The Affordable Care Act and Increased Medical Malpractice Exposures
While there are still issues to be worked out with the Affordable Care Act (aka ObamaCare), to date there are two million individuals who have signed up for coverage and it is hoped that millions more will be enrolling. The ACA is intended to provide all Americans with greater access to quality and affordable healthcare (including preventive care, family planning, and other services) while also fundamentally transforming the delivery mechanism of insurance and healthcare system. How this all plays out remains to be seen, but one facet of all the new provisions is the effect it will have on physicians and other healthcare providers and the potential for increased medial malpractice exposures.
Following are several of the issues as a result of the ACA that could result in a rise in medical malpractice lawsuits against doctors and others in the healthcare field:
- More insureds mean more patients. As more individuals obtain insurance, patient demand will increase, with a physician’s practice becoming busier. Physicians have to be ready with the staff and time to handle the increased volume so that errors don’t occur in providing their services and treatments.
- Payment issues. Many of the plans offered through health insurance exchanges include high deductibles, which will result in patients taking more responsibility for their healthcare costs. As the practice steps up its patient payment collection efforts, patient relations could become strained, which could increase the likelihood of a malpractice lawsuit.
- Non-physician providers. As more patients obtain coverage and as the physician shortage increases, more practices are likely to hire non-physician providers, such as nurse practitioners and physician assistants. It’s critical then that the practice continues to remain in compliance with the scope of its regulations and supervises these individuals appropriately.
- New partners. Many health reform initiatives, such as Accountable Care Organizations (ACOs), require physicians to form new partnerships with other healthcare systems and physicians. The objective of an ACO is to improve the quality of care patients received by providing coordinated care to help prevent repeat and extended hospital stays. In establishing an ACO, there are exposures to those who form the ACO, including Directors & Officers Liability, Errors & Omission Liability, and Cyber Liability. For example, whether through direct employment, provider service agreements, or loose affiliations, a key component of the transition to accountable care is the integration and alignment of physicians with hospitals. Depending on the nature of their agreements with physicians, hospitals and the ACOs in which they participate could face added risks, notably medical professional liability (medical malpractice) exposures.
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