Managed care, office systems and medical liability risk

Abstract

Objective: Medical liability continues to be a concern among physicians and policy makers. This study examines the interaction among managed care, the systems that physicians put into place in their offices to address managed care demands and their resultant medical liability risks.

Methods: A survey instrument based on a conceptual model of risk was mailed to 882 physicians identified by a medical liability insurance company. Multivariate methods were used to compare rates of claims of medical liability with managed care involvement, office systems and risk management techniques.

Results: A total of 393 physicians completed a mail survey, with an overall response rate of 45%. Of respondents, 137 had no claims in the prior two years, 109 had only one claim, and 147 had two or more claims. Having a higher percentage of managed care patients was associated with higher risk (p < .01). Changing office systems (p < .05) and spending more time on risk management (p < .01) were associated with lower risk. Specific risk management techniques were not associated with differences in risk.

Conclusions: Having more managed care patients is associated with a higher risk of malpractice claims. However, more investment in office systems and risk management can help offset such risks. Unfortunately, this study was unable to provide direction on the most effective office systems or risk management techniques to employ.