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Cost Reduction through Partnering with Med-Mal Insurance Providers

Posted by Matt Clark on May 15, 2015 8:00:00 AM
Matt Clark

med mal partnership

Medical malpractice is a phrase that makes doctors across the nation blanch. Whether from claims that are justified or frivolous, our society is all too happy to pull the trigger on initiating litigation against health care providers who we feel haven’t done their job correctly.

This trend is why medical malpractice insurance has become a necessity for practicing physicians who wish to safeguard themselves against the exorbitant financial costs that can come from malpractice suits. And while these insurance premiums are often blamed for the rising health care costs in our society, necessary malpractice insurance isn’t leaving any time soon.

However, the witch hunt against big insurance might be misguided, as a new trend of mutually beneficial partnerships between health care providers and insurance companies may promise to improve the quality of patient care and improve healthcare cost reduction. This is a shift from the “us vs. them” mentality towards a culture of collaboration that may provide benefits for all parties involved.

A New Approach to Med-Mal Insurance Partnerships

The paradigm of insurance programs is straightforward enough: good behavior and reliability will result in cost savings by way of lower premiums. This reward-based incentive system has been effective in the past, but functions primarily as a reactive measure that fails to take a proactive approach to patient care.

What if insurance companies could offer percentage-based premium discounts to hospitals that met certain criteria for patient care? Instituting quality and safety specifications would have the dual benefits of increasing the quality of patient care along with reducing the number of claims filed to the insurance company themselves.

Such measures reflect a shift in the perception of what malpractice insurance means and may foster a greater sense of collaboration between insurance distributors and health care facilities.

Insurance companies have the benefit of knowing which departments in their client’s hospitals generate the highest number of claims. Obstetrics often generate the most claims of any department, creating ideal locations for insurance companies to target with incentive programs.

Diagnostics also tend to be a claims magnet, as the initial diagnosis is essential to the patient care experience. If a patient is given an incorrect diagnosis with improper treatment, defending the hospital against a malpractice claim becomes a difficult process. Incentivizing quality care and safety protocols in high-risk departments will typically generate the biggest rewards for hospitals and insurance companies, but will also greatly enhance the quality of the patient experience.

Tech Advantages and Training

To this end, hospitals are beginning to utilize technological strategies aimed at reducing human error and providing broad-spectrum screenings for patients. Web-based platforms are being used that utilize algorithms to determine diagnoses, providing valuable screening tools for physicians. However, for these tools to be effective, proper training and education is essential to prevent mistakes from occurring that leave clinics liable.

Technology may provide the tools, but the staff utilizing them needs to be able to perform and deliver consistently. Clinical simulation training must be employed to guarantee efficiency and consistency on the part of the operators. Technology can go a long way in reducing human error, but only when the humans behind the wheel can operate it effectively.

The Future of Med-Mal Collaboration

Cooperation between insurance providers and health care facilities provides opportunities not found when viewing med-mal insurance as a “necessary evil.” By communicating and assessing the needs of both organizations, healthcare cost reduction can be optimized and the patient care experience can be improved without the need for exceptional changes to infrastructure.

While the shift from the reactive nature of med-mal insurance may be slow to change, hospitals that do their best to provide the best care for their patients will find that fewer claims are filed over time and that costs are reduced for everyone involved.

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