Predicting Case Outcomes: Medmal Analysis Turns to the Dollars

It’s time for a spotlight on three factors in medical professional liability cases: a lack of a protocol or failure to follow one, patient assessment shortfalls, and documentation problems. A new evaluation of national malpractice data from 22 insurers links those three factors with an increased chance of payment on any given case.

“ It allows us to say with more certainty that the deficiencies that we’re observing today in the clinical space…have a quantifiable financial impact down the road, ”—Douglas Borg, VP of Risk and Quality at Premiere Insurance Management Services

Those words from a national patient safety leader suggest a win. It’s exactly the goal of the authors of the 2020 CBS Benchmarking Report of national malpractice cases from CRICO Strategies, The Power to Predict: Leveraging Malpractice Data to Reduce Patient Harm and Financial Loss.

This month’s CRICO patient safety podcast, Safety Net, explores the research and talks to leaders who will be using it.

It’s a paradigm shift of sorts. CRICO Strategies has issued benchmarking reports from the 450,000 medical malpractice cases in its national Comparative Benchmarking System for several years. But the connection between clinical and financial outcomes is new, a result of using more advanced analytical processes than in prior CBS Reports, with statistical models designed to predict, rather than recount, the outcomes of these malpractice cases.

Massachusetts General Hospital VP of Quality and Patient Safety Elizabeth Mort, MD thinks this approach to carefully coded malpractice data is a big step forward.

“ Looking at the data through the lens of contributing factors and also associating the events with your financial liability is a different way of looking at things and very, very helpful. ”

Dr. Mort says the statistical validity that comes from a large national database of coded malpractice claims is critical because no single institution has enough cases of its own. This has helped clinical leaders see the priorities for safety from the identified trends. But identifying the connection to financial outcomes will help the entire organization, including financial leaders, “see the forest through the trees. ”

The 2020 CBS Benchmarking Report: The Power to Predict: Leveraging Malpractice Data to Reduce Patient Harm and Financial Loss, is available at no charge on the CRICO web site, www.rmf.harvard.edu/CBS2020.