Special perinatal services in a large health maintenance organization

The Kaiser Permanente (KP) Medical Care Program, the largest and oldest health maintenance organization in the United States, is generally considered a model and template for other health maintenance organizations and managed health care programs. Nationally, KP has almost 7 million members-about 5 million in California, 2.4 million of whom are in the KP Northern California Region (KPNCR). About 500,000 of those are children; physicians in the program see 32,000 prenatal patients and deliver more than 28,000 babies annually. KPNCR is the largest KP region; 26% of northern California's population are subscribers. This review addresses special perinatal programs in the KPNCR and emphasizes perinatal screening and genetic services.