What is Forecast for Medical Malpractice due to the Affordable Care Act?

June 22, 2014

The Claims Journal article published 6/12/2014 summarizes the analysis offered by the Casualty Actuarial Society’s seminar in New York “The Impact of the Affordable Care Act on Medical Practice Liability – an Update” that explored the affect of the healthcare reform on medical malpractice claims. The forecast is that medical malpractice claims will increase because there will be about twenty million new insured people many of whom were uninsured prior to healthcare reform. The analysis also concludes that there are many other factors that will result in an increase in claims including:

  • Fewer “Doctor-Patient” interaction
    • An example is the new “Hospitalist” model in which the patient is treated by multiple different physicians. This is part of the Accountable Care Organization (ACO)
    • Affordable Care Act contributes to the rise of the ACO and thus produces different medical malpractice risks – primarily the loss of personal relationship with the doctor
  • ACO promotes standardized treatment methods that may provide adequate care but may also lead to harm.
  • Hospitals, not physicians, will begin to absorb more risk with the increase of the ACOmodel

Additional demographic trends will also result in an increase in medical malpractice claims:

  • Population is aging thus an additional burden on an already overburdened healthcare system
  • Physicians are aging and transitioning to fewer work hours
  • American Obesity continues thus another burden to the healthcare system

With all of these trends, the Casualty Actuarial Society concludes that there will most likely be higher medical malpractice exposure. Therefore, risk management is becoming more and more important.

View the full article at Claims Journal: