Fostering Rapid Advances in Health Care Learning from System Demonstrations (2003) / Chapter Skim
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6. Liability: Patient-Centered and Safety-Focused, Nonjudicial Compensation
6. Liability: Patient-Centered and Safety-Focused, Nonjudicial Compensation
Pages 81-90
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From page 81... ...
Prompt federal action to provide incentives for adopting this approach—coupled with appropriate state legislation—has the potential to produce immediately measurable benefits in terms of provider access to affordable, high-dollar liability coverage; gains in administrative efficiency once criteria for compensation are fully developed, allowing quicker payments to be made to many more injured patients; and Tonger-term improvements in patient safety and stabilization of insurance markets. The Department of Health and Human Services (DHHS)
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From page 82... ...
Prolonged, adversarial haggling over claims by plaintiffs' attorneys and liability insurers alienates both providers and patients, and generates legal fees and administrative expenses that consume more than half the cost of liability insurance premiums (Kakalik and Pace, 1986~. The apparent randomness and delay associated with this pattern of accountability not only prevent severely injured patients from receiving prompt, fair compensation, but destabilize liability insurance markets and attenuate the signal that liability is supposed to send health care providers regarding the need for quality improvement.
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From page 83... ...
strongly suggests the need to create a legal environment that both fosters highquality patient care and relieves financial strain and administrative burden for health care providers. The committee believes that replacing tort liability with a system of patient-centered and safety-focused nonjudicial compensation linking claims resolution to organization-based error disclosure and safety improvement processes—can best accomplish these goals.
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From page 84... ...
Finally, states would engage in sustained efforts to educate the public with respect to the trade-off involved in replacing tort liability with administrative remedies for avoidable medical injury: faster, fairer, surer compensation but forgoing a jury trial. Some states might choose to phase in nonjudicial~approaches to compensation, beginning with selected provider organizations (e.g., hospitals, large medical groups, and closed-panel health maintenance organizations tHMOs]
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From page 85... ...
3. Maintain access to liability insurance Improve predictability of liability costs Increase affordability of high-dollar liability coverage.
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From page 86... ...
cause injury, providers would need to notify patients promptly; express regret, and tender payment for both net economic harm (medical care, lost wages, lost domestic production, with collateral source offset) and capped, scheduled noneconomic harm (pain and suffering)
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From page 87... ...
A definition of compensation that combines net economic harm (medical care, lost wages, lost domestic production, with collateral source offset) and capped, scheduled noneconomic harm (pain and suffering)
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From page 88... ...
This might be done using HRSA or AHRQ grants to states in amounts sufficient to cover the operating costs of calculating payments and resolving disputes, as well as initial expenses associated with defining compensable events and developing damage schedules. As states develop the iniias~ucture needed for the demonstrations, they would need to work with stakeholder groups, including consumer advocacy groups, to anticipate and avoid state constitutional challenges and other implementation delays.
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From page 89... ...
1994. Enterprise Liability for Medical Malpractice and Health Care Quality Improvement.AmJLawMed 20(1-2)
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