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Plaza Health Network Aligns
Malpractice Insurance
with Jackson Health System
EXPERT ADVICE
to Treat Complex Patients

“Hard” Market Is Coming for Plaza Health Network (PHN) and Jackson Health System

have collaborated to provide clinically complex patients with
Malpractice Insurance an option for sub-acute care recovery. PHN’s seven skilled nurs-
ing centers can all receive and treat clinically complex patients
as part of this arrangement. Patients who require extra care
Q. We keep hearing that a and observation but do not have to be in a hospital setting can
continue their recovery at one of Plaza Health Network’s seven
“hard” market is coming for rehabilitation and skilled nursing facilities. The relationship
commenced between Jackson Memorial Hospital (JMH) and
malpractice insurance in The Miami Transplant Institute (MTI) with Plaza Health
Florida. What does this really Network’s two facilities in the Miami Health District,
University Plaza and Jackson Plaza. These two facilities are in
mean and when should we be close proximity to the hospitals, providing JMH and MTI doc- Elaine Bloom
tors and nurses ease of visitation if necessary to monitor their patients. Left ventricular
concerned? assist device (LVAD) patients are among the first to benefit from this unique arrange-
ment. A team of PHN nurse practitioners and nurse navigators visit qualifying patients
to assess their conditions and meet with their families in order to agree to implement the
transfer. This personalized level of service allows both patients and their families to
A.. The market cycle for malpractice insur- BY MATT GRACEY
ance in Florida has fairly predictable cycles, become more engaged in the recovery process.
with extreme fluctuations in pricing and Plaza Health Network provides ease in continuity of care by being equipped with all
insurers’ underwriting. For example, the late the necessary technology and equipment to treat these patients, including a telehealth
1990s and early 2000s were similar to the current market cycle, which is the program that provides rapid, real-time remote monitoring of patients. This innovative
last bit of a “soft”, doctor-friendly section. As insurers lowered their rates and technology allows patients to receive collaborative virtual care from their team of doc-
underwriting rules to fend off competitors throughout the last half of the tors, nurses and medical specialists resulting in quicker evaluations, enhanced outcomes,
1990s, the rates became too favorable for the claims conditions. Within just a and reduced hospital readmissions. In addition to the benefits patients will receive, this
few years, the insurers were losing money as the claims trends became arrangement also provides a tremendous cost savings to the hospitals, insurers and
increasingly unfavorable. As a result, insurers started dramatically raising patients as the average cost per day to stay in a hospital can exceed $2,000, which is sub-
rates to stop the hemorrhaging of claims payments and they severely stiff- stantially higher than the cost at a skilled nursing facility. This initiative will now allow
ened their underwriting requirements. Many just left the marketplace. Some for hospital beds to be released and become available for other sicker patients who
50+ insurers were offering coverage in 2000 in Florida and by 2003 the num- require a more intensive level of care.
ber was down to five or fewer that were really standing by the insured doc- “We have been aggressive and focused on recognizing the changes in the health care
tors. Many physician insureds in Florida were forced to go bare because the sector,” said Elaine Bloom, president and CEO of Plaza Health Network. “By proactively
options for affordable malpractice coverage almost dried up. Doctors with responding to the need for higher levels of sub-acute care, Plaza Health Network has
claims issues were the most vulnerable, as their rates rose even faster or their been able to establish this strategic collaboration with Jackson Health System and the
coverage was non-renewed. Miami Transplant Institute with the goal of getting patients back to their normal daily
Unfortunately, we are headed for similar conditions in Florida’s malpractice living activities at an optimal level of health.”
market, I believe. The reasons for this are many, but they still boil down to the
simple formula of the insurers not charging enough to cover the claims, which
are rising both in severity and frequency, against their doctor insureds. I pre-
dict the claims trends will increasingly worsen because the Florida Supreme
Court has basically gutted the 2003 cap on non-economic damages, which was
heavily influential in bringing us out of the last malpractice-insurance crisis of
the early 2000s.
With 40+ insurers, at last count, now offering coverage to Florida doctors,
you should choose wisely from which of those you want to purchase coverage
since the market conditions will very likely become much worse in the next 18
to 24 months as we careen into a “hard” market. We recommend moving your
coverage as soon as you can to a highly rated insurer, one of a handful rated
“A-, Excellent“ or better by A.M. Best. Remember too that not all rating agen-
cies are created equal and I consider A.M. Best the gold standard and the only
rating group to really consider when comparing insurers.

Matt Gracey, medical malpractice
insurance specialist with Danna-Gracey,
can be reached at (800) 966-2120 or
matt@dannagracey.com.

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