Malpractice cases, defensive medicine account for 3% of total healthcare spending: 7 things to know

Providers spanning the nation often fear malpractice cases which can be both timely and costly, leading Republican House Speaker Paul Ryan (R-Wis.) and Rep. Tom Price, MD, (R-Ga.)  to say tort reform will be integral to their ACA replacement plan. However, Kaiser Health News reports malpractice may not be as significant an issue as legislators portray.

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Here are seven things to know:

1. A Doctors Company analysis found physicians are paying less money for malpractice insurance than they paid in 2001 without adjusting for inflation.

2. The analysis also found the rate of malpractice claims has decreased by nearly 50 percent since 2003.

3. Literature indicates malpractice cases and defensive medicine comprise nearly 3 percent of total healthcare spending. While this figure is relatively high, research shows implementing stronger legal protections for providers does not necessarily result in changed physician behavior and less costly care, KHN reports.

4. Some Republican lawmakers have proposed legislations that would make it easier for physicians to defend themselves in malpractice cases and increase the burden of proof on allegedly injured patients. Others have advocated for implementing caps on malpractice damages.

5. Dr. Price’s proposed healthcare reform law does not include a cap on damage awards, although he has endorsed Speaker Ryan’s “Better Way” proposal. The Better Way supports California’s move to implement financial limits on malpractice claims, saying limits are effective in increasing access to physicians, specialists and lowering medical liability insurance premiums. Others argue caps may deter some lawyers from taking on cases as the rewards may not surpass the costs associated with trial preparation.

6. Dr. Price  also advanced a proposal featuring clinical practice guidelines for physicians to fight malpractice claims. Experts project the clinical guidelines’ adoption would impact merely 15 percent of malpractice cases, KHN says.

7. Additionally, Dr. Price has proposed implementing a fund of state-run tribunals to rule on injury claims. The proposal would mandate patient to prove their physician engaged in gross negligence. It would also create panels of medical experts to screen cases for merit.

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