The Agency for Healthcare Research and Quality has awarded $25 million in grants to states and health systems to test various approaches to medical liability reform.
The grant awards follow through on a 2009 promise made by President Obama. In a speech to Congress last September, the president pledged to fund demonstration projects that would look at malpractice reforms that also improve patient safety.
The focus on patient safety is critical, said Dr. Carolyn Clancy, director of AHRQ, because when physicians fear being sued, they are less likely to be open about potential errors, near misses, and avoidable harms, and that's a major hurdle to improving patient safety in any organization. “If you're fearful and you're worried about being sued, that has a very chilling effect on people's willingness to step forward and say 'we have a problem and we need to do something about it,'” Dr. Clancy said during a press briefing.
The awards, which were announced in June, include 3-year grants to states and health systems of as much as $3 million. The $25 million pool also includes 1-year planning grants of as much as $300,000 and a $2 million grant to JBA/RAND Corp. to evaluate the various projects.
Many of the demonstration grants will focus on early disclosure of errors and early offers of compensation, Dr. Clancy said. The aim with early offers is not to short-circuit the system, she added, but to give both physicians and patients relief from a process that often drags on. Another common theme among the grants is to promote better communication among providers, patients, and families.
None of the grants will examine the concept of health courts. Although health courts have been talked about for years and praised as a possible solution by President Obama, none of the grant applicants proposed studying that concept. One project, however, will look at a judge-directed negotiation program that is currently in use in New York in combination with an early disclosure and settlement model.
The results of these tests could lay the groundwork for the additional medical malpractice studies called for under the Affordable Care Act, which authorizes an additional $50 million over 5 years to fund more studies, Dr. Clancy said.
A list of the projects is available at www.ahrq.gov/qual/liability/demogrants.htmandwww.ahrq.gov/qual/liability/planninggrants.htm