In a major victory for the independent practice of medicine and the value-based care movement, a lawsuit brought by The American Hospital Association (AHA) against The US Dept. of HHS* was dismissed on summary judgment.
Whether by mandate or prudent business practice, virtually every physician in the US carries medical professional liability (MPL) insurance. Though some physicians ignore clear warning signs about financially questionable insurance models, the vast majority use specialized advisors and conduct due diligence before purchasing coverage. But...
The COVID-19 pandemic hit on the heels of yet another brutal financial reporting season for the medical professional liability (MPL) insurance industry. Healthcare providers are risking their lives to help others; the last thing they should have to worry about is whether their liability insurer...
The medical professional liability (MPL) insurance market is surprisingly easy to forecast. Pricing policies remains a challenge, as premium coming in today is used to cover losses often years down the road. But it doesn’t take an expert to look at the following graph and figure out where things are headed.
Since peaking around 2007, physician medical professional liability (MPL) insurance rates had been largely declining. Over the past few years though, most MPL companies have been writing business at a “combined ratio” of more than 100% - meaning that they spend more money than they take in.
The medical professional liability (MPL) market has entered a dynamic cycle in which premiums are rising and underwriting mentality is shifting. Many of the nation’s largest, most well financed MPL carriers have announced rate increases over the past 12 months.
A “bundled payment” is a term that refers to a single, global payment for an “episode” of care. Currently, the most common episodes are orthopedic surgical procedures (e.g. hip and knee replacements), but can include a pregnancy, a colonoscopy or even cancer.
Over time, healthcare systems began to make the connection between various areas of risk – even if not readily apparent to laymen. What does an ambulance company and an answering system have to do with a surgeon?
An Appellate Court in NJ recently revisited the affidavit of merit statute, yet again, but this time with a twist. One question before the Court in Skounakis v. Sotillo was whether a physician was qualified to give an expert opinion on a weight-loss treatment suggested by a computer program.
On the day my Uncle John was diagnosed with terminal pancreatic cancer, he made a choice: He would travel the world and celebrate his life right up until the end. He would not undergo radiation or painful chemotherapy.
The US healthcare reimbursement system has endured endless modifications in an effort to reduce its overall cost. As part of an ambitious shift from “volume to value,” several new programs - such as accountable care organizations - have been tested, and have demonstrated mixed results.
In 2012, NFL Hall-of-Fame linebacker Junior Seau tragically committed suicide by shooting himself in the chest. He did so to preserve his brain so that his condition, chronic traumatic encephalopathy (CTE), could be further studied.
The Iowa Supreme Court recently decided that it is a factual question under the informed consent doctrine as to whether surgeons need to disclose their experience to patients prior to performing surgeries.
In July, the OIG issued a report entitled, "Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity." Fifteen recommendations were made by the OIG to CMS, including to..
If there was any question that US Healthcare’s transition from fee-for-service to value-based would continue under the Trump Administration, the US Department of Health and Human Services’ (HHS) report...
Acadia Professional, LLC (Acadia) announces the establishment of a Value Based Care Risk Advisory Board - the first of its kind in the United States. Advisory Board Members will counsel Acadia on the US healthcare reimbursement system’s transition from fee-for-service to “value-based,” and its impact on healthcare risk.