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 https://medicalliabilitymonitor.com/subscribe-now/ or call 312-944-7900.

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.    

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.”

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.  

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).

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

September 6, 2023 by matray

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.

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.

Markel promotes Sal Pollaro to Executive Underwriting Officer for Professional Liability

September 5, 2023 by matray

Markel, the insurance operations within the Markel Group, recently announced that Sal Pollaro has been named executive underwriting officer, professional liability for Markel Specialty, a division within the Markel insurance business. In his new role, Pollaro will lead the professional liability team to generate profitable growth, including establishing underwriting strategies, driving product development, and enhancing technical and analytical capabilities.

“Sal is a proven leader and brings extensive profit and loss management experience, including profitable growth, maximizing marketplace solutions, and ensuring relevant value propositions,” said Jane Peterson, chief underwriting officer for Markel Specialty. “He also places a special emphasis on talent development, which is critical in this business. We look forward to having him lead our professional liability team.”

Pollaro has more 25 years of experience in the insurance industry. He joined Markel in 2009 and most recently served as managing director of management and professional liability for Markel Specialty. He replaces Jim Gray, who retired at the end of May.

“We’re grateful for Jim’s dedication and industry expertise at Markel over the past 25 years,” said Peterson. “His innovation and customer focus are unparalleled. During his time here, Jim made lasting contributions to the professional liability team, mentoring underwriters, and recruiting countless others in the field.”

Pollaro will report to Peterson and is based out of Markel’s New York City office.  

The Cooperative of American Physicians Tops the 13,000 Member Mark, Reaching a New Milestone

September 5, 2023 by matray

The Cooperative of American Physicians, Inc. (CAP) recently announced that its membership has grown to exceed 13,000 California physicians, its largest member count in its 48-year history. The organization’s growth is further contributing to its already strong fiscal position and outlook.

“Independent physicians have endured more than their share of challenges over the past 15 years, marked most recently by the COVID-19 pandemic and the undermining of decades-old tort reforms contained in MICRA,” said CAP Vice President of Membership Development Dan Cavanaugh. “It’s not surprising that more physicians than ever are choosing CAP’s valuable resources, expertise, and unparalleled services to help them maintain their independence and operate safe and successful medical practices.”

To complement the medical professional liability coverage provided through the Mutual Protection Trust (MPT), CAP offers its members a wide range of value-added programs, including a risk management hotline, online risk reduction training, human resources support, practice management consultation, a group purchasing program, business and personal insurance coverages, and many other free or deeply discounted benefits.

“CAP’s membership milestone comes after MPT earned its 16th consecutive A+ (Superior) rating from A.M. Best earlier this year,” said CAP CEO Sarah E. Scher. “These two recent achievements exemplify CAP’s superior financial stability and long-term standing as a formidable leader in the California medical malpractice coverage arena.”

The enterprise began with approximately 500 physician members. Now, with more than 13,000 physician members, MPT is the second-largest provider of medical professional liability coverage in California. CAP credits its robust internal processes, disciplined underwriting and claims management practices, and dedicated risk management programs for its sustained growth and solid financial record.