Standard & Poor's said it will increasingly scrutinize hospitals' malpractice self-insurance arrangements, including reduced coverage limits or higher deductibles on commercial policies and the establishment of risk-retention groups and captive insurance companies. The ratings agency said greater use of self-insurance, spurred by soaring malpractice premiums in some states, poses "one area where increasing risk may not be visible until a significant problem occurs." S&P noted that some hospitals have mitigated the risks of substantial losses through reinsurance policies and measures to improve patient safety and satisfaction, including making apologies for errors.
Meanwhile, the American Medical Association added Massachusetts to its list of states in a "full-blown medical liability crisis," bringing the total to 20. The AMA said it added Massachusetts after the state's medical society reported that services were being restricted or withdrawn by about 50% of neurosurgeons, 41% of orthopedic surgeons, 36% of obstetricians and 29% of general surgeons in the face of skyrocketing malpractice premiums for high-risk specialties. Obtain the full list of crisis states. -- by Mary Chris Jaklevic and Michael Romano