The Patient Protection and Affordable Health Care Act (PPAC) may pose a catch-22 to medical professionals hoping to protect themselves against liability lawsuits, according to panelists at a recent Casualty Actuarial Society (CAS) seminar.
The law, which will provide 32 million Americans with access to healthcare in 2014, will pose new challenges to medical and insurance providers as newly insured patients flood a changing health-care delivery system.
“Health care coverage offers no guarantee that someone will have access to health care,” said Kevin Bingham, an Associate of the CAS and principal at Deloitte, at the seminar in which members discussed that more insured patients wouldn't necessarily lead to less emergency-room visits.
While 78 percent of doctors in the late 1970's had their own private practice or shared one with another doctor, Bingham argued, while that number has dropped to 30 percent in 2013 as reduced service reimbursement payments by health insurers make shuttering a practice to work for a hospital more appealing.
“There may be fewer doctors to care for a greater number of patients,” said Brian Ingle, a CAS fellow and executive vice president at Willis Re.
This causes reduced quality of care, which may lead to more lawsuits against doctors and overworked nurses and assistants. Although medical professional liability (MPL) policies now protect doctors against lawsuits that allege doctor negligence or errors and omission that could harm a patient, a drop in private practices, combined with the fact that half of all hospitals self-insure MPL, can impact rates for those who stick by their businesses, the panelists said.
Another contradiction is that as more healthcare practitioners of all sizes begin to rely more on data and IT to record patient lab results, vitals, and progress notes to use in the case they have to defend themselves in a malpractice lawsuits, cyber exposures also increase: for example, a lost laptop containing electronic medical records (EMR) may cost insurers up to $60,000.
Ultimately, however, providing old-fashioned quality care may do the most to prevent insurance complications for doctors.
“A lot of medical malpractice claims go away if there's good customer service,” Bingham stated.
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