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He attributed the declines to tort reform passed in 2002, including a $350,000 noneconomic damages cap in medical malpractice cases. Since then, the number of lawsuit filings has gone down and competition among liability insurers has increased, he said.
Legal reforms such as Nevada’s have probably contributed to the overall decrease in lawsuit frequency and payout severity across the country, Mr. Karls said. Patient safety initiatives and better risk management within medical practices also may be having an impact.
Chad Karls
It remains to be seen how the Affordable Care Act will affect medical liability premiums. So far, industry analysts have not seen a definitive impact on medical malpractice insurance rates from the law, Mr. Karls said. The law could ultimately help lower liability claims if the ACA results in more proactive, preventive approaches to medical errors and less acute care, but in the short term, more patients covered under the ACA could mean a rise in lawsuits and, thus, premiums.
There are “more people getting care from the same number of health providers,” he said. “That puts additional pressure on an already strained system. Short term, the impact of the ACA could lead to additional [malpractice] claims.”
As for states with extremely high insurance rates, Dr. Volker does not see premium relief any time soon. He expects the trend of practice mergers and acquisitions to continue as more physicians seek to escape high premium costs and regulatory burdens.
“I think what you’re going to see in the hotbeds is more migration,” said Dr. Volker, who is licensed to practice in Nevada, California, Florida, and Arizona. “More doctors [will be] giving up their individual practices and joining larger groups.”
The MLM survey, published in October, gathered July 1 premium data from the major medical malpractice insurers and examines rates for mature, claims-made policies with $1 million/$3 million limits for internists, general surgeons, and ob.gyns.
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