Physicians may be more willing to accept policy changes that improve access to care and reduce costs if they can obtain some relief from malpractice liability, suggested the researchers of an article published in the January issue of Health Affairs.
While many of delivery and payment reforms seem inevitable, providers and those who advise them often focus on the liability risks of changing their behavior rather than on the cost savings and care improvements, wrote authors William Sage, MD, a University of Texas law professor, and David Hyman, MD, law and medicine professor at the University of Illinois.
“Malpractice liability is not a major cause of what ails the healthcare system, but it is a barrier to change,” the report authors wrote. And since it is generally accepted that physician leadership is needed if reform is to transform the healthcare system, it would behoove lawmakers to strike a deal with doctors, they suggest.
The deal could look like this: to obtain physician acceptance of health reform policies, lawmakers would enact federal legislation limiting malpractice liability while simultaneously restructuring fee-for-service payment, the authors wrote.
While lawmakers have a variety of tort reform models to choose from, Hyman and Sage suggest they create something styled after California’s Medical Injury Compensation Reform Act (MICRA) of 1975, the most popular model among physicians. MICRA imposed a flat cap of $250,000 on non-economic damages. It also limited lawyers’ contingent fees and shortened the statute of limitations for bringing cases.
If the intended benefits from health reform are realized, the authors noted, the need for traditional liability protections may shift as well. For example, better coordination of care and payment for services based on error-free values should make medical services safer.
But in the meantime, not only may federal tort reform offer physicians relief from malpractice liability, it might help reduce uncertainty around the potential for accountable care organizations and other collaborative organizations to incur excessive liability.