2013 PIAA Medical Liability Conference Confronts Challenges of Shifting Marketplace

With the Patient Protection & Affordable Act continuing its squeeze of the American healthcare system into one that offers a greater number of citizens access to quality, affordable medical care while reigning in the overall costs of care to the economy, the Physician Insurers Association of America (PIAA) focused its 2013 Annual Medical Liability Conference on its role—as well as the role of its members—in the evolving marketplace. This year’s conference took place May 15-17 in Palm Desert, Calif.

“The issues facing the PIAA are not insignificant,” said Ted J. Clarke, MD, PIAA chairperson as well as chairman and chief executive of the COPIC Companies, during his remarks opening this year’s Medical Liability Conference. “A decline in the number of private practicing physicians, a significant increase in the number of allied health professionals, new models of care delivery and a shift in the way many carriers, providers and institutions are looking at medical liability coverage are just some of the factors that are currently affecting the PIAA and the individual member organizations as well. “The need to make adjustments in the face of a changing environment is not new to many types of businesses around the world. And, in fact, it isn’t new to the MPL industry, either. Take my company—COPIC —for example. The COPIC of today is very different from what it looked like in 1981. Like today’s successful PIAA companies, it has evolved to stay in sync with the changing world around it.”

The evolving healthcare delivery system has compelled many insurers of medical liability to reexamine and redefine their role in the medical marketplace. The PIAA, too, has confronted the fundamental question of how to adjust its business model to keep in step with a shifting marketplace.
“Defining—or redefining—the PIAA brand is important because this is a time of great change for the MPL community [as well as] the entire healthcare and financial world in which we operate,” explained Brian Atchinson, PIAA president and chief executive officer. “Working with a team of marketing experts, the PIAA Board of Directors and staff looked at our role in the healthcare community …

“We discovered that we are widely recognized as the premiere trade association for everyone with a stake in medical professional liability. However, there was a caveat to this view. As the recognized MPL industry leader, there was considerable agreement that the association needed to evolve—to adapt in some key dimensions, in order to stay aligned with the changing healthcare environment in which MPL providers operate and in which MPL protection and services are provided.”

Contemplating its organizational identity, the PIAA noted how far its member companies have expanded their role in the healthcare arena. In addition to insuring more than two-thirds of America’s private practicing physicians, PIAA members insure more than 3,000 hospitals as well as nurses, physician assistants, nurse practitioners, CRNAs, midwives and other healthcare providers. To maintain its existing brand equity while emphasizing its members’ expanded role in the medical marketplace, PIAA announced at the conference that going forward it will be doing business simply as “PIAA” and employ an updated logo as well as a retooled website (for more on the PIAA branding intiative, see Page No. 3).

“We are committed to ensuring that PIAA remains an indispensable resource for every group with a commitment to quality healthcare and a stake in MPL regardless of structure—mutual, reciprocal, RRG, captive, stock or trust,” Atchinson said. “And PIAA will continue to offer programs and services tailored to meet the needs of all types of healthcare providers and healthcare systems covered.”

Highlights from the Educational Sessions
The 2013 PIAA Medical Liability Conference featured 11 educational sessions. Following are some of the highlights from those forums.
In his aptly titled keynote session, “Healthcare Reform: Change Is the Only Constant,” Leonard Schaeffer gave a sobering examination of how the quest to bend the arc of healthcare spending will affect the practice of medicine for years to come. “You can count on predictable and unpredictable change as the healthcare law is rolled out during the next decade,” he shared. “There will be an endless series of changes as different groups lobby based on their interests.”

In the session titled “Communicating with Patients After a Medical Injury: Myths, Realities and New Horizons,” Mark O’Brien shared his experience as an international medical education consultant for the Medical Protection Society (MPS) of Australia. Between 2010 and 2012, MPS trained more than 11,500 physicians in eight countries on clinical incident management. According to O’Brien, since adopting an early disclosure response to medical injuries, the total number of claims his clients incur has been reduced by 50 percent.

In the session titled “Quality Measures and Data Collection,” Karen Shumate, RN, CPHQ and chief operating officer of Lawrence Memorial Hospital in Kansas, noted that “healthcare quality reform for CMS has been underway for a long time; the Affordable Care Act is health insurance reform.” Key to that reform will be how physicians and hospitals are reimbursed for care. Shumate noted that by 2015, efficiency will comprise 20 percent of reimbursement, and that readmission penalties will not take into consideration whether the patient followed the doctor’s recommendation or not.

In the session titled “Healthcare Reform: New Developments and Long-term Implications,” attorneys Bruce Johnson and Don Herring emphasized that “MPL insurers have three options going forward: 1. Do nothing, wither and die; 2. Build on base of independent practices, but partner with practices on new ways of doing business; or 3. Diversify service mix and customer base.”