When shopping for a medical malpractice insurance company to cover your (or your bosses’) urgent care center, it is important to work with an agent and a carrier that can grow with you. Indeed, a company that can fuel your growth by structuring a policy that supports you financially. Medical Malpractice Insurance for Urgent Care and Hospitalist Groups should be not only your risk transfer partner, taking on the responsibility to defend and coach to build and assist you in administering your group.
I’ve been an insurance agent for 24 years, just in the medical malpractice insurance niche, focusing just on this challenge: How can we work with our insurance clients to partner and plan and help them defend, learn about claims. Additionally, how can we put together a plan that protects you, introduces you to a staff of patient safety experts and prices the coming (recruiting) and going (tail exposure) in a way that makes it an even playing field between your private group and those of the ‘big players’.
With these types of urgent care medical malpractice insurance policies, there is no advantage to the larger, more capital rich medical groups. Whether the center has more of a primary care focus, or whether it is truly a ‘doc in the box’ (as the saying goes) , the urgent care facility still needs to be insured by a policy that does not saddle it with the high cost of tail.
It is all about the recruiting. In healthcare in 2012, you cannot be alive without an understanding that physicians (and employers) are scrambling to align with the right group, to make the right strategic play so that they survive the coming of healthcare reform. The decision to make the strategic partnerships and to bring on committed physicians looking for work, challenge and lifestyle requires that the malpractice insurance policy work with the necessary flexibility.
The medical malpractice insurance for urgent care centers must cover the three tiers or layers of the risk:
- The physician or physicians
- The allied healthcare providers (P.A.’s, N.P.’s)
- And the medical group entity.
If the urgent care center is going to be operated by one physician and one physicians assistant, as many are in the beginning, then the conventional ‘per physician’ policy will suffice. This serves the policy well as it keeps costs down for that one physician. And, the slow, early growth in the beginning of the medical group’s ‘life’, the per physician plan is still probably, in most circumstances, okay. When you add the allied healthcare provider, the coverage can be set up as a shared limit ancillary, with nominal premium added, there is no tail encumbrance left for the group’s owners or administrators to budget and to spend. While staffing the policy with another healthcare provider would allow for more revenue during these sensitive start up months, in order to do this the policy must have two unique endorsements:
The first is a method of rating and providing coverage that allows for pricing accuracy and discounted, affordable premiums: The auxiliary physician endorsement (header) which allows for hourly rating of the policy as well as the ability to add more than one (without the cost of tail when they leave.
This unique benefit bears repeating: Setting up an urgent care policy with the right ‘header’ allows the owner to staff the center with the necessary Medical Doctors to provide quality care when you need it, with more than one physician, without committing to the tail purchase.
The anchor to the policy will be the ‘certificate holder’, the one long term, full time (work horse) so to speak, rated according to their unique specialty, Internal Medicine, Family General Practice or Emergency Medicine. Working more than 40 hours per week, however this and adding the less than full time M.D. assistant to help see the growing volume of patients, this can happen when the auxiliary physician header is part of the policy. The key here, at this juncture of the growing urgent care center policy is to add the physician assistant with the proper, risk based, hourly rating mechanism. This utility in the medical malpractice insurance policy also allows for the physicians to share the limit and for the job to actually not work out. The ‘marriage’ of the culture of the medical group, and the physicians needs to happen, there has to be a match when the policies are rated per physician. When you have an auxiliary physician header, you can add more than one, you can try a physician with the group before committing to the purchase of tail, or moving to the long term contract stage.
We have had hospitalist Groups, Anesthesiologist Groups, Occupational and urgent Care centers all use this rating vehicle. The header is written to accommodate the specialty, rated according to the actually developed American Board of Medical Specialties premium, multiplied by a low rate, hourly factor, and finally multiplied by the year of maturity of the specialty in which the header is written. This auxiliary physician header just may mean the difference between growth and flexibility and presenting a competitive employment opportunity to the universe of graduating physicians, or stagnation and ultimately a slow growth non competitive physician group.
Rigid plans requiring tail to be purchased as the physician contemplates joining or has to cancel off the policy will not serve your needs well when you are growing your medical practice against the big players. These are common, and often the only solution when the clinic based practice requires a commitment by one physicians to staff or add to the growing group, building up clients and patients over time. But, for an urgent care policy, the group’s business is driven by contracts bringing patients into the center, whether by work contract, or agreement, or just by a solid partnership with the community, the urgent care center will have patients coming in the door, 12 hours per day, 6 – 7 days per week, then you need a policy which indeed does not require a long term commitment. This policy will insure physicians for years, using the hourly or patient encounter method of rating, it just doesn’t require you to immediately commit to a claims made policy with the inevitable tail payment and cost built into it.
Without a nationally licensed, experienced malpractice insurance provider (like The Doctors’ Company), you may be stuck competing against Sutter, Kaiser, Dignity HealthCare, St. Joseph’s health system or countless other providers who can compete by purchasing nose from the physician recruit’s current company, and then, they can offer to pay for tail when they leave. When you use the unique tool of the auxiliary physician header, hourly pricing, you have brought in capital and expertise which you will not be able to overstate or over estimate.
Partnering with The Doctors’ Insurance Agency will open the door to a team of finance, risk management, insurance policy and claims specialists and then, later as your group grows, you can introduce the per patient rating, patient encounters and counting of RVU’s.
These are all innovative pricing methods which we would like to take the time to meet with you to discuss and share and implement.