1 / 15

The New Med Mal Crisis

The New Med Mal Crisis. Where have all the doctors gone?. Types of Medical Professional Liability(MPL) Insurance. Healthcare Professionals : Commercial carriers Dentists/Oral Surgeons : Smaller specialists and commercial carriers Physicians/Surgeons : Mostly PIAA companies

emma
Download Presentation

The New Med Mal Crisis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The New Med Mal Crisis Where have all the doctors gone?

  2. Types of Medical Professional Liability(MPL) Insurance • Healthcare Professionals : Commercial carriers • Dentists/Oral Surgeons : Smaller specialists and commercial carriers • Physicians/Surgeons : Mostly PIAA companies • Healthcare Facilities : Commercial carriers • Hospitals : Multi-line carriers or self-insurance trusts

  3. About Physician Insurers Association of America (PIAA) • Formation of PIAA (mid-1970s) • Physician Owned/Operated Carriers • Medical Professional Liability (MPL) Crisis • Availability of MPL Insurance • Policyholder Dividends • www.piaa.us

  4. Historical Healthcare Liability Focus • Serve a small customer base • Offer a small number of products • Compete in a small number of venues …with the coming change in healthcare, does this model still make sense?

  5. Premium Comparison Industry Breakdown Medical Mutual Breakdown Source: SNL Financial Source: Medical Mutual

  6. Number of Venues Source: SNL Financial

  7. Healthcare Liability Outlook • For now, financially strong based on recent results. • Fierce Competition in order to retain business. • Provider Consolidation/Integration. • New and emerging risks from healthcare reform and consolidation will put pressure on loss ratios. …PIAA companies will need to adapt to the new reality.

  8. Healthcare Reform Impact • Number of Hospitals/Health Systems Decline : Fewer, larger systems • Physician Groups Decline : Becoming employees • Managed Care/Health Plans Increase : Moving from FFS to more of a Managed Care delivery system • Miscellaneous Facilities Increase : Primary Care facilities needed • Allied Health Professionals Increase : Growth in nurse practitioners and physician’s assistants • Long Term Care/ Aging Service Increase : Population ages

  9. Effect of Healthcare Reform on Providers • Move from Fee For Service Delivery System • Few incentives to reduce costs • Health care costs exploding • Costs are primary driver of fiscal deficits for federal, state, local governments • Pressure on Providers for FFS • Declining Reimbursements • Cost Pressures • Shift in mix of business (aging population, technology requirements, etc.) New system is designed to provide “Population Healthcare”.

  10. Advantages of Move to Employment • Better reimbursement rates • More time for patient care • Less time spent on business of practice • Work/Life balance • Health system view as a necessity for “Population Healthcare”

  11. Trend to Employed Doctors Source: AHA Annual Survey of Hospitals

  12. Key drivers for Employed Physicians Source: Analysis of AAMC-AMA Survey of Physicians Under 50

  13. Impact of Hiring Physicians as Employees • Possible rise in frequency and severity? • Previously two separate policies, now Hospital and Physician exposure combined. • Joint-Defense. • Vicarious Liability increased. • Physicians providing care under different venues. • Controllability • Consent to Settle claims go to economic buyer. • Claims staff understanding of who controls claim. • Collaboration regarding defense of claims. • What to do with tail exposure?

  14. Success or Failure within the market will depend on… • Pricing/Reserving • Claims/Risk Management • Continue to provide best Products/Services • Expansion in new Markets/Products

  15. Keith AllenSVP, ActuaryMedical Mutual225 International Cr.Hunt Valley, MD 21030(800)492-0193kallen@weinsuredocs.com

More Related