Atchinson said. He said he hopes Congress will quickly pass H.R to remove greater threats facing healthcare providers.

Transcription

1 November 27, 2013 U.S. Rank in Life Expectancy Falls Behind International Average A new report from the Organization for Economic Co-operation and Development (OECD) shows that the average lifespan in the U.S. has fallen one year behind the international average. The report identifies the U.S. as a country that is spending a tremendous amount of money on healthcare, but getting much less than other countries out of that investment. The U.S. tops the list when it comes to high-end medical equipment, such as MRI and CAT scan technology. According to the study, more than one in 10 Americans get an MRI exam each year, a rate higher than any other country. In Austria, which has a life expectancy more than two years longer than the U.S., the MRI exam rate is just about half of the U.S. While life expectancy in the United States used to be one year above the OECD average in 1970, it is now more than one year below the average, the authors write. Many possible explanations have been suggested for these lower gains in life expectancy, including the highly fragmented nature of the U.S. health system, with relatively few resources devoted to public health and primary care, and a large share of the population uninsured. (The Washington Post, 11/21) Medical Professional Liability Carriers Brace for Affordable Care Act Doctors, nurses, and hospital systems could see more sizable and frequent lawsuits from patients as a result of the Affordable Care Act. A larger insured population will likely raise the number of suits healthcare professionals face. W. Stancil Starnes, Chairman, President and CEO of ProAssurance Corporation, said patient frustration is one factor that could result from more people being covered. Patients, dissatisfied with potentially longer wait times, could have a greater propensity to file suit against their doctors. There is an atmosphere that s going to be created that will at least create the possibility of delays in patients being seen in physicians offices and otherwise, Starnes said. The ACA also implements new rules that seek to measure patient outcomes and incentivize higher-quality care. Plaintiffs could use these guidelines to file suits against their doctors, MPL insurance carriers say. PIAA President and CEO Brian Atchinson said these standards do not necessarily reflect the quality of care the patient received but could be construed as such in court cases. The standards are important, but it doesn t have to do with the quality or the delivery of the healthcare to the person in the doctor s office or in the hospital, he said. There is legislation before Congress, H.R. 2810, that would clarify that provisions in the ACA do not constitute standards of care. The Affordable Care Act creates a lot of uncertainty with respect to the future liability of doctors, nurses, nurse practitioners, hospitals, or any licensed health professionals,

2 Atchinson said. He said he hopes Congress will quickly pass H.R to remove greater threats facing healthcare providers. (SNL, 11/19) Competition Driving MPL Premiums Down A recent survey by Medical Economics found that median annual premiums for family/general practitioners in 2012 were $11,900, the same as Internal medicine practitioners saw their premiums decline by 0.7%, from $12,900 to $12,800. Since 2009, median annual premiums for family/general physicians have dropped by 5.8%, and premiums for internal medicine practitioners have come down by 11.7%. Overall, 58% of family/general practitioners and 62% of internists reported an increase or no change in their premiums, while 10% of family practitioners and 11% of internists reported a decrease. The remainder either did not know or didn t respond. The median amount of reported increases among family practitioners was $980, while the median reported increase for internists was $1,200. According to the survey, premiums continue to hold steady or decline for primary care physicians, helped by more insurance carriers entering the field and the ongoing consolidation of primary care practices Rob Francis, chief operating officer for PIAA member The Doctors Company, attributes the downward trend in the MPL market to a flurry of state laws enacted a decade ago aimed at discouraging medical liability lawsuits. More recently, he says, carriers that once served only one or two states or one part of the country have been expanding into new regions, while companies that did not previously offer MPL coverage are starting to do so. Companies are seeing that the physicians are consolidating into larger groups or joining with hospital systems, and in order to maintain market share there s a lot more competition for these accounts, which pushes prices down, Francis said. (Medical Economics, 11/25) Broad Approach May Be Better for Reducing Readmissions According to a study published in the British Medical Journal, top-performing hospitals had fewer readmissions across the board, regardless of condition. Those findings could have significant implications for hospitals that are concentrating their improvement efforts on particular areas, such as heart failure care, the authors said. Our findings suggest that hospitals may best achieve low rates of readmission by employing strategies that lower readmission risk globally rather than for specific diagnoses or time periods after hospitalization, said Dr. Kumar Dharmarajan, the study s lead author. The authors analyzed three years of Medicare data covering more than 600, day readmissions for heart failure, heart attack, or pneumonia at more than 4,000 hospitals. Those are the same conditions tracked by the federal government s Readmissions Reduction Program, a provision of the Affordable Care Act. (Modern Healthcare, 11/25) Patients of Flawed Hip Implants Now Taking Ire Out on Plaintiff Attorneys Patients injured by a flawed hip implant sold by Johnson & Johnson have directed their anger at myriad places over the years. Now, some patients have found a new target for their ire: the legal system and the lawyers they hired to sue Johnson & Johnson. At issue is the $2.5 billion plan announced last week to settle an estimated 8,000 lawsuits involving the all-metal hip device known as the Articular Surface Replacement. After the lawyers fees, patients will get about $160,000 on average to compensate for their pain and suffering. The plan also creates a $475 million pool for added payments to the most severely injured. And Johnson & Johnson agreed to pay claims from private insurers and agencies like Medicare seeking to recover

3 the costs of operations and other medical treatments related to the device. But some patients contend that the deal s real winners are the plaintiffs lawyers. Those lawyers are set to receive about one-third of the settlement, or about $800 million. The single biggest chunk of those fees will go to the firms most involved with developing cases against Johnson & Johnson and negotiating the settlement; they will get a bonus of about $160 million. (The New York Times, 11/25) Liability Costs on the Rise for Long Term Care Facilities According to Aon s 2013 Long Term Care General Liability and Professional Liability Actuarial Analysis, liability costs for long term care providers are expected to increase by 5% and claims frequency also is expected to rise. The report also indicated that plaintiff law firms have focused attention on states with more vulnerable legal climates. Conservative jurisdictions with long standing tort limits are less economically attractive to attorneys. The firms have focused their attention on venues with no tort limits, less mature tort laws, or more liberal judiciaries. We are seeing this in Kentucky, Tennessee, and West Virginia, where claim frequency rates are growing, said Christian Coleianne, associate director and actuary, Aon Global Risk Consulting. The analysis provides estimates of loss rates, or the cost of liability to the beds that care providers operate. The projected national 2014 loss rate, which is a combination of claim severity and frequency, is $1,940 per occupied bed. This means that an operator with 100 beds can expect $194,000 in liability expenses in (AON, 11/21) Oregon Judge Retains Jury s $12 Million Verdict An Oregon jury s $12 million verdict in favor of a boy severely injured after treatment by Oregon Health and Science University (OHSU) surgeons should stand despite the hospital s arguments to reduce the award to a $3 million liability cap established by state law, a Multnomah County Circuit judge ruled last week. The judge said capping the award at a level so far below what the jury determined to be appropriate would be constitutionally inadequate, but acknowledged he is just a way station for the case as it likely heads to the Oregon Supreme Court over the legality of the Oregon Tort Claims Act limits for OHSU and other public bodies. In a statement, OHSU said, We deeply regret that a surgical error caused them harm. The hospital said it anticipates the case will go directly to the Oregon Supreme Court, and the hospital will await its decision. In addition, the hospital stated that the legislature chose the $3 million cap as an appropriate balance between the need for public institutions like OHSU and its practitioners to provide public services within the confines of limited budgets, while at the same time, ensuring that those who seek to obtain damages are treated fairly. (The Oregonian, 11/22) Chicago Jury Awards $15 Million in Childbirth Suit The husband of a woman who died giving birth in 2008 was awarded $15.5 million last week in a wrongful death lawsuit against two Chicago, Illinois area doctors and hospitals. Karen Lopez, 33, died in February 2008 during a cesarean section delivery at MacNeal Hospital in Berwyn, Illinois from excessive bleeding after doctors failed to diagnose and treat her for a high-risk complication called placenta accreta. The baby was delivered safely. We have great sympathy for this family, but we respectfully disagree with the jury s decision

4 and are reviewing our options, a University of Chicago Medical Center spokeswoman said. (Chicago Sun- Times, 11/22) Canada Ranks Low on Patient Safety in International Comparison The Organization for Economic Cooperation Development s new report, Benchmarking Canada s Health System: International Comparisons, finds Canada ranks below the average on several patient safety indicators. In particular, Canada is among the worst for leaving objects such as sponges or medical equipment in patients after surgery. Obstetric trauma was also cited as a problem area. In instrument-assisted vaginal deliveries, 17% of women experienced a perineum tear, a higher rate than in all peer countries (those with comparable economies and health systems). One reason for the low rankings, however, may be that Canada is better at collecting patient safety data than many other countries. Accuracy of statistics can vary widely depending on how they are recorded and collected. Areas where Canada performs well includes breast cancer screening, stroke mortality rates, and admission rates to hospitals for asthma and diabetes, according to the report. This means that we are doing better than others [in these areas], but it does not mean we don t have room to improve, said Katerina Gapanenko, manager of health system research at the Canadian Institute for Health Information. (CMAJ, 11/23) PIAA Webinar One Week Left to Register! Reengineer Your Website, Engage Customers What are customers looking for in an MPL website? How can your website function as a powerful tool for engaging current customers, and attracting new ones? Sign up for PIAA s webinar on December 4 at 2 p.m. and find out. You ll hear the practical details of a case study how one PIAA member company succeeded in reengineering its website, with measurable success. You will also hear some insider tips from an MPL insurance buyer. He ll provide a full discussion on what customers are looking for, how to create messaging that resonates with customers, and how to tailor what s on your website to each type of customer you work with. (PIAA, 11/27) New PIAA Study Analyzes Diagnosis and Treatment of Breast Cancer The PIAA Research Department has released the PIAA Breast Cancer Study MPL Cancer Claims Miniseries: Volume 1 which provides a comprehensive analysis of current issues in the diagnosis and treatment of breast cancer, with a special emphasis on how they impact MPL claims. Breast cancer claims emerged as the costliest among all cancer claims, 2002 to 2011, with total indemnity payments exceeding $296 million.

5 DSP participating companies receive complimentary copies and significant discounts on orders of the study. It also is available at a reduced cost to all PIAA members. If you are interested in ordering the study, please click here. (PIAA, 11/27) PIAA Government Relations Department Posts New Webcast This week the PIAA Government Relations Department released the most recent installment of its webcast series, Inside Government Relations (IGR). Produced every other week, the brief video provides updates and insights on Government Relations activities as they relate to Medical Professional Liability. MMIC Awarded STAR Rating by Demotech MMIC was one of 1.6% of property/casualty insurers to receive the STAR (Stakeholder Team Accomplishment Recognition) award from Demotech, Inc. for The STAR award identifies and recognizes insurers who were able to satisfy all stakeholders, not just certain groups. MMIC displayed relative profitability in the top third of coverage specialists based upon the return on net admitted assets. MMIC prides itself on its commitment to its agents, employees, and policyholders, as well as other important stakeholders that Demotech considered, MMIC President and CEO Bill McDonough said. (MMIC, 11/22)