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Volume 16 • Issue 1• $5.00 July 2019
THE REGION’S MONTHLY NEWSPAPER FOR HEALTHCARE PROFESSIONALS & PHYSICIANS

Telehealth Malpractice Insurance Financial

Medical Malpractice “Shock Loss

Claims” Are On the Rise

BY MATT GRACEY

Insurance underwriters use simple loss ratios (losses
and expenses divided by premiums) as one of the tools
with which to gauge a company's suitability for cover-
age. High loss ratios, in which the losses approach,
equal, or exceed the premium, are not good. One factor
that has a large effect on loss ratios are “shock loss”
claims, catastrophic losses so large that they have a
material effect on the underwriting results of an entire
insurance company. Alex Fernandez
Bill Manzie
These shock losses wreak havoc on a carrier’s overall
loss ratio. As one can imagine, it is only a matter of time Matt Gracey
The Future until the carrier can no longer absorb these losses if Ensuring Quality
they become the norm, and the damages must be addressed and recovered in order to
Is Closer Than maintain sustainability. Inevitably, this leads us into all-too-familiar territory for Patient Care
Florida’s medical professionals – a return to a hard market, with increased rates and
You Think strict underwriting requirements for medical malpractice insurance. Every Step
Let’s look at just a few of the larger malpractice judgments from 2018 close to home:

• Hillsborough County, 2018 of the Way
BY BILL MANZIE
Award Amount: $109,760,930
It’s been said the only constant is A patient was admitted for outpatient surgery to remove a benign ovarian cyst.
change, but when it comes to telehealth, During the procedure, the doctor sliced through a portion of the patient’s small intes- BY ALEX FERNANDEZ
change has been taking steroids. Continued on page 12
Enabled by a healthcare industry look- From a financial and revenue perspec-
ing to better serve patients, protect its tive, there are several competing factors
bottom line, and desired by an increas- that go into running a successful non-
ingly technology-addicted customer Quantum in the Community Grant profit health care system while also
base, delivering clinical services without meeting the growing and varied needs of
an in-person visit has gone from barely Period Opens for Grassroots patients. With a budget of $1.2 billion,
on the radar to potentially revolutioniz- Broward Health is one of the largest pub-
ing the delivery of care within a genera- lic health care systems in the nation and,
tion. Organizations as with any organization of this size, we
The move from a fee-for-service pay- face a myriad of challenges. From pre-
ment model to value-based healthcare dicting the needs of a broadly diverse
shepherded in the age of telehealth (or BY VANESSA ORR patient population to navigating external
telemedicine). Instead of providing factors, such as fluctuating federal and
episodic care and billing for on-site serv- On June 2, the application period opened for state funding and evolving payer models,
ices, organizations are increasingly Quantum Foundation’s Quantum in the Community the challenges large systems now face
entering into contracts where they are (QIC) program, which provides grant money to help demand constant institutional introspec-
compensated based on patient health grassroots charities in Palm Beach County meet the tion to foster growth and positive out-
outcomes that value overall improve- basic needs of the county’s most vulnerable residents. comes.
ments, reduce the effects and incidence Now in its ninth year, the program is celebrating its suc- Delivering high-quality, patient-
of chronic disease, and help individuals cess by increasing the pool of available funds to $1 mil- focused care is our single greatest priori-
live healthier lives. lion, with selected nonprofits receiving up to $25,000 ty. It requires striking a balance between
At Memorial Healthcare System, that each. shrewd investments and implementing
has led to a concentration on the “triple “It is amazing to see what a smaller organization can the necessary operational measures to
aim:” improve the patient experience, do with $25,000; you can actively see better outcomes,” ensure efficiency and efficacy. To
reduce per capita costs, and positively said Eric Kelly, president of Quantum Foundation. “In Erik Kelly enhance our growth strategies, for exam-
impact the health of the communities we some cases, it may mean the opportunity for a family to PHOTO CREDIT: ple, we have invested in new patient
serve. Not coincidentally, that is some of put nutritious meals on the table seven days a week. TRACEY BENSON facilities and expanded existing ones,
what telehealth does best. Even with both parents working, some families can’t while further developing our robotic sur-
Our providers are eager to include afford to live in Palm Beach County without assistance, and there’s no greater impact gery capabilities.
telemedicine into their approach, than being able to complement what they do with meals on the table. Enhancing and improving the patient
whether it’s as basic as patients connect- “We often talk numbers when we talk about food distribution,” he added. “But this experience starts with leadership, which
ing from their phones to clinicians for is those numbers on a granular level.” must be embedded in every facet of the
Continued on page 21 Continued on page 13 Continued on page 18