Ambulatory, Allieds and Chiros

Ambulatory Surgery Centers expand procedures:

Bariatric Procedures, Plastic  and Orthopedic Surgeries are among just some of the 23 Million Surgeries that are performed annually in one of the 5,200 surgery centers in the United States.  There are many medical malpractice insurance companies which specialize in writing professional liability insurance for this class; AIG, One Beacon, Admiral, Allied World, Ironshore, James River and Gen Star to name a few.

With the healthcare landscape continuing to change, the ambulatory surgery class is going to be one of the answers to reducing the cost and increasing the access to health care.  The number of procedures is increasing, so the premium in this class of the healthcare risk world will increase with it. 

How are Ambulatory Surgery Centers rated for malpractice insurance policies:

Ambulatory Surgery Centers are going to play a larger role in the delivery of healthcare;  underwriters are going to ask the following questions to understand and price these policies: types of procedures performed, which specialties and allied assistants are performing the procedures, the number of them and whether the physicians performing the work already have insurance provided by other carriers.  Of course, if there is insurance provided, then the risk and the premium for the ASC is substantially lower; the main risk covered is the  vicarious liability that rises to the corporate entity and the center itself (which is significantly less to cover than protecting the center and the physicians).

Single limit protects physician and the center:

Surgery Centers will need insurance coverage to expand as they take on more procedures and expand  into more rural areas.  The malpractice insurance policies which cover surgery centers also vary depending upon whether the physicians need coverage.    The easiest to insure are the single specialty centers such as gastroenterology, orthopedic, and ophthalmology,  They can be written to include the physicians as well as the center, often providing a single per incident limit shared by the physician and the center.

Patients increasing at Surgery Centers, driving claims:

As the landscape in healthcare changes daily and more procedures are performed at ASC’s, the patient load increases.  As the count increases so does the cost of claims.  Additionally, the general  liability is a growing need.  Slip and Fall claims from post-surgery patients increases.  And, in addition to patient falls,  in the parking lot or off of a stretcher, or wheel chair, the centers are vicariously connected to larger severity claims as the adverse events during procedures performed by the surgeon who shares a limit by a center.

The Surgery Center becomes the primary target in the claim when the allegation is that the center should have been more careful in credentialing the surgeon.  This is a common claim in the theory of medical group, hospital or other outpatient facility entity liability insurance.  The Doctors Insurance Agency will eliminate these costly claims by ensuring the surgeons carry the same or greater limits than the facility.  The best solution to insuring a surgery center is to make sure the credentialed physicians at the center carry their own malpractice insurance, just like at a hospital.

Surgery Center Professional Liability Insurance, endorsements broaden coverage:

Surgery Center Insurance policies will be expanded to include administrative, Hipaa and Cyber Liability limits.  The policies can be expanded to include physicians performing surgeries or acting as medical directors only.

If the ASC’s are certified by AAAHC or JCAHO, and if they follow some directives of the carrier’s patient safety program, then there will likely be lower deductibles, higher limits and lower premiums available.  The forms which cover these policies can include general liability limits of up to 1 Million property coverage and HIPAA limits of 250,000.

Cost efficient, capable Allied Health care providers are in higher demand

Allied Health care providers are a big reason why some practices, including surgery centers and other surgical medical groups are still in business.  They can provide a wide range of services at a lower cost to the employer physician group.  However, as the demand for their services increases, the claims frequency and severity will grow.

Many Carriers are waiting to see the effects of how much the claims rise as allied healthcare providers are called into services.

Physician Assistants and CRNA’s will pay higher premiums,  their demand is high as the ACA legislation will bring  more than 3 Million new patients to the system.  Preventative care is a new priority, which will pressure allied health care providers to deliver broader and better services.  Although premiums are not rising for these programs by AIG, Med Pro Chicago Insurance or C.N.A., they are all expecting to see some stability in these markets, which translates to higher premiums in the near future.

250 different Allied Health care insurance types:

Hanover Insurance Group recently expanded its healthcare capabilities to include allied centers.  These targeted markets look to be sleep study centers, pharmacies, optical goods and occ therapy centers.  Hiscox and Protective Specialty are also joining the markets.

The Allied market potential is so great that Protective Specialty is now offering up to 250 sub classes, in the same model as CM&F, MedPro.

Chiropractor Liability Insurance:

Chiropractor pricing is stable right now as the carriers are not sure how much they will play a part in the new healthcare landscape.  ProAssurance filed for rate increases in California and, ultimately did not increase.  Proassurance and Philadelphia did not increase or decrease rates for chiropractors, they simply increased the coverage by adding cyber and confidentiality liability  (Hipaa) insurance. 

Midwives Rates trend up:

Midwifes rate increases are expected to rise by 40 % in some parts of California Claims are not a large concern right now as most of the assisted births involve low risk births,  pre term, low weight births are referred to the MD deliveries.  As  midwife assisted births entail low risk.  However, as the sheer number in the number of mid wife assisted births increases so will the cost of insuring them.

Lexington Insurance Company is the most popular and competitive amongst Midwives;  The American College of Nurse Midwives has more than 12,000 certified members,  the carriers premiums start as low as $ 1,500 and can range up over $ 15,000. 


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