The KAISER PERMANENTE MEDICAL CARE PROGRAM evolved from industrial health care programs for construction, shipyard, and steel-mill workers for the Kaiser industrial companies during the late 1930s and 1940s. It was opened to public enrollment in October 1945. It developed locally from the Community Health Foundation, which was established in 1964. Providing comprehensive medical and hospital services to members, the group-practice prepayment plan is decentralized into eight regions in fifteen states, as well as Washington, DC. Each region is a federally qualified health-maintenance organization (HMO), which manages local operations through closely cooperating but separate health-care services and facilities. In 2006 each of Kaiser's regions were comprised of three distinct organizations, Kaiser Foundation Health Plans, Kaiser Foundation Hospitals, and Permanente Medical Groups. Based on 2005 statistics, the Ohio region, which encompassed Cleveland and Akron, included 145,962 patient-members.

In 1933 Dr. Sidney Garfield established a small California hospital to provide health-care services for builders of the Los Angeles aqueduct. When the fee-for-service payments failed to generate sufficient revenues, Garfield developed a successful prepayment health-care plan. He established other plans in 1938 for Kaiser workers building the Grand Coulee Dam, and in 1942 for West Coast shipyard workers. After World War II the plan opened membership to whole communities.

Operations in Cleveland began when the Meatcutters & Retail Store Employees Union (see UNITED FOOD & COMMERCIAL WORKERS) established the Community Health Foundation. Structured similarly to Kaiser-Permanente, it provided services through east-side ambulatory facilities and community hospitals (see HOSPITALS AND HEALTH PLANNING) and a west side medical center. In 1969 it merged with Kaiser-Permanente to form the Kaiser Community Health Foundation. That year Kaiser purchased a skilled-nursing facility on Snow Road in Parma for conversion into an acute general hospital. In 1971 another facility was purchased, at 11203 Fairhill Boulevard, and a third hospital was purchased in 1973 across the street at 2475 Martin Luther King, Jr. Drive, to form the Cleveland Medical Center. In 1986 medical offices in North Olmsted, Rocky River, and Strongsville complemented the Parma Medical Center (which included the eighty-two-bed Kaiser Foundation Hospital) while medical offices in Akron, Bedford, Cleveland Heights, and Willoughby supplemented the Cleveland Medical Center. Because of increased competition for revenues, Kaiser-Permanente expanded its use of community hospitals. In 1986 the medical institution began to use the Cleveland Medical Center for outpatient services, and became affiliated with Saint Luke's Medical Center, Fairview Hospital, Lakewood Hospital, Akron City Hospital, and the Lake Hospital System to provide specific services. In 1993 the health plan also formed a relationship with the CLEVELAND CLINIC.

By 1995 Kaiser was no longer affiliated with St. Luke's and Lakewood, and had established new affiliations with Akron Children's Hospital and the Cleveland Clinic Foundation, where it opened an innovative emergency department in May 1994. This department was unique in that it functioned independently of the Clinic's neighboring department, yet shared use of some of the Clinic's expensive, high-tech equipment. By 2006 Kaiser's relationship with major health facilities had expanded to include the Summa hospital group in Akron; the HMO maintained a variety of facilities, including medical centers, hospitals, medical offices, and regional administrative offices throughout the Cleveland-Akron region.

See also MEDICINE.

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