The volume of malpractice claims against physicians could increase by 5% as more Americans gain health care coverage and access health services under the Affordable Care Act, according to a study by the RAND Corporation released April 9.
That increase could translate into higher malpractice premiums for physicians, RAND researchers found in a study of the ACA’s impact on all liability insurances.
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The volume of malpractice claims against physicians could increase by 5% as more Americans gain health care coverage and access health services under the Affordable Care Act, according to the study.
"The Affordable Care Act is unlikely to dramatically affect liability costs, but it may influence small and moderate changes in costs over the next several years," said lead author David Auerbach, a policy researcher at RAND. "For example, auto insurers may spend less for treating injuries, while it may cost a bit more to provide physicians with medical malpractice coverage."
RAND investigators theorized that a greater number of insured patients would escalate the rate of malpractice lawsuits because of more procedures, interactions, and visits with physicians. Previous analyses have found the uninsured currently use about half of the care that insured patients do, they said.
To test their theory, the researchers compared National Practitioner Data Bank (NPDB) data on liability claims from 2008 to 2010 to insurance coverage data from the Census Bureau’s American Community Survey (ACS). The results suggested that having insurance coverage is associated with a 2%-10% increase in malpractice activity. Thus, if 10% of a state’s population gains coverage, analysts estimated a 5% rise in malpractice claims.
"This study highlights the far-reaching impacts of the Affordable Care Act," said Jayne Plunkett, head of casualty reinsurance for Swiss Re, an international reinsurance company that sponsored the study. "Businesses and policymakers need to understand how and why their risk profiles might change as the Affordable Care Act is implemented."
But other insurers believe the study results are another uncertain forecast of the ACA’s future effects.
"You’re trying to look through a very cloudy crystal ball in making predictions about the Affordable Care Act," said Frank O’Neil, senior vice president and chief communications officer for ProAssurance, a national medical liability insurer. "There are a number of things that could cause a 5% change in medical liability rates that could happen at the same time as the implementation of the ACA, but be totally unrelated."
For example, if there is a sudden increase in either the frequency or the severity of malpractice claims in a particular state, that could impact the medical liability climate, Mr. O’Neil said. He added that other experts believe that new patients entering the health care system may be so appreciative of previously absent care that they would be reluctant to sue.
"There are a lot of unknowns yet, and I think it’s hard to agree or disagree with a prediction that doesn’t say over what time frame [an increase in claims] would occur," he said. The study "should be taken as just one other prediction."