The Med-Mal Insurance Storm of 2020

I was living in Panama City, Florida when Hurricane Michael all but destroyed our community. As we all remember, the storm hit the Panhandle so quickly that we barely had time to prepare.

This experience made me reflect back to the medical malpractice insurance crisis that hit Florida back in the late 1990s and early 2000s. It was harsh and destructive. I remember attending many town hall meetings with my partner Matt Gracey where we’d listen to stories and pleas of desperate physicians and surgeons begging for help. Carriers had either pulled out of Florida or made it very difficult for us to find coverage that our clients and prospects could afford.

Now I go to work each day knowing that we are about to revert back to those days and I can’t help but wonder if it will hit as quickly as Hurricane Michael – will the healthcare providers and facilities be prepared?

In 2003, the Legislature put caps on noneconomic damage awards for medical malpractice cases. The caps were overturned by the court in 2014 and 2017. Starting in 2003, premiums steadily decreased and then in the past few years the premiums stabilized and flattened. Now that Tort Reform has been fully overturned we are already seeing the frequency and severity of claims rising. The carriers are now running at a loss and some have already pulled out of medical malpractice insurance and/or taking rate with the promises of more rate increases on the horizon.

At first, carriers began taking money out of their claims reserves to offset the growing legal fees and claims expenses in order to try and eliminate the rate increase. Some decreased dividends and other unseen discretionary credits so they wouldn’t have to announce their rate increases. With most insurers of doctors and facilities in Florida are now losing money on every policy they write, the only question is how much will rates increase and how quickly.

We predict that many specialties will, in the upcoming years, experience rate increases of up to twenty-five percent, some even higher. Recently in Georgia, an insurer announced that rates will immediately increase up to forty-five percent on one specialty and thirty-six percent on another. It’s sad to say that in Florida you aren’t immune from such market changes.

It’s really important to understand that many of the small insurers and Risk Retention Groups could either stop offering coverage or merge into the larger insurers. The last Florida hard market quickly went from over fifty carriers to under five who when they did offer coverage, underwrote policies with very strict underwriting guidelines.

My entire career has been solely dedicated to medical malpractice insurance. I’ve seen what’s to come, and I’m writing this article in hopes to prepare you for the hardening of the malpractice insurance marketplace. Now more than ever, I can’t express the importance of moving your coverage into the Emerald Coast Medical Association’s Medical Malpractice Insurance Group Program and safely purchasing coverage with your peers.

Doctors in this program are insured with Medical Protective (MedPro Group, A Berkshire Hathaway Company). Established in 1899, MedPro is the oldest, most highly rated and financially stable insurance carrier in the market (A++ Superior by A.M. Best).

There is power in numbers – this time we can prepare for the storm before it hits.

For more information please contact Michelle Flatt, Executive Director of the Emerald Coast Medical Association at (850) 784-2090 or Julie Danna of Danna-Gracey, the program facilitator, at (850) 530-3924.

Insurance Companies are NOT your Doctor

By Michelle Flaat, Executive Director of the Emerald Coast Medical Association.

It’s that time of year again…Open Enrollment for Individual Health Insurance plans. Confusing information and sometimes empty promises will be made by a multitude of insurance companies about their plans. Medicare-eligible patients will be inundated with marketing materials that promise you can have the best care with a $0 premium. Younger people will be enticed with calls, emails, and advertising that promise good health if only you purchase the right insurance plan with their insurance company.

I want to provide you with insight and information to help you make your decisions with a dose of reality.

1. Your insurance company is NOT your Doctor. And when I say Doctor, I mean your physician, an MD or DO. Other health care providers with the title of Doctor hold a Ph.D. in their field of study such as Nursing or Physical Therapy and are not to be confused with the rigor it takes to become an expert and hold a degree in Allopathic (M.D.) or Osteopathic Medicine (D.O.).

2. Look carefully, ask questions and talk to your physician’s office before changing plans, the insurance company may give you a list of providers that include your physician’s name, but the list could be outdated. Nothing is more important than having a say in who your physician is and having the ability to see the specialists you need.

3. Understand that your physician will at times have to fight your insurance company on your behalf to get approval for the right medication or procedure to treat you. If your physician is employed by the insurance company do you think they will fight their employer on your behalf? There is a trend of clinics opening that are owned and operated by insurance companies, be aware and do your research. Nothing can compare to the relationship you have with your physician and their staff.

4. For Medicare patients specifically: It is always enticing to hear that you could get a supplement plan at no cost to you. Ask questions and understand the limitations of that coverage. These Medicare Advantage plans can be very restrictive and are based on cost you more out of pocket to utilize it. Many times, if you see a specialist for your condition, they will not be covered in that plan and your out of pocket costs for treatment will far outweigh the premiums you would have paid. The contract physician, in-network for your plan, may be 2 hours away.

5. Be realistic about your health status. Prevention is far more affordable than treatment. Again, you need to see an expert, a Physician, on a regular basis to stay on top of your health and prevent disease. As the mug in one of our member physician’s office says: “please don’t confuse my medical degree with your google search.”

6. Pharmacy benefits: If you know you need a specific drug look carefully at what the plan covers. You can never predict when you will need medication so again understand what your options are. I personally know stories of physicians calling and fighting the insurer on their patient’s behalf. The insurance companies hire physicians (not necessarily from Florida) to approve/deny exception requests for medications outside the approved drug list. You want your personal physician to be free to work on YOUR behalf in this process. Your insurance is a financial agreement and the physicians working for your insurance company to review claims and authorizations do not even have to be of the same specialty as your physician. Example: your Dermatologist is trying to get approval for a drug to treat your skin condition and the specialist they need to get approval from with your insurance company is an ophthalmologist. ECMA also partners with Florida RX card to offer medications at a discount. Go to our website http://emeraldcoastmedicalassociation.com/florida-rx-card/ to download the card and find out which pharmacies offer the best price on specific drugs.

7. Remember that an insurance company provides financial aid for the costs incurred for your health care. They may deny coverage, no matter the consequences, as it is not their responsibility to take care of you, just help pay the bills. Only you and your doctor are responsible for your health. An insurance company has a contractual responsibility to cover some health care items incurred and no more.

With all of that said I hope each of you are able to find a plan you can afford. If you don’t already have an established physician, I strongly recommend you choose a member of the Emerald Coast Medical Association. They are a strong group of physician leaders who spend countless hours outside of their own practice planning, advocating and learning to take the best possible care of you! Go to www.850docs.com to access our Doctor Directory or call and I’ll be happy to guide you to the best physician for your needs.

Give yourself the gift of good health in 2020 by choosing a physician and an insurance plan that will allow that physician to make the best medical decisions for you.

Study Reveals TRICARE Families are Reporting Worse Care than Commercially Insured

The families who are covered by TRICARE have reported worse access to healthcare than those with private plans and even people who are uninsured. 

A research team led by the Children’s Hospital of Philadelphia (CHOP) analyzed nearly 85,000 children to see how the different coverage groups rated their access to care and the overall quality of care they get. In the study, only 34% of TRICARE enrollees described their care as “accessible,” while 51% went to private coverage and 37% toward the uninsured. 

Then to worsen the blow for TRICARE, 47% of enrollees described their care as responsive, whereas the commercially insured were at 52% and almost 51% for the uninsured. However, what makes TRICARE look even more poor to its counterparts is the acceptance rate by physicians:

-TRICARE: 67%

-Private Plans: 95%

-Medicare: 65%

Private plans are obviously the favored choice of care by users and physicians alike. The results also slumped for those who have special healthcare needs (which is very common with those who use TRICARE). 

Roopa Seshadri, M.D., a research scientist at CHOP’s PolicyLab and the study’s lead author, said, “These families may struggle to access needed specialty or behavioral healthcare services to meet those needs.”

The study was also done in part for the military to realize their personnel needs through better insurance procedures. 

“The researchers hope that the findings lead to additional consideration about how the military could most effectively ensure families that need it to have access to pediatric care and other specialty services.”

Findings like these should also advise the Department of Defense to recognize more why a provider would choose not to accept TRICARE coverage, and adjust policy to ease those barriers and enhance access.

Emerald Coast Medical Association is here for our medical community no matter what. We also offer our members access to Group Health Insurance, which provides better benefits with long-term security at lower rates. 

Interested in taking advantage of our Group Health Insurance? Click below to reach out today for more information.

Contact ECMA

Florida Supreme Court Deems Caps Unconstitutional

The Florida Supreme Court ruled the caps presented to injured patients is unconstitutional.

“The caps on noneconomic damages … arbitrarily reduce damage awards for plaintiffs who suffer the most drastic injuries,” the court said.

As a result of a challenge in a recent injury case from Broward County, the Florida Supreme Court has ruled the caps limiting recoverable damages against healthcare providers in medical negligence cases unconstitutional. The caps were first enacted by the Florida Legislature in 2003.

To read more about the recent case you can click the link below:

Regional Vice President of Med Pro, Eric Clark, has written about cap removal. Read more about the Supreme Court Ruling by clicking the link below:

Fighting the Opioid Epidemic

Approximately 2,600 people have died in 2016 from opioid overdoses, according to Florida Medical Association CEO, Timothy J. Stapleton. Opioids are a severely dangerous addiction that needs to be addressed.

The best way to start conquering this issue is to get educated. The Emerald Coast Medical Association is assisting in the production of a CME event addressing this Drug Crisis in October. Not only can you earn CME credits, but you will learn how to change and save lives.

To read more on what CEO, Timothy Stapleton, has to say about the continuing opioid overdoses by clicking the button below:

More information on the Drug Crisis event is coming soon. To stay up-to-date on event details you can visit our Upcoming Events page by clicking the button below:

Part 2: What Actions to Take When You’ve Received a Phishing Email

What actions are necessary to take if you receive a phishing email?

There are a few tasks you should do when you suspect a phishing email:

  • Do not open any links or attachments
  • Contact the entity via website or publicly listed phone numbers to validate any unexpected requests
  • Notify your IT department
  • If you have already clicked a link or attachment, disconnect from the internet and call your IT department

To read more on How to protect your practice from phishing breaches, you can visit our Cyber liability insurance page by clicking the button below:

Part 1: What is Phishing and How Do I Spot a Phishing Email?

Before learning how to avoid phishing and other fraud schemes, what is phishing? Phishing is when an attacker crafts emails that look like a real email with call to actions and genuine content, but once a button or link is clicked or an attachment is accessed or downloaded from the email, custom code is run to exploit vulnerabilities and gain access to administration functions. A successful phishing email opens the affected computer to outside control which in turn allows access to the network that computer resides on. This provides the basis for multiple breaches, both of the local user accounts and data as well as those of the entire network that the computer has access to.

How do you spot a phishing email? It is not as easy as it used to be. Hackers have gotten clever in how they design the emails to make them look more legitimate. Phishing emails will often have the following characteristics:

  • Ask for a username and password
  • Are unexpected but appear to come from a trusted source
  • Contain content that urges the user to act promptly (click links, download files, call phone numbers, etc…)
  • Look like they come from Accounting, HR, an IT department or from a friend or contact of the user
  • Include grammatical errors
  • Contain email address that are different between the header and body (Ex: @ourcompany-othersite.com or like @gmailll.com)
  • Have links that show a different destination when you hover over them

To read more on How to protect your practice from phishing breaches, you can visit our Cyber liability insurance page by click the button below:

Check back on the ECMA Blog next week to learn what steps you need to take if you receive a phishing email.

Global Cyber Attack Updates

After the global cyber attack on the hospitals in London, the rest of the world was left scrambling for cyber security. The attack spread fear as it travelled across the world. No one wants to be the next victim of a cyber attack.

The reality is that no one is 100% safe from cyber attack. It only takes one failure in your defenses to create a devastating loss making cyber liability insurance a must. Protecting your systems means protecting your patients.

This attack and others will not stop, to the contrary they are increasing in frequency and severity. “We are in the second wave,” said Matthieu Suiche of Comae Technologies, in regards to the current round of attacks illustrated by London “As expected, the attackers have released new variants of the malware. We can surely expect more.”

You may find the full article on this global cyber attack below:

The Emerald Coast Medical Association may be contacted via the link below for questions on Cyber attacks, liability and insurance

The link below contains additional information about cyber liability insurance and how it can save your practice:

The Importance of Digital Marketing for Healthcare Providers

Often times we are told by Physicians that they do not need digital marketing. “My practice is already seeing as many patients as we can handle.” or “What’s the point of us having a website?” The reality is always the same. If you don’t tell your story on digitally, someone else will and while it’s great that your practice is full, is it full with the type of patients you want? Finally, the easiest question to answer, yes your practice needs a website.

In today’s digital landscape there is a great opportunity for healthcare providers to use digital marketing to educate, inspire, motivate, and engage their patients. Unfortunately the healthcare industry is almost two years behind other industries in adopting and leveraging social and online in their marketing efforts.

So why is digital marketing so important to your practice? Let’s look at a couple reasons:

Yes, You Need a Website
In today’s digital landscape every Physician and /or group practice needs a website. With over 60% of patients looking for a Doctor now turning to the web first, it is vital that a practice have a website. Without a website you either miss those patients immediately or look less professional by comparison. A good site makes your service offerings easier to find, increasing the likelihood of a positive match with the patient. Prospective clients have come to us frustrated after losing a cutting edge procedure patient to a facility that is 2 hours away. “Why didn’t the patient call us?” Because the other facility was positioned for that service when the patient searched for it. A well put together website allows a practice to position offerings where they need to be seen.

Increase Your Reach
A healthcare facility can amplify who they reach quickly with a solid digital marketing plan. With search engine optimization, social media and mobile marketing tactics, your business will be seen by a broader and more diverse audience in a faster and more effective manner. The addition of an inbound marketing approach that is targeted to attract specific or preferred patients is also an effective method of improving success. This allows Physicians the ability to increase the preferred patients vs taking any patient that walks through the door.

As mentioned above, more than 60% of prospective patients are using the internet to search for a provider. These outlets are proving to be a necessity rather than accessory to marketing plans. Always remember if you don’t control your digital footprint, someone else will control it for you.

Personalized Messaging
Building on the Inbound approach, digital marketing is allowing physicians to be more personal in approach with the type of message that is sent to or used to attract patients. This all comes back to one thing; Data. With so much data available to the healthcare industry, marketers are turning to digital tactics to better reach and target the right prospective patients. Data including demographics, age and even behavioral information are giving marketing teams a much clearer picture of how to reach the preferred patients. The end result? Happier patients and happier physicians. Transparency is key.

Measuring Efforts
Just as the healthcare industry is big on data, digital marketing is as well. Unlike other forms of marketing (tv, radio, billboards, newspapers, etc) these efforts can be tracked, in most cases, in real time. Day to day, week to week, analytics and data reports are gathered for your viewing. This allows for the marketing team to optimize the plan and yield better results at a day’s notice. In most cases with tv, radio and other traditional marketing executions you are given monthly reports and you have, in some situations, wasted the months efforts if it has missed the mark.

There is a reason the phone book has decreased in size drastically and the delivery driver no longer knocks on your door to ask you how many you would like. They know if they did, the circulation would decrease drastically and in some cases cause the phone book to disappear. If you are reading this and still have a phone book listing, back down to the smallest listing and move your budget to the internet. You will have more transparency and will quickly see the impact from the moving of this budget.

Closing
When it comes to the advantages of moving your business to a more structured digital marketing plan, I could go on for hours. But to keep this to a shorter post know this: If a healthcare practice and the healthcare industry fully adapt a digital strategy, it has the potential to increase their reach and effectively bring in the more optimal person for their practice. Increasingly, the Internet based world and catering to patients in it will continue to grow. The goals – to find more, engage existing patients in a more modern way, resulting in improved patient care and a healthier society overall.

How does your practice currently use digital marketing? Would it help improve your marketing tactics?

Chris Josten is the founder of Curiosity, a digital marketing company based in Panama City, FL. With over 15 years in marketing experience and digital marketing it has become the focus of the company. Curiosity is the perfect combination of creativity, talents, and vision. The group is diverse, innovative and client-focused. Curiosity’s route to digital transformation starts with collaboration from clients and only stops when the team lands an idea that is incredible.

www.curiositymg.com

MARCA Updates

As a result of President Trump’s executive order titled “Reducing Regulation and Controlling Regulatory Costs.” The American Academy of Family Physicians(AAFP) is taking advantage of this opportunity to push the Centers for Medicare and Medicaid Services (CMS)to simplify the implementation requirements mandated in the new Medicare Access and CHIP Reauthorization Act(MACRA).

For more on the details of this in depth recommendation made by the AAFP as well as the implications to your practice by the decisions of the CMS regarding implementation of MACRA, read the full article on the AAFP website.

The MACRA rules are changing everyday and the Emerald Coast Medical Association(ECMA) has a connection to get the most recent news.

The ECMA May Membership Meeting will be devoted to the MACRA updates. Visit the ECMA Upcoming Events Page to RSVP for the highly anticipated MACRA findings. You can also call the Executive Director, Michelle Flaat, at 850-784-2090 to RSVP.

Not a member? You can become a member today by clicking the link below. Besides attending the monthly membership meetings, there are numerous benefits that can improve your practice.