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Situation

An obstetrics group practice sought to understand whether or not issues with post-term pregnancies and night shift staffing contributed to a medical malpractice insurance premium increase and what, if any, recourse was available.

Solution

The Partnership program includes access to a risk management specialist to help identify and target areas of risk. The RMFS Risk Manager used all available tools and resources to determine that this group had incurred a much higher share of the OB-related losses than other OB practices in the captive. Post-term pregnancies did not seem to be a contributing factor, though one-third of the obstetrics claims resulted from care rendered at night. Among all groups, birth asphyxia was a common final diagnosis, and was a leading cause of claims with the exception of one group. Further examination of the exceptional group identified that they had implemented a 'preparing parents for a difficult outcome' program 3 years prior.

Value

Hunches regarding the nature of the claims experience could now be confirmed or denied with data as evidence. Armed with the knowledge that the average loss in birth asphyxia cases for the captive was $660,000, and that implementation of a 'parent notification' program was associated with a reduction in birth asphyxia claims, the notification program was broadly implemented and resulted in potential savings of 2 claims in year one, or $1.3 million and a significant improvement in patient outcomes.