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How will Affordable Care Act impact medical malpractice suits?

Although the number of people who obtained health insurance through the state and federal exchanges is subject to political spin, according to a May 1 article in the "Miami Herald," federal health officials say nearly one million Floridians obtained private health insurance by March 31, when the initial enrollment period ended. Another 223,000 enrolled in Medicaid.

One insurance expert said that about a quarter of enrollees were previously uninsured and that in a few years, there will be over 22 million newly-insured Americans. What will the impact be on medical malpractice lawsuits? At an actuarial conference this spring, several insurance experts made their predictions for the next ten years.

While more insured people will mean more malpractice claims, the experts noted that demographic trends will also likely increase those numbers. We are becoming an older, heavier nation with more medical problems.

The health care system model is changing for many Americans in part because of the Affordable Care Act. The number of accountable care organizations is growing quickly. More hospitals are acquiring medical practices. This decreases the continuity of patient care. According to one casualty actuary, most medical malpractice claims begin "with a loss of connection with the patient."

An advantage of ACOs, however, is standardized methods of treatment. Usually, as one actuarial executive noted, these methods are sound. When something goes wrong, however, hospitals will generally face the brunt of the malpractice suit.

Even outside of ACOs, the doctor-patient relationship has changed. Hospitalists are becoming increasingly prevalent. These doctors monitor patient care during hospital stays instead of personal physicians. Further, within medical practices, nurses are taking on greater responsibilities.

These changes mean that throughout an illness or injury, a patient is more likely to have his or her care overseen by multiple professionals, diluting the doctor-patient relationship. This can also lead to lack of communication that can prove dangerous, and even deadly.

People getting regular health care for the first time may not know what to expect or to question. While we as patients must be our own health care advocates, that doesn't relieve medical professionals of the responsibility to provide the best care possible and to be held accountable when they don't.

Source: Insurance Journal, "How Healthcare Reform Is Challenging Medical Malpractice" Jul. 15, 2014

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