Integris Group Board President/Chairman to Retire, Company Announces Successor

October 26, 2023 by matray

Integris Group announced today that the president and chairman of its Board of Directors, John Hornby, MD, will be retiring from both the practice of medicine and his role on the Integris Group Board of Directors on Oct. 31, 2023. Succeeding Hornby will be Mark D’Agostino, MD, whose term will begin on Nov. 1, 2023.

“The impact that Dr. Hornby has had on this company is unmistakable,” said Stephen J. Gallant, Integris Group chief executive officer. “His insights, leadership and steadfast guidance have led Integris to many years of growth — from a footprint standpoint as well as through the constantly evolving benefits and comprehensive coverage provided to our member physicians.”

Hornby joined the Integris Group (then CMIC) Board of Directors in 2006 and has been president and chairman since 2017. He also previously served as vice president of the Integris RRG Board of Directors.

“On behalf of the Company, I want to express our gratitude for Dr. Hornby’s decades of dedicated service to our policyholders and wish him all the best in his well-deserved retirement,” Gallant said. “We look forward to continuing his legacy of strategic growth, with a central focus on supporting our physician members, in the years to come.”

D’Agostino was elected president and chairman by the Integris Group Board of Directors at the September Board Meeting. He has been serving on the Integris (and prior to that, CMIC) Board of Directors since 2009. Formerly the board's treasurer and chair of the Finance & Audit committee, D’Agostino was also a member of the Governance, Claims and Executive Committees.

“Dr. D’Agostino brings a wealth of knowledge and experience to the President and Chairman role,” Gallant said. “His longevity with the company, as both a policyholder and a board member, combined with his strategic vision for the future, makes him the ideal person to lead Integris in our continued expansion.”

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Integris Group Promotes Clifton P. Render to Vice President of Information Technology

October 17, 2023 by matray

Integris Group announced that Clifton P. Render has been promoted to vice president of information technology.

“Clif’s leadership has been instrumental in accomplishing our strategic goals for the information technology department,” said Kirk Tweedy, Integris Group chief operating officer. “His management of an extensive data migration project, culminating in a new policy management system, and the implementation of new reporting software has both enhanced the level of data we have access to as a company and also streamlined many of our internal processes, enabling us to better serve our growing membership population.”

Before joining Integris Group in 2021 as its director of information technology, Render served as director of enterprise architecture and corporate development at ProAssurance Corp. Prior to that, he held a variety of leadership positions in the technology field.

Mr. Render earned a Bachelor of Science in Computer Science and Speech Communications from Troy University. Additionally, Mr. Render holds a Master of Engineering in Information Engineering and Management from the University of Alabama at Birmingham.


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Medical Liability Monitor’s 2023 Annual Rate Survey Indicates a Medical Professional Liability Insurance Market Reaching Maturity

October 5, 2023 by matray

The Medical Liability Monitor Annual Rate Survey has been cataloging and analyzing medical professional liability insurance base-rates since 1991. The only source for benchmarking medical malpractice insurance rate data, this year’s Annual Rate Survey publishes premium rates effective July 1, 2023, indexed by state and county territory.

Chicago — After years of questioning when the medical professional liability (MPL) insurance market would respond to a string of underwriting losses with hardening rate increases, the 2023 Medical Liability Monitor Annual Rate Survey asks whether the MPL market may have reached maturity — a market where supply meets the demand price, and the primary goal is to retain customers and defend market share, stable profits and excess working capital.

Despite 2022 marking the ninth consecutive year the MPL industry posted an underwriting loss, results from this year’s Annual Rate Survey indicate that the rising rate trend that began in 2019 subsided slightly between 2022 and 2023. The average overall rate change for 2023 was approximately +1.6%, slightly more than half of the +3% reported in 2022. While 35% of the reported base-rates increased in 2023, this marked a subtle 2% decrease when compared to last year’s Survey results. And significant shifts occurred within the ranges of those rate increases. Specifically, increases in the 10% to 24.9% range dropped from 10% of all rates in 2022 to 4% in 2023, while increases in the 0.1% to 9.9% range rose from 27% to 31%.

Upon investigating rate filings at various departments of insurance, Annual Rate Survey authors found many companies requested rate increases significantly lower than what was indicated necessary to balance premium intake with losses, underwriting expenses and underwriting profit. It seems companies are happy to take modest rate increases and enjoy reasonable profits over adequate rate pricing.

“If the key objectives for today’s MPL companies are to retain customers while making stable profits, then most have met these goals and the dampened pricing levels we see in 2023 should be expected to continue,” said Bill Burns, Annual Rate Survey editor and Medical Professional Liability Association vice president of research and analytics. “However, there always exists the possibility that external forces could act upon the industry that necessitate restorative behaviors that include raising rates. Until such a time, it is unlikely we will see a significant jump in pricing that — based on information submitted in rate filings — appear necessary.”

In addition to its catalog of mature, base-rate premiums from every MPL insurer of significance — listed by state and county — this year’s Annual Rate Survey gives insights into:
• The average overall percentage of premium rate changes for the MPL insurance industry to see how your rates compare. • Average rate change by specialty — internal medicine, general surgery and OB/Gyn.
• Why MPL insurers will have to rely on improvements in accident-year loss ratios to generate improvement in their combined ratio. • Pricing trends by geographic region with specifics about the rate movement in your area.
• What the MPL industry’s performance in key financial metrics, such as combined ratio, return on equity, loss reserve margins, policyholder surplus and investment income, says about the market’s overall health and direction.
• Why 2022 and 2023 rate increases are comparable to those at the end of the last hard market in 2006.
• How other segments of the MPL market (hospitals, other/ancillary professionals, other facilities and nursing homes) are faring under current market conditions.
• How reinsurers view the MPL market.
• …and much more!

To order your copy of the Medical Liability Monitor Annual Rate Survey, please visit or call 312-944-7900.

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Curi Holdings, Inc. & Constellation, Inc. Complete Merger

October 3, 2023 by matray

Editor’s note: A longer article featuring exclusive interviews with Curi and Constellation executives will appear in the November 2023 issue of Medical Liability Monitor.

Curi Holdings and Constellation today reported the closing of their previously announced merger. With merger effectiveness, the combined company now operates under the name Curi, creating a national brand that seamlessly delivers the products, services and valued advice that healthcare providers need to thrive.

With more than $2 billion of consolidated assets and nearly $400 million in revenue, the merger builds on each company’s legacy of mutual ownership, client service and innovation to create an even stronger combined company. The merged organization now serves more than 50,000 physicians, healthcare providers and organizations across the U.S.

“We are proud to announce the completion of our merger with Constellation and even more excited for our collective future,” said Jason Sandner, Curi’s chief executive officer. “This merger represents strategic growth and investment in our company, our offerings, and our team, so that we can continue delivering on our ultimate vision—to be the trusted partner that physicians, healthcare organizations, and their families call on to drive success in their professional and personal lives.”

Both Curi and Constellation had been seeking organic and strategic growth opportunities with like-minded companies sharing aligned cultures, values and a commitment to clients. According to the two companies, the combined company carries forward a shared dedication to disciplined underwriting, proactive risk mitigation and supportive claims management in the insurance space, underscoring a deep commitment to defending good medicine. Recent investments in complementary service lines, such as wealth management, healthcare consulting and proprietary technology platforms, have also strengthened the combined company’s portfolio.

“Our clients are at the heart of everything we do, and the scale, scope and strength gained with this merger are important for keeping pace with those we serve,” said Ryan Crawford, Constellation’s former president and CEO. “The national reach of our combined organization, coupled with the expertise and localized presence of our team, will allow us to meet healthcare leaders and organizations where they are today and support them in where they want to go tomorrow.” The merger received approval from the Curi and Constellation Boards of Directors, the member-owners for both companies and all necessary regulatory bodies. The insurance company subsidiaries of Curi and Constellation are now operating under Curi’s consolidated mutual holding company, such that the policies held by their insureds will remain in force. Effective Oct. 1, 2023, Sandner continues as CEO of Curi, the consolidated mutual holding company. Crawford is now CEO of the merged Curi Insurance business. In addition, the 10 directors serving on each company’s board at closing have come together in equal representation to govern as the Board of Directors of the combined company.    

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MedPro Group Endorses I-PASS as Trusted Patient Safety, Risk Management Solution

September 26, 2023 by matray

MedPro Group endorsed I-PASS as a trusted patient safety and risk management solution for reducing communication-related medical errors. The endorsement signifies a shared commitment between MedPro Group and I-PASS to reduce communication-related adverse events that contribute to patient harms.

According to data recently published in the Journal of Patient Safety, 49% of medical malpractice claims involve miscommunication. The I-PASS handoff bundle is designed to address the issue of care transition miscommunication by providing a structured framework for reliable handoffs. Hospitals and health systems that have implemented the I-PASS handoff methodology have successfully reduced handoff-related harms by 76%, preventing more than three million major and minor safety events.

“We’re honored to receive this vote of confidence from MedPro, an organization that has long recognized the severity of miscommunication in patient care and the importance of improving patient safety,” said William Floyd, CEO of I-PASS. “This partnership enables us to offer our solution to hospitals that share our mission of achieving zero patient harm.”

“Errors in patient handoffs are a tremendous issue across the industry,” said Graham Billingham, MD, chief medical officer of MedPro Group. “We believe organizations that leverage I-PASS can begin addressing the root cause of miscommunication to improve patient safety and decrease liability exposure. We look forward to seeing the impact that I-PASS will have in optimizing clinician communication and elevating the standard of care.”

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LAMMICO Awards 2022-2023 Patient Safety Award & Grant to St. Bernard Parish Hospital

September 25, 2023 by matray

LAMMICO awarded its 2022-2023 Patient Safety Award and Grant to St. Bernard Parish Hospital (SBPH) in Chalmette, La., for its work preventing central line-associated bloodstream infections (CLABSI). Healthcare providers had been making strides in reducing infections associated with central lines; however, in the third quarter of 2020, the CDC reported a 53% increase in the number of CLABSI, compared to the same group of hospitals in 2019. Of all the hospital-associated infections, the CLABSI rate increased the most. The heightened CLABSI incidence is likely attributed to a lack of infection prevention activities involving central line insertion and maintenance practices.

Grant applicants completed an educational activity, “Central Line-Associated Bloodstream Infection (CLABSI) Prevention,” in LAMMICO’s learning management system. This program provided an overview of strategies to help prevent CLABSIs, and the associated consequences.

By demonstrating the best improvements (in policies, procedures, protocols and/or processes) related to a reduction in CLABSI after completing this risk management and patient safety education, St. Bernard Parish Hospital was awarded a $10,000 grant for nursing development and a one-year risk manager membership to the American Society for Healthcare Risk Management (ASHRM).

Some of the steps taken by the team at SBPH to reduce CLABSI rates included performing a Failure Mode Effects Analysis, making an action plan (decreasing the use of central lines, ensuring proper infection prevention strategies, improving the CLABSI prevention bundle element compliance, and improving organizational infection prevention practices). LAMMICO’s education was a major component in the process. They demonstrated success in all components of their action plan. In addition, SBPH included their medical staff in the process and celebrated their success with staff in a variety of ways.

St Bernard Parish Hospital also won the LAMMICO Patient Safety Award and Grant in 2021 that focused on preventing catheter-associated urinary tract infections (CAUTIs).

  St. Charles Parish Hospital in Luling, La., placed second for the Patient Safety Award and Grant. A grant of $5,000 for nursing professional development was presented to this hospital in recognition of this honor. St. Charles Parish Hospital recently opened a behavioral health unit that incorporated the treatment of patients’ complex medical conditions. Many patients admitted to this unit had central lines for their medical management. Caring for these lines was a new skill for many of the behavioral health staff and a need for change in their practice was identified. They used LAMMICO’s education as a guide to incorporate the CLABSI prevention bundle and compliance. They were successful in decreasing their CLABSI rate.  

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Medical Liability Monitor September 2023 issue highlights

September 11, 2023 by matray

Below are some headlines and article synopses from the September 2023 issue of Medical Liability Monitor. To read the articles in entirety, please subscribe today.

Connecticut Supreme Court Narrows Scope of COVID Immunity for Medical Liability Claims
The Connecticut Supreme Court last month determined that Gov. Ned Lamont’s pandemic-era executive order, which granted healthcare professionals and healthcare facilities immunity from civil liabilities resulting from care delivered in support of the state’s COVID-19 response during the public health emergency, did not apply in two medical malpractice cases …

Who Pays the Liability Bills When Artificial Intelligence Kills?
Modern AI systems are based on statistical methods. As providers increasingly rely on AI to make critical decisions, its statistical nature guarantees that certain AI systems will not perform as intended on some occasions, leading to more and more AI-related disputes. So, the question of who pays when something goes wrong dominates much of the debate surrounding AI in medicine as well as in other industries. The concept of “wrong” ranges from physical harm to privacy violations to biases that can be more easily perpetuated by AI on social media platforms …

Rate of ‘Serious Discipline’ of Physicians by State Medical Boards Drops from Previous Benchmark
A new analysis of disciplinary actions taken by state medical boards between 2019 and 2021 determined that Michigan disciplined physician misconduct at a higher rate than any other state, but the analysis also indicates an overall decline in the rate of serious disciplinary actions when compared to the rate between 2017 and 2019 …

Indemnity Payments Swell During Second Quarter for MPL Specialty Writers
Indemnity payments for the MPL industry have continued to rise through the second quarter 2023. A composite of MPL writers experienced a prolonged slowdown in indemnity payments for about 18 months from the second quarter 2020 through the third quarter 2021. In the last three quarters, the composite has seen the three largest quarterly indemnity payments on record, with the second quarter 2023 coming in at nearly $775 million. Based on the depth of the decline in indemnity payments after the pandemic started and general severity concerns in the industry, the composite may expect these sizable levels of indemnity payments to persist as the industry tries to dig out of the hole created by the court slowdown that the COVID-19 pandemic caused …

US Senator Questions Google About its AI Healthcare Chatbot Technology
U.S. Sen. Mark Warner, chairman of the Senate Select Committee on Intelligence, urged Google chief executive officer Sundar Pichai to provide greater clarity into his company’s deployment of Med-PaLM 2, an artificial intelligence (AI) chatbot currently being tested in healthcare settings. In a letter sent last month to the multinational technology company, Sen. Warner expressed his concern about reports of inaccuracies in the technology, calling on Google to increase transparency, protect patient privacy and ensure ethical guardrails ...

Is Artificial Intelligence Ready For Healthcare Applications?
What use could healthcare have for someone who makes things up, can’t keep a secret, doesn’t really know anything, and, when speaking, simply fills in the next word based on what’s come before? Lots, if that individual is the newest form of artificial intelligence, according to some of the biggest companies out there. Companies pushing the latest AI technology — known as “generative AI” — are piling on. Google and Microsoft want to bring types of so-called large language models to healthcare. Big firms that are familiar to folks in white coats — but maybe less so to your average Joe and Jane — are equally enthusiastic. Electronic medical records giants Epic and Oracle Cerner aren’t far behind. The space is crowded with start-ups, too …

Subscribe today to get this issue (as well as the 2022 Annual Rate Survey at no additional cost).

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AM Best Affirms A (Excellent) Rating of Mutual Insurance Company of Arizona

September 6, 2023 by matray

Mutual Insurance Co. of Arizona MICA) announced that AM Best has affirmed its Financial Strength Rating (FSR) of A (Excellent) and its Issuer Credit Rating (ICR) of a+ (Excellent) — both with a stable outlook. MICA Risk Retention Group, Inc. also received a rating of A (Excellent), a+ (Excellent) with a stable outlook.

“MICA is proud of its continued financial excellence as exemplified by our approach to business and the ongoing recognition by AM Best,” said Ed Markey, MICA president and CEO. “MICA’s commitment to the independent physicians, advanced healthcare professionals and group practices we cover remains stronger than ever. The people at MICA live our mission every day, and we are committed to bringing value to our members.”

In its rating report, AM Best recognized that MICA maintains the strongest level of risk-adjusted capitalization while maintaining a strong record of distributing policyholder dividends. MICA continues to deliver strong operating results that outperform the medical professional liability composite and the overall property/casualty industry. AM Best also recognized MICA’s significant market knowledge and expertise and its ability to appropriately assess and manage risk.

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Positive Physicians Insurance Co. Appoints Shelly Ursini Senior Vice President of Insurance Services

September 6, 2023 by matray

Positive Physicians Insurance Company announced the strategic appointment of Shelly Ursini as the senior vice president of insurance services, effective immediately. Shelly joins the team with a rich portfolio of experience in insurance services, marketing, underwriting and business development.

Shelly Ursini has more than 18 years of experience in the Medical Professional Liability (MPL) arena. She has served in various capacities on both the broker and carrier sides of the industry. Most recently, she held the position of vice president of marketing and business development at Integris Group where her leadership extended to both business development and underwriting teams, showcasing her versatility and comprehensive understanding of the industry.

Ursini will spearhead Positive's expansion initiatives in the New England region as part of the company's strategic plan to extend its national footprint. Beyond geographical expansion, she will be instrumental in diversifying the portfolio of products and services offered to our insureds, thereby enhancing customer value.

"Shelly is an extraordinary addition to our Senior Leadership Team," said Michael G. Roque, president and CEO of Positive Physicians Insurance Co. "Her extensive leadership and national experience in the MPL industry will be pivotal in executing Positive's strategic vision. We're excited to have Shelly's expertise as we make our forthcoming expansion into the New England territory and the introduction of new, region-specific products and services."

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I-PASS Institute, Coverys Collaborate to Bring Patient Safety Solution to Hospitals Nationwide

September 6, 2023 by matray

I-PASS Patient Safety Institute (I-PASS), an authority on highly reliable clinical handoffs, announced it is working with Coverys to offer a structured communication tool to hospitals nationwide. For more than 15 years, I-PASS has provided hundreds of healthcare institutions with the methodology, platform and training to implement best-in-class clinical handoffs that capture critical patient information, prevent communication breakdowns, and significantly improve patient safety. I-PASS will now be offered to select hospitals at no cost. The funds for this program have been made available through the Coverys Community Healthcare Foundation, Inc., through its Transitions in Care grant program.

Of the hospitals that applied to the grant’s call for nominations, up to three recipients will be selected to participate in the pilot program. The program will offer access to the full I-PASS handoff bundle, hands-on training and EHR integration to help these institutions reduce medical errors that occur due to miscommunication and poor patient handoffs. The grant recipients will be announced in fall of 2023.

A recent analysis by the Joint Commission identified communication breakdowns as the leading cause of sentinel events, which have increased by 78% from 2020 to 2022. With communication breakdowns, handoffs are a particularly vulnerable time for communication failures and can lead to serious or fatal medical errors. Further, hospitals and medical professional liability (MPL) organizations are seeing a steady rise in claims severity and medical malpractice nuclear verdicts. A 2022 study published in the Journal of Patient Safety shows that nearly half of all medical malpractice cases involve miscommunication, 77% of which could be prevented with a proper handoff tool.

“We recognize that in this challenging time in healthcare, proactive strategies are what’s going to drive meaningful change in patient safety,” said Dana Siegal, vice president of risk management and analytics at Coverys. “The Coverys team is committed to being part of this positive progress and bringing highly reliable handoff communications to hospitals to improve care delivery and experience. We’re looking forward to collaborating with I-PASS to bring world-class solutions to our providers.”

“I-PASS and Coverys are deeply aligned on the importance of advancing patient safety and mitigating risk through structured communication,” said William Floyd, CEO of I-PASS. “Seeing all sides of the ecosystem collaborating towards the same mission is heartening. When we implement solutions that are proven to address the root cause of harmful events, we create a higher standard of care and a system where everyone wins.”

The I-PASS handoff method was first established by the I-PASS Study Group – a team of clinicians determined to create a blueprint for safer handoffs that captured often-missed patient information. The I-PASS handoff bundle is a direct result of their cumulative experience and research. The bundle offers a universal structure that enables caregivers across clinical settings to communicate patient information reliably and uniformly. Today, I-PASS Institute coaches and clinical leaders work with hospitals to help them adopt the I-PASS methodology through planning, implementation, training, and ultimately, sustained behavior and positive culture change. The cumulative effect is a more positive care experience for all parties and the opportunity to significantly reduce preventable adverse events.

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