New CRICO Strategies Report Reveals Three Key Clinical Processes that Predict the Likelihood and Amount of Malpractice Indemnity Payments

Boston, MA, July 14, 2020—CRICO Strategies new report, The Power to Predict: Leveraging Medical Malpractice Data to Reduce Patient Harm and Financial Loss identifies, which breakdowns in clinical processes are the strongest predictors of indemnity payments in malpractice cases.

The 37,000 medical professional liability (MPL) claims and suits analyzed for this Report were drawn from CRICO Strategies’ Comparative Benchmarking System (CBS)—a 20-year-old national database of deeply coded medical malpractice claims with more than 450,000 cases, roughly one-third of all cases in the U.S. The inclusion of paid and unpaid medical malpractice cases in CBS—a difference from other comparably sized MPL datasets—enables the application of data models to predict the likelihood that a case will pay.

Among the Report’s key findings:

The Report found that the odds of an MPL case closing with an indemnity payment increase:

• 145% when a policy or protocol is not followed
• 85% when there are indications of inadequate patient assessment
• 76% when there are indications of insufficient documentation

For the complete analysis, download the free pdf of the CBS Report, The Power to Predict.

“Turning avoidable patient harm into evidence-based risk management is a key tenet of the evolving field of safety science,” says Mark Reynolds, President and CEO of CRICO. “Understanding how today’s patient care missteps will impact tomorrow’s outcomes and financial losses has long been a capability that MPL insurers and health care providers have sought. We believe this report represents meaningful progress toward such capability.”

This study delves deeply into processes clinicians struggle with that contribute to adverse events and can lead to malpractice claims. By understanding the common drivers—or contributing factors—of these claims, hospital leaders and clinical teams can proactively address them with confidence.

“For years, I have relied on analytics from CBS to help me understand patterns of risk and plan for needed improvements,” says Elizabeth Mort, MD, MPH, Senior Vice President of Quality and Safety for Massachusetts General Hospital. “Any one leader, thankfully, sees small numbers of adverse events. Fundamentally, sharing patterns of patient harm and exchanging best practices for mitigating risk is what we are obliged to do. CBS enables us to fulfill that obligation more effectively.”

In addition to its benefits for clinicians and clinical leaders, MPL claims managers can use such predictive data to inform case reserving, defense strategies, and pricing cases for settlement. Similarly, MPL underwriters can use it to inform their rate setting and coverage decisions.

“While each medical malpractice case has its own compelling story, the aggregation of MPL cases at scale transforms anecdote into evidence that can be used to reduce harm and loss,” says Michael Paskavitz, Vice President of CRICO Strategies. “This Report represents practical applications for predictive analytics that can help clinical and business leaders make confident and reliable decisions.”

Download the free pdf of the CBS Report, The Power to Predict.

About CRICO Strategies

CRICO Strategies is a division of The Risk Management Foundation of the Harvard Medical Institutions Incorporated, a CRICO company. CRICO Strategies mission is to unite the medical and insurance communities into a single voice with reliable and actionable data as our shared language. Partnering with national organizations, CRICO Strategies works to strengthen their ability to reduce medical malpractice risks with powerful analytics derived from its Comparative Benchmarking System (CBS). CBS reflects the medical professional liability experience of more than 550 hospitals and health care entities and 190,000 physicians from commercial and captive insurers nationwide.

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