Managed care in the Northern California Kaiser Permanente health care system

Kaiser Permanente in Northern California is a group model health maintenance organization (HMO) that contracts with The Permanente Medical Group, Inc. (TPMG) to provide care for health plan members. TPMG is the largest (for-profit) private group practice in the world, with 3600 physicians in Northern California, including 62 urologists, providing care to 2.5 million health plan members. Recent changes in health care financing and delivery mandate an HMO-physician relationship which addresses issues of cost, quality of care, and the needs of physicians. (C) 1998, Elsevier Science Inc. All rights reserved.