HOSPITALISTS/PRIMARY CARE PHYSICIANS New alliances and Affordable Medical Malpractice Insurance

October 31, 2014

Hospitalists’ practices are growing;

I’ve written before about the unique methods of rating Hospitalist groups:

and, I’m reminded each time I hear the ‘inbox’ ping on my lap top and tablet,

as an agent for a digital healthcare liability national organization (O’Brien Insurance Services, Inc..) there are more physicians (trained as Internists) or Primary Care Providers finding work in this area.

I see the requests daily (sometimes, literally hourly) for rates, comparisons, premium estimates for in state, out of state, solo, affiliated, large and small group hospitalist practices. This area of medicine was almost nonexistent years ago when Robert Wachter, M.D. and Lee Goldman, M.D. wrote about it in the New England Journal of Medicine: now, here we are, with medical malpractice carriers (like The Doctors’ Company, Medical Protective, Norcal Mutual, etc. offering ‘stand alone’ independent contractor’s premiums just as if they were one of the approved specialties in the American Board of Medical Specialties’.

Do not rate the number of physicians: that results in unnecessary premiums paid by the group.

when rating a hospitalist medical group, it’s not ‘all about’ the number of physicians, it’s the encounters, revenue and RVU’s.

There are innovative rating systems, which The Doctors’ Insurance Agency has worked on for years, with The Doctors’ Company, endorsed Carrier for the Society of Hospital Medicine: refining and specifying the variables which go into the actual risk of this unique practice of medicine. The Doctors’ Company underwriting team is working to charge for just the work provided rather than develop the premium based upon the number of physicians in the group.

Financial Analysts track results of growth:

Growth Industry: the Hospitalist niche within the health care landscape is growing; the groups are forming with the need to add and delete physicians, mid-levels, facilities and employees (non MD) as well as Techs. The agents representing the Hospitalist Group need to be aware of the sensitive issue and risk of tail, the obstacle of recruiting physicians with retroactive risk (nose); the importance of rating all of the procedures and hence covering them all, rather than only those at one facility (hospitalist groups frequently contract with facilities outside of the county and state.

in an online article from the Financial report of one of the largest hospitalist groups: there is evidence that this is rapidly becoming one of the opportunity and growth areas of our fledgling, evolving and struggling healthcare economy.

IPC The Hospitalist Company Reports Third Quarter 2014 Financial Results

NORTH HOLLYWOOD, Calif., Oct. 22, 2014 (GLOBE NEWSWIRE) -- IPC The Hospitalist Company, Inc. (Nasdaq:IPCM), a leading national hospitalist physician group practice, today announced financial results for the third quarter ended September 30, 2014.

Third Quarter 2014 Highlights (comparisons are to third quarter 2013):

Net revenue increased 14% to $169.8 million, with same-market area net revenue growth of 9%. Patient encounters increased 16% to 1,749,000.

Nine Months Ended September 30, 2014 Highlights (comparisons are to nine months ended September 30, 2013):

Net revenue increased 15% to $514.8 million, with same-market area net revenue growth of 10%.
Patient encounters increased 14% to 5,240,000.
Primary Care or Hospitalist, solo or group, your premium should be accurate and affordable!

whether you work independently and pay between $ 3,000 to $ 5,000 annual premium in lower rated venues (Northern California, Colorado, parts of Texas, Washington State,..) or, you work as part of a growing group, and your rate is developed by the number of RVU’s divided by the national average RVU production of the average physician working full time in that same specialty: this calculus is used in order to develop an FTE, which helps malpractice insurance companies develop a premium (usually inclusive of the cost of tail for when that physician leaves. You need a company and brokerage network working on your behalf.

The Doctors’ Insurance Agency partners with the national network of patient safety to continue the study and evolution of this specialty: Through the Society of Hospital Medicine: these results just came in regarding flexibility and art of medication management for patients treated for something other than their cause for admission:

The ongoing study of claims and managing the risk:

Little is currently known regarding physicians' opinions on the relative appropriateness of inpatient management of medical conditions unrelated to the reason for admission.

Physicians were emailed a survey consisting of 6 pairs of clinical cases. Each pair included 1 case with an inpatient management decision related to the reason for admission, followed by a case involving the same management decision but unrelated to the reason for admission. Respondents rated the appropriateness of the interventions.

Physicians were significantly more likely to rate inpatient interventions as appropriate when they were related, compared to unrelated, to the reason for admission. Primary care physicians were significantly more likely than hospitalists to feel that inpatient interventions were appropriate.

Physicians are more likely to rate inpatient medication changes as appropriate when they are related to the reason for admission. Our results suggest that opportunities for meaningful medical interventions may be underutilized in current systems that adhere to a strict dichotomy of inpatient and outpatient roles.

This is just one of the ways that the Society for Hospital Medicine is working to finely educate and improve the medical outcomes of hospitalists and further the practice of good medicine.

The Doctors’ Insurance Agency would like to be a part of your analysis of the medical malpractice choices available in the market; let us bring our years (since 2001) of working with these specific groups to your new practice to help you obtain the best premium and the appropriate coverage.