Paid malpractice claims on the decline nationally, premiums lower in some states, too

Rates of paid malpractice claims have been decreasing in recent years, according to a new analysis of the medical liability climate in the U.S.

Researchers used data from the National Practitioner Data Bank, the American Medical Association's Masterfile, and the Medical Liability Monitor's Annual Rate Survey to assess trends in physicians' paid claims and liability insurance premiums. Results were published in a special communication by the Journal of the American Medical Association on Oct. 30.

Between 2002 and 2013, paid claims against MDs decreased from 18.6 claims per 1,000 physicians to 9.9 claims per 1,000 physicians, which regression analyses showed to be an annual average decrease of 6.3%. During the same period, claims against DOs decreased 5.3% annually. The study also looked at the amounts paid, adjusted to 2013 dollars. Between 1994 and 2007, the size of payouts increased at an average of 5% per year. But since 2007, the median payment has decreased slightly, to $195,000 in 2013. The largest payments followed a similar trend of increasing and then plateauing in recent years.

Liability insurance premiums were analyzed in 5 diverse areas: California, New York, Illinois,

Tennessee, and Colorado. In all of the areas except New York, premiums for internists decreased by 20% or more between 2004 and 2013. In Nassau and Suffolk counties of New York, which had some of the highest rates in the country, premiums for internists went up 16%.

The results are consistent with other recent reports showing decreases in paid malpractice claims in the last decade, the authors concluded. The causes of this trend are unclear but are as likely to be cycles in insurance markets as tort reforms, they said. The authors expressed support for ongoing experiments with nontraditional approaches to liability reform, including communication-and-resolution programs, mandatory presuit notification laws, apology laws, state-facilitated dispute resolution, safe harbors, judge-directed negotiation, and administrative compensation systems.

An accompanying editorial noted that malpractice litigation is not always about money, for either patients or physicians, and that new reforms can help both parties achieve their goals and save time for all involved.