Malpractice Insurance Costs And Physician Practice, by Margo L. Rosenbach and Ashley G. Stone
|
|
- Wendy Hodge
- 8 years ago
- Views:
Transcription
1 DataWatch Malpractice Insurance Costs And Physician Practice, by Margo L. Rosenbach and Ashley G. Stone One of the major issues underlying the medical malpractice debate is whether problems with the cost or availability of insurance have led physicians to modify their practice patterns to reduce the risk of being sued. This DataWatch documents the cost impact of malpractice insurance premiums and problems with the availability of insurance coverage and assesses the impact of rising malpractice insurance costs on physician practice in the mid-1980s. Most research to this point has focused on positive defensive medicine strategies, that is, the performance of additional tests or procedures to avoid being accused of negligence. 1 Stephen Zuckerman found that physicians are indeed taking certain precautions in their day-to-day practice. 2 Similarly, Harry Paxton reported that most physicians involved in obstetrics were adopting one or more defensive tactics, most frequently ordering more tests. 3 A key feature of our study is the focus on negative defensive medicine practices-in other words, the discontinuation of certain procedures or cases. Of particular concern with the adoption of negative defensive medicine is the impact on access to care. To the extent that the perceived malpractice crisis impedes patients access to care, public policy intervention might be warranted. Study Data And Methods This analysis is based on a sample of physicians who responded to the 1983 Physicians Practice Costs and Income Survey (PPCIS) and who also participated in the 1986 Physicians Practice Follow-up Survey (PPFS). This study is the only known source of data on changes in malpractice insurance premiums for a panel of physicians. The 1983 PPCIS included 4,729 physicians, with a response rate of 67.6 percent. The follow-up survey excluded physicians specializing in pediatrics, pathology, psychiatry, and a few other small specialties (emergency medicine, Margo Rosenbuch is vice-president of Health Economics Research, Inc. (HER), in Needham, Massachusetts. Ashley Stone was a research assistant at HER at the time this study was done.
2 D ATAWATCH 177 rehabilitation medicine, occupational medicine, and general preventive medicine). The sample for the follow-up survey consisted of 3,554 physicians, of which 2,499 (74.2 percent) completed the interview. Three open-ended questions were asked to assess availability problems and practice impacts: (1) Have you ever had any problems with the availability of malpractice insurance? (2) Since this time last year, have you stopped performing certain high-risk procedures because of malpractice insurance costs? (3) Since this time last year, have you stopped seeing certain types of cases because of malpractice insurance costs? Physicians who reported an availability problem or practice impact were probed as to the nature of the problem. Physicians verbatim responses were recorded and coded into closed-ended categories. Multiple responses were permissible and were most common with respect to the types of procedures that were discontinued. We have weighted multiple responses so as not to overrepresent physicians with more than one availability problem or practice impact. 4 The Malpractice Environment Who pays the premium? For the vast majority of physicians (90 percent), the malpractice premium was paid solely by the physician or his or her practice in 1986 (Exhibit 1). For 3 percent, the hospital bore sole responsibility for paying the premium, while for 6 percent, the physician/ practice and the hospital shared the cost of the coverage. Hospital coverage may be provided through a commercial policy or through self-insurance. In 1986, only 1 percent of physicians were uninsured for cases of medical malpractice. About a fourth of these physicians were never insured, about two-fifths discontinued their policy during the malpractice crisis of the 1970s, and the remainder (about one-third) of the bare physicians had discontinued their coverage since Exhibit 1 also displays the source of payment by specialty. The dominant payment source across all specialties was practice revenues. We might expect hospitals to defray the cost of malpractice premiums for the two hospital-based specialties-radiology and anesthesiology-but this does not appear to be the case. Although obstetricians/ gynecologists have the highest malpractice premiums, nine in ten paid for their insurance coverage entirely out of practice revenues. The cost was defrayed by hospitals (either in whole or in part) for only one in ten. The sources of payment for malpractice premiums clearly vary by practice arrangement. Self-employed physicians as well as those employed by another physician or corporation were most likely to pay the malpractice insurance premiums out of practice revenues. Among those
3 178 HEALTH AFFAIRS Winter 1990 Exhibit 1 Sources Of Payment For Malpractice Insurance Premiums, 1986 All physicians Specialty General practice Family practice Internal medicine Cardiology Other medical specialties General surgery Orthopedic surgery Ophthalmology Urology Obstetrics/ gynecology Other surgical specialties Anesthesiology Radiology Physician or practice 90.3% Hospital a 3.0% Both physician and hospital No coverage 5.7% 1.0% Practice arrangement Self-employed Employed by: Hospital or university Clinic or HMO b Another physician or corporation Source: 1986 Physicians Practice Follow-up Survey. a Includes coverage through hospital self-insurance. b For clinic/ HMO employees, the second and third columns may reflect payments by the employer (that is, the clinic or HMO), not necessarily the hospital. employed by a hospital or university, the premium was most often paid by the hospital in its entirety or shared by the practice and hospital. About two-thirds of clinic or health maintenance organization (HMO) employees paid the premium out of pocket, while another third received malpractice insurance coverage as a fringe benefit with either full or partial payment by the employer. Changes in malpractice premiums. According to the 1983 PPCIS and 1986 PPFS, malpractice premiums rose 75 percent, from $8,500 in 1983 to $14,800 in Relative to gross revenues, they were only 57 percent higher, increasing from 4.0 percent to 6.2 percent of gross. Malpractice insurance premiums rose faster than other prices, as measured by the consumer price index (CPI) and the medical care index (MCI). Exhibit 2 compares the estimates derived from the 1983 PPCIS and 1986 PPFS to those obtained from two alternative data sources: the American Medical Association s (AMA s) Socioeconomic Monitoring
4 D ATAWATCH 179 Exhibit 2 Changes In Malpractice Premiums, Comparison Of Alternative Data Sources, Average malpractice premiums (thousands of dollars) Percent of gross revenues Percent change Percent change Physicians Practice Costs and Income Survey $5.4 $ % 4.0% 6. 2% 57% Socioeconomic Monitoring System a Medical Economics Continuing Survey b Sources: 1983 Physicians Practice Costs and Income Survey; 1986 Physicians Practice Follow-up Survey; American Medical Association Socioeconomic Monitoring System; and Medical Economics Continuing Survey. a Self-employed physicians. b Malpractice premiums expressed in medians. System and the Medical Economics Continuing Survey. Several methodological differences may account for the discrepancies among the three sources First, the specialty mix differs across the three sources. The PPFS excluded pediatricians, pathologists, and psychiatrists, which have below-average malpractice premiums in both absolute and relative terms. Second, the PPCIS/ PPFS is based on a panel of physicians, rather than independent samples for two time periods. Third, the Medical Economics Continuing Survey produces estimates of malpractice premiums based on the median rather than the mean, thereby lowering the average. Specialty differentials. Premiums ranged nearly fivefold across specialties, from $6,474 for internists to $31,180 for obstetrician/ gynecologists (Exhibit 3), Also at the low end (under $10,000 on average) were general and family practitioners, other medical specialists (such as allergists and dermatologists), and ophthalmologists. At the high end of the range (over $20,000) were anesthesiologists, general surgeons, orthopedic surgeons, and other surgical specialties (such as cardiovascular/ thoracic surgeons and plastic surgeons). Physicians with high premium costs in absolute terms also bore a high cost relative to their gross revenues. For example, the five specialties averaging more than $20,000 in physician-paid malpractice insurance costs devoted about 8 percent or more of their gross revenues toward insurance coverage. In contrast, those paying under $10,000 spent 5 percent or less of their gross revenues on malpractice insurance. From 1983 to 1986, malpractice insurance premiums increased about 50 percent among general practitioners, cardiologists, and anesthesiologists. However, they doubled for radiologists, obstetrician/ gynecologists,
5 180 HEALTH AFFAIRS Winter 1990 Exhibit 3 Changes In Physicians Own Malpractice Insurance Payments, By Specialty, Region, And Practice Arrangement, a All physicians Specialty General practice Family practice Internal medicine Cardiology Other medical specialties General surgery Orthopedic surgery Ophthalmology Urology Obstetrics/ gynecology Other surgical specialties Anesthesiology Radiology Region New England Middle Atlantic South Atlantic Average own malpractice payments Own malpractice payments as percent of gross income Percent Percent chan ge change $8,446 $14, % 4.0% 6.2% 57.2% 4,457 6, ,138 7, ,684 6, ,288 11, ,818 7, ,850 21, ,563 26, ,614 9, ,664 15, ,230 31, ,315 25, ,759 20, ,864 11, ,248 13, ,461 17, ,040 13, East North Central 6,671 13, East South Central 8,267 16, West North Central 6,405 12, West South Central 5,738 9, Mountain 7,800 14, Pacific 10,800 16, Practice arrangement b Self-employed 8,460 14, Employed by: Hospital or university 6,264 10, Clinic or HMO 9,190 15, Another physician or corporation 8,925 16, Sources: 1983 Physicians Practice Costs and Income Survey; and 1986 Physicians Practice Follow-up Survey. a Own malpractice payments refer to payments made by the physician or the physician s practice. Excludes payment made by the hospital on the physician s behalf.
6 D ATAWATCH 181 and other medical specialists. In 1983, orthopedists, obstetrician/ gynecologists, and other surgical specialists averaged about $15,000 in premiums, but by 1986, obstetrician/ gynecologists exceeded the other two specialties by $5,000-$6,000. Obstetrician/ gynecologists also bore a greater burden relative to their gross revenues. Other medical specialists also experienced a doubling in premiums, but this translates into only a 56 percent increase relative to gross revenues and represents a relatively small share of gross revenues (3.2 percent). Regional variation. Premiums also vary substantially across regions of the country. In 1986, premiums were lowest in the West South Central region and highest in the Middle Atlantic region, with an 81 percent differential (Exhibit 3). Relative to gross revenues, malpractice premiums were also at the extremes in these two areas of the country. From 1983 to 1986, malpractice insurance premiums paid by physicians increased 75 percent overall, but this increase was uneven across regions. Practice differences. Premium changes relative to gross revenues are particularly striking across practice arrangements. Whereas employed physicians devoted about 2.5 percent of gross revenue to premiums in 1983, by 1986 the share was 6 to 7 percent of gross revenue. This amount is now comparable to the proportion paid by self-employed physicians. Thus, the perception that employed physicians bear a lower financial burden relative to gross income is simply no longer true. Level of liability coverage. As do other forms of liability coverage, malpractice insurance policies contain limits on the amounts insurers will pay per occurrence (that is, for each case against the insured) and in the aggregate during the policy period. The most common level of coverage in 1986 was $1 million/ $3 million, where the insurer will pay up to $1 million per case and $3 million total. Two in five physicians had such coverage. The second most common limits were $1 million/ $1 million (11 percent of physicians), followed by $100,000/ $300,000 and $200,000/ $600,000 (6 percent each). Altogether, the four most common policies accounted for two-thirds of physicians, suggesting that there is a high degree of consistency in the policy limits. Among the remaining third, however, the variation is quite extensive. Within specialties, there was little variation in coverage limits. The most common limit for all specialties was $1 million/ $3 million, ranging from 27 percent of general practitioners to 51 percent of internists, other medical specialists, and orthopedists. For most specialties, the second most common limit was $1 million/ $1 million, although general practitioners, urologists, and other medical specialties tended to have lower coverage, while cardiologists frequently had a higher total limit. Policy limits do not vary substantially by practice arrangement, al-
7 182 HEALTH AFFAIRS Winter 1990 though physicians employed by a clinic or an HMO appear to carry more coverage. For example, the second and third most common policies were $5 million/ $5 million (7 percent) and $1 million/ $5 million (6 percent). Changes in coverage. In response to various pressures, physicians may lower coverage limits to reduce the cost of malpractice insurance. Or they may increase the limits due to increases in the number of medical malpractice claims filed by patients. In some cases, policy limits are beyond the physician s control, remaining at the discretion of states, carriers, or hospital employers. Since 1983, one in three physicians changed their coverage limits. In the aggregate, the average per case limit rose from $984,000 to $1.1 million, a gain of 7.1 percent from 1983 to The average total limit rose 7.4 percent, from just under $2.3 million to slightly more than $2.4 million. Changes in liability limits did not keep pace with inflation (as measured by either the CPI or MCI). Availability of malpractice insurance. When a physician experiences a lack of availability of insurance, it usually means one of two things: either the insurance is available but only at a price the physician is unwilling to pay, or it is unavailable at any price. Exhibit 4 shows the nature of availability problems reported by physicians. The responses of the 13 percent of physicians who indicated they had experienced problems are broadly grouped according to the nature of the problem. About half of those reporting any problem cited a general problem with insurance availability, such as withdrawal of carrier, denial or cancellation of policy, or not enough carriers to choose from. Another 2 percent specified that the preferred type of insurance was unavailable, for example, because of limits on levels of coverage, types of procedures covered, or types of policies offered. The high cost of insurance was reported by another 2 percent, although this is not an availability problem per se. (It should be recalled that respondents were asked if they had experienced problems with the availability of insurance. Had we asked physicians whether they considered the cost of insurance to be a problem, the number of affirmative responses undoubtedly would have been much higher.) Physicians in two specialties-obstetrics/ gynecology and anesthesiology-most frequently mentioned the cost of insurance to be a problem. Changes in practice patterns. One in five physicians stopped treating certain cases in the past year due to malpractice insurance costs. (Because of the open-ended nature of the questionnaire, each respondent placed his or her own interpretation on the meaning of the term high-risk.) We have grouped the responses into broad categories based on the complexity of the procedure or the type of patient affected. The single most commonly discontinued procedure was obstetrics, reported by 4 percent of
8 D ATAWATCH 183 Exhibit 4 Perceived Problems With Availability Of Malpractice Insurance, 1986 Insurance not available (general) Withdrawal of carrier from state Denial/ cancellation by one or more carriers Not enough carriers to choose from Part-time physicians not covered Preferred type of insurance not available Limit on extent of coverage Certain procedures or specialty not covered Umbrella coverage not available Desired type of coverage not available (occurrence vs. claims-made) Limit on practice size Cost of insurance too high High cost (general) High cost for obstetrics High cost for older physicians Percent of all physicians 6.3% 47.8% a 0.2 Other problem Problem more than 5 years ago 11.0 Other/ uncodeable Total Source: 1986 Physicians Practice Follow-up Survey. a Less than 0.05 percent. Percent of physicians indicating problems physicians. Three-fourths of those discontinuing general obstetrics were family and general practitioners, while three-fourths of those discontinuing high-risk obstetrics were obstetrician/ gynecologists. Altogether, 15 percent of obstetrician/ gynecologists reportedly discontinued obstetrics during the previous year due to malpractice insurance costs. About 3 percent of physicians discontinued some kind of major surgery, including orthopedic, cardiovascular, and head and neck surgery. Another 3.5 percent of physicians discontinued all surgery, some surgery, surgical assisting, or office surgery. Of the physicians who discontinued all or some surgery, general and family practitioners accounted for onehalf. The high cost of insurance also prompted 3.4 percent of physicians to discontinue minor surgery or invasive diagnostic procedures, including biopsies, lumbar puncture, and arthrocentesis. A small number (0.9 percent) said they discontinued seeing emergency patients. The final category, reported by 3.7 percent of physicians, includes those who refused to see certain patients based on their nonmedical characteristics. Patients involved in litigation and Medicaid and indigent patients were most often affected. We examined the specialty breakdowns
9 184 HEALTH AFFAIRS Winter 1990 for these two patient characteristics and found that surgeons were most likely to refuse patients involved in litigation (although only 1 percent of all physicians refused to treat patients involved in litigation). Orthopedic surgeons and obstetrician/ gynecologists were most likely to deny services to Medicaid patients. (Again, 1 percent of physicians refused to see such patients.) These findings raise questions about the extent to which physicians decisions are motivated strictly by rising insurance costs or are also based, for example, on the level of Medicaid payments for obstetrical or other services. Availability problems and practice impacts vary by specialty. Obstetrician/ gynecologists, orthopedic surgeons, and other surgical specialists were most likely to report availability problems (Exhibit 5). These are the same specialties with the highest malpractice insurance premiums, on average. Radiologists and other medical specialists, with relatively low premiums on average, were least likely to report availability problems. Variation across specialties is more pronounced with respect to practice impacts. Over one-fourth of family and general practitioners indicated they had discontinued certain procedures or cases because of malpractice insurance costs. Orthopedic surgeons and general surgeons also responded at a rate well above the average. Well below the average were cardiologists, other medical specialists, radiologists, and anesthesiologists. Exhibit 5 Availability Problems And Practice Impacts, By Specialty, 1986 Percent of all physicians who have: Ever had problems with availability of insurance All physicians 13.0% 19.8% Specialty General practice Family practice Internal medicine Cardiology Other medical specialties General surgery Orthopedic surgery Ophthalmology Urology Obstetrics/ gynecology Other surgical specialties Anesthesiology Radiology Source: 1986 Physicians Practice Follow-up Survey. Discontinued certain cases in the past year due to cost of insurance
10 D ATAWATCH 185 Conclusion Has the rising cost of insurance led physicians to alter their practice patterns? Altogether, 20 percent of physicians have changed their practice patterns, including some physicians who have ceased performing any surgery, others who have stopped seeing certain types of patients, and still others who have selectively discontinued performing certain procedures. Nevertheless, only 3.7 percent refused to treat patients on the basis of nonmedical characteristics. Clearly, negative defensive medicine strategies are far less common than positive defensive medicine practices. The most common practice impact was the discontinuation of obstetrics. General and family practitioners tended to stop performing all deliveries, while obstetrician/ gynecologists generally stopped seeing high-risk patients. Overall, 15 percent of obstetrician/ gynecologists reported they had discontinued some form of obstetric care in Evidence from this and other studies suggests that the malpractice concern centers on the affordability rather than the availability of malpractice insurance coverage. We conclude that the malpractice problem of the 1980s, while not necessarily of crisis proportions, is serious nevertheless because of its implications for access to early and adequate prenatal care and competent labor and delivery services. As the 1990s progress, we must continue to monitor the practice climate to ensure that access to care is not placed in further jeopardy. This paper was presented at the annual meeting of the American Public Health Association, 15 November This research was supported by Department of Health and Human Services (DHHS) Contract no , cosponsored by the Assistant Secretary for Planning and Evaluation (ASPE) and the Health Care Financing Administration (HCFA). The views and opinions expressed are the authors, and no endorsement by ASPE, HCFA, or DHHS is intended or should be inferred. NOTES 1. M.L. Gonzales, Trends in Physicians Professional Liability Claims and Insurance Premiums, in Socioeconomic Characteristics of Medical Practice 1986, ed. M.L. Gonzales and D.W. Emmons (Chicago: American Medical Association, 1986). 2. S. Zuckerman, Claims, Legal Costs, and the Practice of Defensive Medicine, Health Affairs (Fall 1984): H. Paxton, Just How Bad Is the Malpractice Crisis in Obstetrics? Medical Economics (11 August 1986). 4. E. Weinberg et al., Follow-up to the 1983 Physicians Practice Costs and Income Survey: Final Methodological Report (Chicago: National Opinion Research Center, September 1988). 5. U.S. General Accounting Office, Medical Malpractice: No Agreement on the Problems or Solutions, Pub. no. GAO/ HRD (Washington, DC.: U.S. GPO, 1986).
128 HEALTH AFFAIRS. Medical Malpractice: Claims, Legal Costs, And The Practice Of Defensive Medicine
128 HEALTH AFFAIRS Medical Malpractice: Claims, Legal Costs, And The Practice Of Defensive Medicine Despite the fact that the crisis atmosphere of the mid-1970s has subsided, the costs of medical malpractice
More informationMedical Council of New Zealand List of approved qualifications for locum tenens specialist appointments (showing amendments)
Anaesthesia Fellowship of the Australian and New Zealand College of Anaesthetists Fellowship of the Faculty of Anaesthetists, Royal Australasian College of Surgeons Fellowship of the Royal College of Physicians
More informationAppendix 1 Current list of approved qualifications for Locum Tenens registration
Appendix 1 Current list of approved qualifications for Locum Tenens registration Anaesthesia Fellowship of the Australian and New Zealand College of Anaesthetists Fellowship of the Faculty of Anaesthetists,
More informationhttp://www.bls.gov/oco/ocos074.htm gov/oco/ocos074.htm
http://www.bls.gov/oco/ocos074.htm gov/oco/ocos074.htm Physicians and Surgeons Nature of the Work Training, Other Qualifications, and Advancement Employment Job Outlook Projections Data Earnings Related
More informationA Descriptive Analysis of Medical Malpractice Insurance Premiums, 1974-1977
A Descriptive Analysis of Medical Malpractice Insurance Premiums, 1974-1977 by Nancy T. Greenspan The rapid increase in medical malpractice insurance claims and concomitant increases in premiums in the
More informationC-1 APPENDIX C - NATIONAL AND INTERNATIONAL HEALTH CARE EXPENDITURES AND HEALTH INSURANCE COVERAGE CONTENTS
C-1 APPENDIX C - NATIONAL AND INTERNATIONAL HEALTH CARE EXPENDITURES AND HEALTH INSURANCE COVERAGE CONTENTS National Health Expenditures Expenditures for Hospital Care Trends in Hospital Utilization Admissions
More informationRockbridge Underwriting Agency Limited 3700 Buffalo Speedway, Suite 300 Houston, TX 77098 (713) 874-8800 (713) 874-8899 fax
Rockbridge Underwriting Agency Limited 3700 Buffalo Speedway, Suite 300 Houston, TX 77098 (713) 874-8800 (713) 874-8899 fax Corporate Locum Tenens Underwriting Questionnaire and Application for Professional
More informationFull name/ Title of Medical Qualifications Eligible for Conditional Registration. American Board of Obstetrics and Gynaecology
Conferred by s in the United States of America: Board Cert (Anaesthesiology) Board Cert (Anatomic Pathology) Board Cert (Cardiology) Board Cert (Cardiovascular Disease) Board Cert (Clinical Pathology)
More informationPolicy Research Perspectives
Policy Research Perspectives Medical Liability Claim Frequency: A 2007-2008 Snapshot of Physicians By Carol K. Kane, PhD Introduction This report presents a snapshot of physicians experiences with medical
More informationTrends in Physician Compensation: Specialist Physician Growth Coupled with Primary Care Stagnation
Special Report: Trends in Physician Compensation: Specialist Physician Growth Coupled with Primary Care Stagnation Bruce A. Johnson, JD, MPA Physicians in the United States in virtually all medical and
More informationAggregate Indemnity and Medical Costs for Calendar Year 2012 (CA-IM-2012) Due Date: April 2, 2013
February 1, 2013 525 Market Street, Suite 800 San Francisco, CA 94105-2767 Voice 415.778.7008 www.wcirbonline.org escad@wcirbonline.org David M. Bellusci Executive Vice President, COO & Chief Actuary To:
More informationAugust 13, 2014. Dear Administrator Tavenner:
Marilyn B. Tavenner Administrator Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services Hubert H. Humphrey Building, Room 445 G 200 Independence Avenue, SW Washington, DC
More informationMalpractice Risk According to Physician Specialty
T h e n e w e ngl a nd j o u r na l o f m e dic i n e special article Malpractice Risk According to Physician Specialty Anupam B. Jena, M.D., Ph.D., Seth Seabury, Ph.D., Darius Lakdawalla, Ph.D., and Amitabh
More informationEXCESS CASUALTY HOSPITAL SURVEY - MISSOURI
EXCESS CASUALTY HOSPITAL SURVEY - MISSOURI 1. Legal name and address of hospital: 2. List all affiliates and subsidiaries to which this insurance is to apply. Include a complete description of the operations
More information2010 Physician Survey
Vermont Department of Health 2010 Physician Survey Statistical Report 2010 Physician Survey Statistical Report State of Vermont Peter Shumlin, Governor Agency of Human Services Douglas Racine, Secretary
More informationSeptember 10, 2007. The Honorable Harry Reid Majority Leader United States Senate S-221 Capitol Building Washington, DC 20510
September 10, 2007 The Honorable Harry Reid Majority Leader United States Senate S-221 Capitol Building Washington, DC 20510 Dear Majority Leader Reid: On behalf of the undersigned organizations, we urge
More informationMEDICARE PHYSICIAN PAYMENTS
GAO United States Government Accountability Office Report to the Subcommittee on Health, Committee on Ways and Means, House of Representatives July 2007 MEDICARE PHYSICIAN PAYMENTS Medicare and Private
More informationMilitary Crosswalk - Texas State Auditor's Office
Occupational Category - Medical and Health Job Classification Series - Dietetic 4001 - Dietetic I 4002 - Dietetic II 4001 - Dietetic I 4002 - Dietetic II 68M Nutrition Care No military equivalent HM Hospital
More informationAPPLICATION FOR LOCUM TENENS AND CONTRACT STAFFING ORGANIZATIONS PROFESSIONAL LIABILITY
APPLICATION FOR LOCUM TENENS AND CONTRACT STAFFING ORGANIZATIONS PROFESSIONAL LIABILITY (CLAIMS MADE BASIS) APPLICANT S INSTRUCTIONS: 1. Answer all questions. If the answer requires detail, please attach
More informationFlorida Statewide and Regional Physician Workforce Analysis: Estimating Current and Forecasting Future Supply and Demand
Florida Statewide and Regional Physician Workforce Analysis: Estimating Current and Forecasting Future Supply and Demand Prepared for: SAFETY NET HOSPITAL ALLIANCE OF FLORIDA Submitted by: IHS GLOBAL INC.
More informationADVANCE DIRECTIVE VOLUME 19 SPRING 2010 PAGES 306-315. The Effect of Medical Malpractice. Jonathan Thomas *
ANNALS OF HEALTH LAW ADVANCE DIRECTIVE VOLUME 19 SPRING 2010 PAGES 306-315 The Effect of Medical Malpractice Jonathan Thomas * I. INTRODUCTION: WHAT IS MEDICAL MALPRACTICE Every year, medical malpractice
More informationA COSTLY DEFENSE: PHYSICIANS SOUND OFF ON THE HIGH PRICE OF DEFENSIVE MEDICINE IN THE U.S. By Jackson Healthcare
A COSTLY DEFENSE: PHYSICIANS SOUND OFF ON THE HIGH PRICE OF DEFENSIVE MEDICINE IN THE U.S. By Jackson Healthcare TABLE OF CONTENTS pg 2 Findings at a Glance... pg 4 Why Ask Physicians about Defensive Medicine
More informationMedical Registration What does it mean? Who should be registered?
Statement 14 March 2012 Medical Registration What does it mean? Who should be registered? Purpose This statement provides advice to help individuals with medical qualifications to decide whether or not
More informationDid Medical Litigation Against Physicians Increase Hospital Inpatient Costs
Did Medical Litigation Against Physicians Increase Hospital Inpatient Costs Zeynal Karaca, Ph.D. Social & Scientific Systems, Inc. Herbert S. Wong, Ph.D. Agency for Healthcare Research and Quality Motivation?
More informationTeaching Physician Billing Compliance. Effective Date: March 27, 2012. Office of Origin: UCSF Clinical Enterprise Compliance Program. I.
Teaching Physician Billing Compliance Effective Date: March 27, 2012 Office of Origin: UCSF Clinical Enterprise Compliance Program I. Purpose These Policies and Procedures are intended to clarify the Medicare
More informationLEGISLA Alaska State Legislature
LEGISLA ATIVE RESEARCH SERVICES Alaska State Legislature Division of Legal and Research Services State Capitol, Juneau, AK 99801 (907) 465 3991 phone (907) 465 3908 fax research@legis.state.ak.us TO: FROM:
More information100.1 - Payment for Physician Services in Teaching Settings Under the MPFS. 100.1.1 - Evaluation and Management (E/M) Services
MEDICARE CLAIMS PROCESSING MANUAL Accessed September 25, 2005 100.1 - Payment for Physician Services in Teaching Settings Under the MPFS Payment is made for physician services furnished in teaching settings
More informationMaryland Physician Workforce Study Prepared by Boucher & Associates
Maryland Physician Workforce Study Prepared by Boucher & Associates EXECUTIVE SUMMARY SUMMARY OF FINDINGS It is a silent crisis but a real one: Maryland has a serious shortage of clinical physicians to
More informationSUMMARY REPORT 2005 Survey of Hospital Physician Recruitment Trends
SUMMARY REPORT 2005 Survey of Hospital Physician Recruitment Trends Overview Merritt, Hawkins & Associates (MHA) is a national physician search and consulting firm that periodically conducts surveys regarding
More informationLiability Limits in Texas Fail to Curb Medical Costs
Liability Limits in Texas Fail to Curb Medical Costs December 2009 Acknowledgments This report was authored by David Arkush, Peter Gosselar, Christine Hines and Taylor Lincoln. About Public Citizen Public
More informationhttps://www2.careercruising.com/careers/printer-friendly/410 Surgeon
Surgeon At a Glance Surgeons are medical doctors who perform surgeries on any part of the human body to correct problems caused by injury or disease. Michigan Career Pathways Health Sciences Range: 100K
More informationCost to the Government for Providing Medical Malpractice Coverage to Community and Migrant Health Centers (A-04-95-05018)
.. 19.1({,, *+ + - *. DEPARTMENT OF HEALTH& HUMAN SERVICES Off Ice of Inspector Genera! 5 * 3 +4 c * 2*,4,0 MAR2519% Memorandum Date. %A4.@7- June Gibbs Brown From (& Inspector General Subject Cost to
More informationSTATE OF NEW JERSEY DEPARTMENT OF BANKING AND INSURANCE. from the Medical Malpractice Liability Insurance Premium Assistance Fund (the Fund ) in
ORDER NO. A05-122 STATE OF NEW JERSEY DEPARTMENT OF BANKING AND INSURANCE IN THE MATTER OF THE MEDICAL ) MALPRACTICE LIABILITY ) DECISION AND ORDER INSURANCE PREMIUM ASSISTANCE ) FUND - PREMIUM SUBSIDY
More informationDuration: Two class periods (with several days to complete the interview)
Assignment Discovery Online Curriculum Lesson title: Careers in Health Grade level: 6-8 Subject Area: Health Duration: Two class periods (with several days to complete the interview) Objectives: Students
More informationIHCP Provider Enrollment Provider Type and Specialty Matrix
Type and Specialty Matrix Specialty Codes In-State Out-of-State (OOS) 01 Hospital 010 Acute Care 011 Psychiatric (distinct part or unit) 012 Rehabilitation (distinct part or unit) 01 Hospital 011 Psychiatric
More informationPhysician Assistants 2012 Survey
Vermont Department of Health Physician Assistants 2012 Survey Statistical Report 2012 Physician Assistants Survey Statistical Report State of Vermont Peter Shumlin, Governor Agency of Human Services Douglas
More informationTo cc bcc. chris.cochran@unlv.edu. Subjects: malpractice reform
ProQuest 08/22/2006 06:09 PM To cc bcc Subject chris.cochran@unlv.edu malpractice reform The following document has been sent by chris cochran at UNIVERSITY OF NEVADA LAS VEGAS
More informationAnesthesia Malpractice - Patterns from the ASA Closed Claims Project (ACS)
Posner KL: Data Reveal Trends in Anesthesia Malpractice Payments. ASA Newsletter 68(6): 7-8 & 14, 2004. Full Text Early results from the ASA Closed Claims Project showed that payments in anesthesia lawsuits
More informationSurvey PRACTICE AND COMPENSATION EXPECTATIONS FOR PHYSICIAN ASSISTANTS. 800.780.3500 mdainc.com
Survey PRACTICE AND COMPENSATION EXPECTATIONS FOR PHYSICIAN ASSISTANTS 800.780.3500 mdainc.com Overview OBJECTIVE The objective of this survey was to collect and quantify practice and compensation expectations
More informationOHIO STATE MEDICAL ASSOCIATION HOUSE OF DELEGATES
Addressing Safety & Regulation in Medical Spas WHEREAS, Medical spas, which are facilities that offer cosmetic procedures such as laser hair removal, dermal fillers, and botulinum toxin injections in a
More informationThe Facts About Medical Malpractice in Pennsylvania Congress Watch March 2004
The Facts About Medical Malpractice in Pennsylvania Congress Watch March 2004 Public Citizen s Congress Watch i Medical Malpractice in Pennsylvania Executive Summary Section I: Lawsuits Are Not Responsible
More informationJanuary 13, 2016. Lois M. Nora MD JD MBA President and CEO American board of Medical Specialties. Dear Dr. Nora,
January 13, 2016 Lois M. Nora MD JD MBA President and CEO American board of Medical Specialties Dear Dr. Nora, CMSS is pleased to comment on the proposed ABMS Standards for Focused Expertise. We have uploaded
More informationCHS INSURANCE PROFESSIONAL LIABILITY HANDBOOK
CHS INSURANCE PROFESSIONAL LIABILITY HANDBOOK 2009 HISTORY OF CHS PROFESSIONAL LIABILITY INSURANCE In 1980 Hartford Hospital developed a professional liability insurance program with the Aetna Life and
More informationMcLAUGHLIN & ASSOCIATES GEORGIA PHYSICIAN SURVEY DECEMBER 11, 2013
McLAUGHLIN & ASSOCIATES GEORGIA PHYSICIAN SURVEY DECEMBER 11, 2013 1. ARE YOU A CURRENT MEMBER OF THE MEDICAL ASSOCIATION OF GEORGIA, ALSO KNOWN AS MAG? YES 46.5 NO 48.4 DK/REFUSED 5.1 2. HAVE YOU EVER
More information(A) Information needed to identify and classify the hospital, include the following: (b) The hospital number assigned by the department;
3701-59-05 Hospital registration and reporting requirements. Every hospital, public or private, shall, by the first of March of each year, register with and report to the department of health the following
More informationPhysician Practice Acquisitions
Trend Watch: Physician Practice Acquisitions Tracking Which Physician Practices Hospitals are Acquiring Introduction Are hospitals actively acquiring physician practices? If so, which specialties? In this
More informationDataWatch. Exhibit 1 Health Care As A Percentage Of The GNP, 1965-85
DataWatch National Medical Care Spending by Gerard F. Anderson In 1985, the United States spent 10.6 percent of the gross national product (GNP) on health care, continuing a trend of devoting an increasing
More informationMASSACHUSETTS MEDICAL SOCIETY. Investigation of Defensive Medicine in Massachusetts. November 2008
MASSACHUSETTS MEDICAL SOCIETY Investigation of Defensive Medicine in Massachusetts November 2008 Current Environment It is estimated that medical liability premiums in the United States have reached an
More informationHospital-Based Physicians- Independent Contractor or? - Barry H. Frank, Esq.
Hospital-Based Physicians- Independent Contractor or? - Barry H. Frank, Esq. The attack by the Internal Revenue Service on the classification of workers who operate as independent contractors has continued
More informationNovember 6, 2013. Dear Administrator Tavenner:
November 6, 2013 Marilyn B. Tavenner Administrator Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services Hubert H. Humphrey Building, Room 445-G 200 Independence Avenue,
More informationMarkle Survey: Demographics of Public and Doctors Surveyed
Markle Survey: Demographics of Public and Doctors Surveyed January 2011 Markle Survey on Health In a Networked Life General Comparisons Between the Public and Doctors Surveyed Age : Doctors 90% 80% 70%
More informationAnalysts and policymakers have noted the potential for electronic
DataWatch Which Physicians And Practices Are Using Electronic Medical Records? Survey data show limited use of these information tools. by Catharine W. Burt and Jane E. Sisk ABSTRACT: Greater use of electronic
More informationDecember 21, 2012. The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Washington, DC 20510
December 21, 2012 The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Washington, DC 20510 The Honorable Mitch McConnell Republican Leader U.S. Senate S-230 U.S. Capitol Washington,
More informationPerspectives: A Nurse Anesthetist
Perspectives: A Nurse Anesthetist by Jeffery M. Beutler Nurse anesthesia became a formal specialty in the United States in the latter part of the nineteenth century as a result of the dismal morbidity
More informationAppendix I: Description of 32 Direct Physician Surveys of Defensive Medicine Reviewed by OTA
Appendix I: Description of 32 Direct Physician Surveys of Defensive Medicine Reviewed by OTA 149 Sample Author, year of release Survey year location Specialty Survey characteristics (percent) Porter, Novelli
More information2012 Physician Specialty Data Book. Center for Workforce Studies. November 2012. Association of American Medical Colleges
Center for Workforce Studies November 2012 Association of American Medical Colleges Table of Contents Introduction... 1 Acknowledgments... 1 Key Findings... 2 Key Definitions... 3 Commonly Used Acronyms...
More informationCERTIFICATE OF MEMBERSHIP FOR NON-JUA MEMBERS EXCESS PROFESSIONAL LIABILITY INSURANCE ASSESSABLE
Membership # SC Medical Malpractice Patients Compensation Fund Application for Membership Agreement PO Box 210738 - Columbia, SC 29221-0738 Tel# (803) 896-5290 Fax# (803) 896-5294 General Information CERTIFICATE
More informationDataWatch. Administrative Medicine: A New Medical Specialty?
DataWatch Administrative Medicine: A New Medical Specialty? by David A. Kindig and Santiago Lastiri The growing complexity of the health care system in the United States and the importance of balancing
More informationCOMPARISON GUIDE TO MARYLAND MEDICAL PROFESSIONAL LIABILITY INSURANCE RATES
COMPARISON GUIDE TO MARYLAND MEDICAL PROFESSIONAL LIABILITY INSURANCE RATES l~m-$! J INSURANCE ADMINISTRATION Comparison Guide to Maryland Medical Professional Liability Insurance Rates How to Shop for
More informationMedical Malpractice Insurance Policy
Proposal Form Medical Malpractice Insurance Policy ADNIC is a Public Joint Stock Company incorporated in the United Arab Emirates by Law No. (4) of 1972, and it is governed by the provisions of the UAE
More informationThe most discussed malpractice reform
Tr ends Trends Malpractice Premiums In Massachusetts, A High-Risk State: 97 To If any state has a crisis, Massachusetts should, yet s were lower in than in 99 for nearly all physicians. by Marc A. Rodwin,
More informationGovernment of Nunavut Department of Health. 2012/2013 Annual Report on the Operation of the Medical Care Plan. From the Director of Medical Insurance
Government of Nunavut Department of Health 2012/2013 Annual Report on the Operation of the Medical Care Plan From the Director of Medical Insurance Page 1 of 6 Legislative Authority Legislation governing
More informationComparison Guide to Maryland Medical Professional Liability Insurance Rates
Comparison Guide to Maryland Medical Professional Liability Insurance Rates How to Shop for Medical Professional Liability Insurance Do comparison shopping. Comparison shopping is the key to getting the
More information2010 Physician Sentiment Index Taking the Pulse of the Physician Community. athenahealth & Sermo February 2010
2010 Physician Sentiment Index Taking the Pulse of the Physician Community athenahealth & Sermo February 2010 Contents Introduction Methodology Key Insights Results Appendix 2 Introduction As the country
More informationWhich physicians and practices are using electronic medical records?
Which physicians and practices are using electronic medical records? Catharine W. Burt, Ed.D. Chief, Ambulatory Care Statistics Branch July 19, 2006 The HIT Symposium U.S. DEPARTMENT OF HEALTH AND HUMAN
More informationEXHIBIT 3 SPECIALTY CLASSIFICATION CODES FOR PHYSICIANS, SURGEONS AND OTHER HEALTH CARE PROVIDERS (JUA)
EXHIBIT 3 SPECIALTY CLASSIFICATION FOR PHYSICIANS, SURGEONS AND OTHER HEALTH CARE PROVIDERS () CLASS 005 PHYSICIANS - NO SURGERY 00534 Administrative Medicine No Surgery 00508 Hematology No Surgery 00582
More informationHealth Workforce Analysis Program
Office of Rural Health and Primary Care Health Workforce Analysis Program Greater Minnesota Health Professional Demand Survey 2008 Highlights At the beginning of 2008, hospitals and clinics in Greater
More informationIowa Medical Group Management Association. Medical Malpractice Interim Committee October 5, 2005
Iowa Medical Group Management Association Medical Malpractice Interim Committee October 5, 2005 The Iowa Medical Group Management Association (IMGMA) is a non-profit organization of approximately 600 members
More informationMutual Company since 1976 14,000+ Physicians Plus Employed Health Care Providers (ie. NP, PA, CRNA) and Practice Entities Licensed in 9 states
Underwriting Administration Copyright 2013 State Volunteer Mutual Insurance Company SVMIC History Mutual Company since 1976 14,000+ Physicians Plus Employed Health Care Providers (ie. NP, PA, CRNA) and
More informationCatlin Underwriting Agency, U.S., Inc. 1330 Post Oak Blvd. Ste 2325 Houston, TX 77056
Catlin Underwriting Agency, U.S., Inc. 1330 Post Oak Blvd. Ste 2325 Houston, TX 77056 CORPORATE EMERGENCY ROOM / AMBULATORY CARE MEDICAL PROFESSIONAL UNDERWRITING QUESTIONNAIRE AND APPLICATION FOR PROFESSIONAL
More informationLeague of Women Voters. November 20, 2012
League of Women Voters November 20, 2012 Palo Alto Medical Foundation Multi-Specialty Medical Group for past 82 years. Outpatient Medical Centers not a hospital Community based, not-for-profit Physician-led
More informationMABEL. Medicine in Australia: Balancing Employment and Life. Doctor Enrolled in a Specialty Training Program (Specialist Registrar)
W5C Mabel username id: Please write id shown on letter if different from id above MABEL Medicine in Australia: Balancing Employment and Life 0 Doctor Enrolled in a Specialty Training Program (Specialist
More informationGAO MEDICARE. HCFA Can Improve Methods for Revising Physician Practice Expense Payments
GAO United States General Accounting Office Testimony Before the Subcommittee on Health, Committee on Ways and Means, House of Representatives For Release on Delivery Expected at 12:00 Noon Tuesday, March
More informationPLATINUM BUSINESS CORPORATION
Department of Veterans Affairs Federal Supply Service Authorized Federal Supply Schedule Price List Effective Date: 15 November 2011 On-line access to contract ordering information, terms and conditions,
More informationKanCare Managed Care Organization Network Access as of July 31, 2015
Provider Type Amerigroup Kansas, Inc. Providers/ Locations % Covered (Urban & Semi-Urban) Average Distance to Provider (Urban/ Semiurban) % Covered (Rural/ Frontier) Average Distance to Provider (Rural/Frontier)
More informationMarch 5, 2014. The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Building Washington, DC 20510
March 5, 2014 The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Building Washington, DC 20510 The Honorable Mitch McConnell Republican Leader U.S. Senate S-230 U.S. Capitol Washington,
More informationNew York state medical malpractice coverage premiums
T H E F A C T S A B O U T New York state medical malpractice coverage premiums 2013-2014 standard medical malpractice premium rates Rochester area counties Internal medicine $7,185 General surgeon $26,861
More informationSubmission to the Private Health Insurance
Submission to the Private Health Insurance Consultations 2015-16 The AMA welcomes the opportunity to provide a submission to the Private Health Insurance Consultations 2015-16. The Review will no doubt
More information2009 REVIEW OF PHYSICIAN AND CRNA RECRUITING INCENTIVES
2009 REVIEW OF PHYSICIAN AND CRNA RECRUITING INCENTIVES 2009 Merritt Hawkins & Associates 5001 Statesman Drive Irving, Texas 75063 (800) 876-0500 MerrittHawkins.com SUMMARY REPORT 2009 REVIEW OF PHYSICIAN
More informationPolicy Research Perspectives
Policy Research Perspectives New Data On Physician Practice Arrangements: Private Practice Remains Strong Despite Shifts Toward Hospital Employment By Carol K. Kane, PhD and David W. Emmons, PhD Abstract
More informationMGMA PROVIDER COMPENSATION 2015
Physicians Allergy/Immunology 203 86 Anesthesiology 2,146 120 Anesthesiology: Pain Management 127 59 Cardiology: Electrophysiology 327 126 Cardiology: Invasive 424 148 Cardiology: Invasive-Interventional
More informationThe level of health care spending continues to make headlines,
DataWatch The Concentration Of Health Expenditures: An Update by Marc L. Berk and Alan C. Monheit Abstract: An earlier study tracing trends in health spending from 1928 to 1980 found health expenditures
More informationMarch 28, 2012. Dear Acting Administrator Tavenner:
March 28, 2012 Marilyn B. Tavenner Acting Administrator U.S. Department of Health and Human Services Hubert H. Humphrey Building, Room 445-G 200 Independence Avenue, SW Washington, DC 20201 Dear Acting
More informationList of Australian Recognised Medical Specialties
List of Australian Recognised Medical Specialties The List of Australian Recognised Medical Specialties includes those organisations, specialties and qualifications that are recognised as medical specialties
More informationWas the growth in physician
DataWatch Trends In Physician Income by Gregory C. Pope and John E. Schneider Now is a particularly appropriate time to examine trends in physician income. The federal Medicare program has begun the transition
More information2013 Physician Inpatient/ Outpatient Revenue Survey
Physician Inpatient/ Outpatient Revenue Survey A survey showing net annual inpatient and outpatient revenue generated by physicians in various specialties on behalf of their affiliated hospitals Merritt
More informationAmerican the. Allergy. March 2012. Prepared by: The. Studies. of New York One. University (518) 402-02500. Jean. distribution,
American Academy of Allergy Asthma and Immunology Report on the Allergy and Immunology Physician Workforce, 1999-2009/10 March 2012 Prepared by: The Center for Health Workforce Studies School of Public
More informationHEALTHCARE PROVIDERS INSURANCE EXCHANGE APPLICATION FOR HPIX MEMBERSHIP AND INSURANCE
Name (First, Middle Initial, Last) Home Address (Include City, State, Zip) HEALTHCARE PROVIDERS INSURANCE EXCHANGE APPLICATION FOR HPIX MEMBERSHIP AND INSURANCE MD DO Social Security Number: Gender: M
More informationWCIRBCalifornia. Report on 2011 California Workers Compensation Losses and Expenses. Released: June 25, 2012
Workers Compensation Insurance Rating Bureau of California Report on 2011 California Workers Compensation Losses and Expenses Released: June 25, 2012 WCIRBCalifornia WCIRB California 525 Market Street,
More informationIHCA Submission on Clinical Indemnity to the Joint Committee on Health and Children
IHCA Submission on Clinical Indemnity to the Joint Committee on Health and Children Thursday 22 nd January 2015 1 I thank the Chairman and other members of the committee for the opportunity to address
More informationINDUSTRY PERSPECTIVES
INDUSTRY PERSPECTIVES Behavioral Health: Staying ahead of the shortage As the demand for behavioral health professionals increases, facilities should consider what implications this may have on facility
More informationLess than zero: The effect on clinics of raising MICRA s $250,000 cap
Less than zero: The effect on clinics of raising MICRA s $250,000 cap By Jay Angoff This white paper addresses the effect on Community Health Centers of increasing California s $250,000 limit on compensation
More informationHEALTHCARE FACILITY LIABILITY APPLICATION HEALTHCARE FACILITY LIABILITY APPLICATION
390 S. Woods Mill Rd. Suite 125 Chesterfield, MO 63017 T: 314-523-3650 F: 314-523-3685 HEALTHCARE FACILITY LIABILITY APPLICATION DATE: Thank you for considering Berkley Medical Excess Underwriters as your
More informationMIEC. What to Look for. A buyer s guide. for Physicians. Medical Insurance Exchange of California. Professional
Professional Liability Insurance What to Look for MIEC MIEC Medical Insurance Exchange of California 6250 Claremont Avenue Oakland, California 94618 800-227-4527, 510-428-9411 www.miec.com A buyer s guide
More informationhttp://www.bls.gov/oco/ocos014.htm Medical and Health Services Managers
http://www.bls.gov/oco/ocos014.htm Medical and Health Services Managers * Nature of the Work * Training, Other Qualifications, and Advancement * Employment * Job Outlook * Projections Data * Earnings *
More informationBest... MRHC. of Both Worlds. McAlester Regional Health Center
Best... of Both Worlds MRHC is a 197 bed not-for-profit health care facility approved and recognized by JCAHO, American College of Radiology, College of American Pathologists and the Commission on Accreditation
More informationREPORT TO THE 2015 LEGISLATURE. Report on Findings from the Hawai i Physician Workforce Assessment Project
REPORT TO THE 2015 LEGISLATURE Report on Findings from the Hawai i Physician Workforce Assessment Project Act 18, SSLH 2009 (Section 5), as amended by Act 186, SLH 2012 January 2015 Hawai i Physician Workforce
More informationMarch 16, 2015. The Honorable John A. Boehner Speaker U.S. House of Representatives 232 U.S. Capitol Washington, DC 20515. Dear Speaker Boehner:
March 16, 2015 The Honorable John A. Boehner Speaker U.S. House of Representatives 232 U.S. Capitol Washington, DC 20515 Dear Speaker Boehner: The undersigned state and national medical associations strongly
More informationProfessional Liability Insurance Program of the Japan Medical Association
JMA Policies Professional Liability Insurance Program of the Japan Medical Association JMAJ 50(5): 390 396, 2007 Katsuyuki KINOSHITA* 1 Introduction The shortage of physicians has become a social issue
More information