and compliance
policies and procedures directly relevant to their responsibilities.
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Effective lines of communication
Kaiser Permanente is committed to fostering a culture where
everyone is free to speak up. Our goal is that all employees, whether
seeking answers to questions or
reporting potential instances of
noncompliance, will know who to
turn to for a meaningful response and
should be able to do so without fear
of retribution. In addition, we have
adopted the appropriate policies
that support a safe, nonthreatening
environment. As part of our
commitment to ethical behavior,
employees are required to report any
actual or suspected violations of law or
ethical standards so that they can be appropriately investigated and
addressed. Employees can raise concerns in several ways, including
contacting their supervisor or a human resources, legal, or ethics and
compliance representative; calling our toll-free, 24-hour, anonymous
hotline; or submitting a concern online.
Kaiser Permanente provides its customers and members with
information and descriptions of policies and practices to secure
protected health information and other personally identifiable
information. Learn more about protecting your privacy.
Vendor code of conduct
Vendors play an integral role in our organization’s goal to comply with
all applicable laws, regulations, and adherence to internal policies. At
Kaiser Permanente, we strive to demonstrate high ethical standards
Responsible Business
Other
Ethics and Compliance year in review
2022 investigations
10,786
reports
received
14%
decrease
over 2021
41%
reports submitted
anonymously
Industry
benchmark: 58%
89%
investigations
completed
within 90 days
Internal
benchmark: 80%
38%
cases reported
directly to Ethics
and Compliance
62%
cases reported
through the
hotline
Top investigation categories
38%
cases reported
directly to Ethics
and Compliance
10,786
reports
received
14%
decrease
over 2021
Internal
benchmark: 80%
89%
investigations
completed
within 90 days
22%
Privacy and Security
Unauthorized access and
disclosure of protected
health information
12%
Fraud, Waste, and Abuse
Misuse/theft of KP assets
and resources
52%
Human Resources
Work environment,
unprofessional behavior,
and timecard concerns
(these cases are handed
over to HR for follow-up)
14%
Other
Top investigation categories
41%
reports submitted
anonymously
Industry
benchmark: 58%
Privacy and Security
Unauthorized access and
disclosure of protected
health information
Human Resources
Work environment,
unprofessional behavior,
and timecard concerns
(these cases are handed
over to HR for follow-up)
Fraud, Waste, and Abuse
Misuse/theft of KP assets
and resources
14%
22%
52%
12%
Other
38%
cases reported
directly to Ethics
and Compliance
10,786
reports
received
14%
decrease
over 2021
Internal
benchmark: 80%
89%
investigations
completed
within 90 days
Top investigation categories
Privacy and Security
Unauthorized access and
disclosure of protected
health information
Human R
esources
Work environment,
unprofessional behavior,
and timecard concerns
(these cases are handed
over to HR for follow-up)
Fraud, Waste, and Abuse
Misuse/theft of KP assets
and resources
14%
22%
52%
12%
Top investigation categories
62%
cases reported
through the
hotline
41%
reports submitted
anonymously
Industry
benchmark: 58%
Privacy and Security
Unauthorized access and
disclosure of protected
health information
Human Resources
Work environment,
unprofessional behavior,
and timecard concerns
(these cases are handed
over to HR for follow-up)
Fraud, Waste, and Abuse
Misuse/theft of KP assets
and resources
14%
22%
52%
12%
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in our business practices and have created a vendor code of conduct
outlining the minimum standards they are expected to follow.
Conducting internal monitoring and independent auditing
Kaiser Permanente measures its effectiveness and adherence to
applicable policies and regulatory requirements through internal
monitoring and independent auditing. The ethics and compliance
function monitors or partners with departments throughout the
organization to monitor activities and processes so that compliance
with various relevant requirements
and standards may be assessed.
Monitored activities and processes
include but are not limited to
the following:
Fraud, waste, and abuse
Kaiser Permanente performs data
mining to identify anomalies that
may indicate an opportunity to
recover funds, avoid inappropriate
payments, or detect diversion of
funds or assets, for example for controlled substances. Compliance
and operations teams regularly partner to develop and refine studies
targeted to risk areas. Investigators regularly receive data mining
reports to evaluate potential concerns.
Conflicts of interest
Employees have a duty to disclose potential conflicts via the annual
disclosure process and as they arise. To meet the expectations of
regulators and the obligation of the Kaiser Foundation Health Plan
and Hospitals Boards of Directors to monitor conflicts of interests,
Kaiser Permanente administers an annual questionnaire to members
of the boards of directors, officers, and employees, including
researchers, in positions with greater potential for conflict between
personal interests and the best interests of Kaiser Permanente.
Federal and state health care programs exclusion list
Kaiser Permanente screens individuals and entities that it engages
with both initially and, at a minimum, on a monthly basis, against
federal and state exclusion lists, and only engages with individuals
and entities that are not identified on the state and federal exclusion
lists unless an approved exception exists.
Independent auditing of the ethics and compliance program
The effectiveness of Kaiser Permanente’s ethics and compliance
program is evaluated annually by the Internal Audit Services
Department or another independent third party. Compliance risk
areas are periodically audited by Kaiser Permanente’s internal audit
services department or other appropriate internal or, as necessary,
external audit resources. Compliance-related audit results are
reported to senior leadership and the appropriate boards of
directors committee, as applicable.
Responding promptly to detected offenses and
developing corrective action
Kaiser Permanente has established comprehensive internal
investigation and corrective action protocols that enable the timely,
complete, and objective investigations of reported noncompliance.
The effort is designed to ensure that corrective action and
preventive measures are identified, documented, and implemented
as appropriate upon conclusion of an internal investigation.
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Kaiser Permanente communicates compliance-related issues and
activities to internal and external stakeholders, as appropriate, to
promote transparency, meet regulatory requirements, and establish
and maintain a sustainable ethical and compliant culture within Kaiser
Permanente. At least annually, the boards of directors are provided
a report outlining significant compliance and ethics activities for the
year. Various regional, facility, business unit, and applicable functional
teams submit routine reports of ethics and compliance-related issues
within the scope of their associated jurisdiction.
Kaiser Permanente regularly interacts
with external agencies through
required reports to regulators, self-
disclosure reporting, coordination
of audits, or referrals to law
enforcement. Kaiser Permanente’s
ethics and compliance policy
outlines accountability to disclose
issues of noncompliance or detected
fraud to federal and state agencies. Overpayments received under
state and federal health care programs are reconciled and repaid
timely in accordance with applicable regulations. Kaiser Permanente
reports information related to data breaches, including personally
identifiable information or protected health information to regulatory
agencies in compliance with law and regulation.
Organizational governance
Kaiser Foundation Health Plan, Inc., and Kaiser Foundation
Hospitals are nonprofit, public benefit, tax-exempt organizations
described in Section 501(c)(3) of the Internal Revenue Code. They
are organized for public and charitable purposes and not for the
private gain of any person, and operate to improve the health of the
communities they serve.
The boards maintain and enhance the success of Health Plan and
Hospitals’ activities, including carrying out the charitable mission of
the organizations and ensuring they fulfill their charitable purpose to
operate in a manner that benefits the community. Strong corporate
governance serves as the foundation for the organizations to fulfill
their purposes and mission.
Throughout our history, Kaiser Permanente’s mission and values
have led us to embrace diversity and pursue equity for our members
and patients, our employees and physicians, and the communities
we serve. We strive to have leadership and a workforce that reflects
the rich diversity of our members and communities, understands
their needs and preferences, and delivers culturally responsive and
competent care and services. As of December 31, 2022, 36% of
the members of the boards were female and 43% were racially or
ethnically diverse. Further, 13 of 14 directors are nonmanagement
and independent.
Appendix:
Sustainability Accounting Standards
Board (SASB) Metrics for Managed
Care and Health Care Delivery
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Access to coverage
• SASB HC-MC-240a.1: Medical Loss Ratio (MLR)
The Affordable Care Act (ACA) established MBR thresholds of
85% for the large group market and 80% for the small group,
individual, and student health markets. MBRs are calculated
using an average of 3 years of data.
• Kaiser Permanente exceeded the law’s thresholds for medical
spending in all required lines of business and in all our markets.
Therefore, Affordable Care Act rebates are not required this
year.
• Kaiser Foundation Health Plan 2022 MLRs range from 88.5% to
117.5% .
• Additional details can be found on the CMS website here:
https://www.cms.gov/cciio/mlr.
Plan performance
• SASB HC-MC-250a.1: Average Medicare Advantage plan
rating for each of the following plan types: (1) HMO, (2) local
PPO, (3) regional PPO, (4) PFFS, and (5) SNP
Year after year, Kaiser Permanente ranks among the top
Medicare health plans in the country according to the Centers
for Medicare & Medicaid Services Star Quality Ratings. Of the
507 Medicare Advantage plans with Parts C and D evaluated
nationwide in 2022 for plan year 2023, only 57 earned 5 out of
5 stars — the highest possible rating for quality and service. Five
of those are our plans, representing 26% of all beneficiaries
enrolled in Medicare 5-star plans.
Region Kaiser Permanente’s 2023
overall Medicare ratings
California 5 Stars
Colorado 5 Stars
Georgia 5 Stars
Hawaii 5 Stars
Mid-Atlantic States
(D.C., Md., Va.) 5 Stars
Northwest
(
Ore., Southwest Wash.) 4 Stars
Washington 4.5 Stars
Kaiser Permanente Medicare health plans rated 5 out of 5 stars
will be marked with a special icon on medicare.gov.
The outstanding care we provide for our Medicare members
is reflective of the same high-quality care that our entire
membership receives, across the organization, regardless of
plan type or line of business.
• SASB HC-MC-250a.2: Enrollee retention rate by plan type,
including: (1) HMO, (2) local PPO, (3) regional PPO, (4) PFFS,
and (5) SNP
How we define enrollee retention rate: We compare who was
enrolled in a Kaiser Permanente plan at end of December 2021
to who is still enrolled in a Kaiser Permanente plan in December
of 2022. We have 87.6% retention across lines of business,
products, and regions.
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Improved outcomes
• SASB HC-MC-260a.1: Percentage of enrollees in wellness
programs by type: (1) diet and nutrition, (2) exercise, (3)
stress management, (4) mental health, (5) smoking or alcohol
cessation, or (6) other
All Kaiser Permanente members have access to a variety
of wellness programs. Some programs are integrated into
the care delivery system, such as wellness coaching and
health education on a variety of health and wellbeing topics,
while others are offered online on kp.org or telephonically.
Everything offered on kp.org, telephonically, and in care
delivery is available to all Kaiser Permanente members. We
don’t track engagement rates by topic; however, we do track
engagement rates with our online platforms. As of 2021,
90% of eligible Kaiser Permanente members were registered
on kp.org. For 2022 detailed engagement metrics, please
r
eference the table below:
Category Metric Volume
kp.org Appointments scheduled 11.1M
Lab tests viewed 74M
Prescriptions filled online 42.8M
Members with digital access 85%
Email Email exchanges 71.1M
Phone and video Phone and video visits 24.5M
% of all care interactions 15%
E-visits # of e-visits 10.6M
• SASB HC-MC-260a.2: Total coverage for preventive health
services with no cost sharing for the enrollees, total coverage
for preventive health services requiring cost-sharing by the
enrollee, percentage of enrollees receiving Initial Preventive
Physical Examinations (IPEE) or Annual Wellness Visits (AWV)
All Kaiser Permanente’s plans are compliant with the federal
Patient Protection and Affordable Care Act (PPACA). All the
plans that we design for portfolios, and the plans that we
customize for employers, include preventive benefits at $0
cost-share for the members. We have an immaterial number
of grandfathered plans remaining, which are not required to
adhere to the PPACA rules for preventive services.
• SASB HC-MC-260a.3: Number of customers receiving care
from Accountable Care Organizations or enrolled in Patient-
Centered Medical Home programs
All Kaiser Permanente regions have received Patient-Centered
Medical Home (PCMH) recognition from the National
Committee on Quality Assurance (NCQA). Level 3 is the
highest recognition, and all Kaiser Permanente regions have
received Level 3 recognition specifically. All our customers and
members receive care from our PCMH-recognized system.
The Patient-Centered Medical Home (PCMH) recognition
from NCQA is given to health care organizations that provide
high-quality primary care while managing the overall health
of their patients. The program focuses on a set of standards
that govern the organization of care around patients, working
in teams, coordinating care that supports access, involving
patients in their care plans, and tracking care over time.
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Kaiser Permanente created a fully integrated care delivery
system long before the model was named patient-centered
medical home. The principles of NCQA’s PCMH designation
reflect how we already provide care to our members. It’s an
integrated approach that allows us to:
• Enhance access and continuity
• Identify and manage patient populations
• Plan and manage care
• Provide self-care support and community resources
• Track and coordinate care
• Measure and improve performance
Integrating physicians and rewarding them for controlling
costs and improving quality is an important part of our
integrated health delivery system. Our health plan, hospitals,
and medical groups function as one organization — with an
aligned purpose, goals, and performance expectations. Our
unique integrated system ensures that not only the providers,
but our entire system functions at optimal efficiency to
manage costs. The benefits to our integrated approach
are essential to higher quality care, better outcomes, and
sustainable affordable health care for our members.
Customer privacy and technology standards
• SASB HC-MC-230a.1: Description of policies and practices to
secure customers’ protected health information (PHI) records
and other personally identifiable information (PII)
We take every precaution possible to secure member
information wherever it’s stored, accessed, or transmitted.
Kp.org and my.kp.org have advanced security systems in place
to pro
tect against the loss, misuse, or alteration of information
and are fully compliant with the Health Insurance Portability
and Accountability Act (HIPAA), which strictly adheres to all
state and federal privacy and security regulations.
Digital traffic, including email and file transfers within our
fir
ewalls and with vendors and employer groups, are protected
by an array of technical controls systems, including:
• Perimeter network security devices (network firewalls,
web application firewalls)
• Access control lists for network routing and system/data
level resources
• Secure Socket Layer (SSL) and Transport Layer Security
(TLS) to secure browser/server to server communications
• Vulnerability, Configuration, and Patching Management
program to ensure technical security flaws are
remediated timely
• Technical security standards to ensure systems are
designed to high security standards
• Anti-virus, phishing, and malware applications
• File and hardware encryption
• File integrity monitoring
• Logging and auditing to enable 24x7 threat detection,
response and prevention capabilities
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• User access restricted to the minimum necessary
information to perform job functions
• Multi-Factor Authentication is required for remote
connections
We have more than 6 million users, and we plan for availability,
monitoring, and server capability to meet this need and the
growing possible membership. We have two data centers
(Irvine, CA, and Napa, CA) that have failover capabilities —
immediately available stand by web servers — so that our
availability to all membership in all regions is estimated at or
above 98.5%.
Our code of conduct
Every individual and organization that works for or on behalf
of Kaiser Permanente must follow our code of conduct.
This code guides our daily work and helps us meet Kaiser
Permanente’s high ethical standards, which include complying
with the following:
• Federal, state, and local laws and regulations
• The requirements of the Health Insurance Portability and
Accountability Act (HIPAA) Privacy and Security Rules
• Federal health care program requirements
• Licensing requirements
• Accreditation standards
• Requirements of the Centers for Medicare and Medicaid
Services (CMS)
• Other federal and state contracts
Kaiser Permanente conducted the appropriate assessments
of its technical, physical, and administrative safeguards
as required by the Security Rule, and then adopted
and implemented the required technical, physical, and
administrative security safeguards to protect the PHI that it
obtains and maintains. We have adopted Information Security
Policies across our enterprise. Information regarding the
internal policies and results regarding internal or external
audits are confidential and proprietary. Kaiser Permanente
issues the Service Organization Control 2 Type II Report
(SOC-2 Report) as defined by the Statement on Standards for
Attestation Engagements (SSAE) No. 16 to customers requiring
assurance over relevant IT, Security, and Business controls.
Activity metric
• SASB HC-MC-000.A: Number of enrollees by plan type
The majority of our plans are HMOs, so we have chosen to
disclose this data by line of business rather than plan type.
Enrollment for all HMO plans as of December 2022:
Category % of total # of members
Commercial
44% 5,386,841
Public sector
22% 2,756,086
Medicare
15% 1, 837, 552
Individual
9% 1,065,275
Medicaid
10% 1,294,449
Total
12,340,203
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Health care delivery
• SASB HC-DY-130a.1: Energy Management
Total energy consumed: 9,908,011 Gigajoules. Percentage grid
electricity: 53%. Percentage renewable energy: >53%.
• SASB HC-DY-150a.1: Waste Management
Total amount of medical waste, 29,100 tons: 19% incinerated in
2022. 81% autoclaved and then landfilled.
• SASB HC-DY-450a.1: Climate Change Impacts on Human
Health & Infrastructure
Climate change directly impacts the populations in all
geographical areas that KP serves. While all regions in which
Kaiser Permanente operates are at risk of illnesses and
loss of life due to extreme temperatures, the specific risk
exposures may vary. Kaiser Permanente carefully monitors
studies and reports issued by government agencies and
other organizations that speak to climate change-related risks
and uses these reports and findings to assess impact on our
business.
Kaiser Permanente has a robust business continuity program
that ensures continued operations in the event of natural or
manmade disasters. The Healthcare Continuity Management
(HCM) team provides updates on resilience including
emergency management and business continuity efforts across
regions and business units. The HCM maintains vigilance by
tracking and responding to all threats to the organization,
including multiple earthquakes, wildfires, severe weather
events, civil unrest, and labor-related issues. Concurrently,
HCM also provided support to the National Command
Center (NCC), Regional Command Centers (RCCs), and Local
Command Centers (LCCs) throughout the year.
Kaiser Permanente also maintains crisis planning and response
te
ams for all crisis events, including any climate-related crises.
Kaiser Permanente communicates in a variety of ways with
health plan members (policyholders) regarding environmental
contributors to disease as part of our efforts to promote
healthy environments. Kaiser Permanente also conducts and
publishes Community Health Needs Assessments (CHNA’s)
across the communities we serve. These publicly available
assessments help Kaiser Permanente identify, prioritize and
address community health needs including poor health
outcomes that are correlated with climate change.
In June 2022, Kaiser Permanente aligned with the White House
Clima
te Pledge, which includes a commitment to “develop
and release a climate resilience plan for continuous operations
… anticipating the needs of groups in their community that
experience disproportionate risk of climate-related harm.”
Kaiser Permanente’s Emergency Preparedness program
inte
rnally ensures all our medical facilities comply with CMS’s
Emergency Preparedness Rule.
