NYS Medical Malpractice Coverage Premiums

Transcription

1 T H E F A C T S A B O U T NYS Medical Malpractice Coverage Premiums 2007 Standard Medical Malpractice Premium Rates* Rochester area Internal medicine $7,011 General surgeon $22,400 OB/GYN $37,384 St. Lawrence Franklin Clinton Buffalo area Internal medicine $9,959 General surgeon $31,818 OB/GYN $53,102 Jefferson Lewis Hamilton Essex Warren Oswego Washington Chautauqua Niagara Erie Cattaraugus Orleans Monroe Genesee Wyoming Livingston Allegany Oneida Wayne Onondaga Ontario Cayuga Madison Seneca Yates Cortland Chenango Tompkins Schuyler Stuben Chemung Tioga Broome Herkimer Otesgo Delaware Fulton Montgomery Schohaire Greene Saratoga Schenectady Albany Rensselaer Albany Columbia Lower Hudson River Internal medicine $15,846 General surgeon $50,626 OB/GYN $84,492 Other Upstate Internal medicine $9,404 General surgeon $30,045 OB/GYN $50,143 Manhattan and Suburban Internal medicine $25,814 General surgeon $82,473 OB/GYN $137,642 Sullivan Ulster Orange Dutchess Poughkeepsie Putnam Westchester Long Island Internal medicine $33,360 General surgeon $106,583 OB/GYN $177,880 Rockland *Source: Medical Liability Mutual Insurance Company. Internist premiums cited exclude cardiac catheterization, and premiums for general surgeons exclude those who perform bariatric surgery. Bronx, Kings, Queens and Richmond Internal medicine $30,620 General surgeon $97,828 OB/GYN $163,269 Nassau Suffolk Standard medical malpractice premium rates paid by most physicians in New York State rose by 14 percent in According to the Department of Insurance, this increase follows years of the government artificially setting rates below what was needed under New York s prior approval of rates system for malpractice coverage. Rates vary significantly by medical practice and geography within New York State. For example, the premium rate for a neurosurgeon practicing on Long Island is $291,807 while the rate for an allergist in Rochester is $2,064. The state is divided into seven malpractice rating territories. A sample of premium rates for three types of physicians is displayed above to illustrate the significant variations by practice and geography, reflecting the underlying aggregate claims experience. Physicians and hospitals that employ physicians are often able to qualify for discounts from the standard rates. Standard rates typically reflect what are called occurrence policies that provide liability coverage for services rendered during a policy period regardless of when the claim is reported. The typical limits of liability are $1.3 million for damages sustained by a single patient and a $3.9 million maximum liability for an entire policy year. 1 of 7

2 Distribution of Medical Malpractice Costs by Health Service Type, of the Medical Benefits Dollar Paid By Insurance Premiums Reflects the Costs of Liability and Defensive Medicine } 10 The breakdown of those expenses: 4 Outpatient 1 Hospital Inpatient 1 Prescription Drugs 3 Physician Services 1 Other Medical Services Source: PriceWaterhouseCoopers: The factors fueling rising healthcare costs,. Health care experts and survey responses from doctors show that liability concerns have placed physicians on the defensive. In a March 2002 Harris Interactive survey, 38 percent of physicians reported that excessive care in the form of unnecessary tests and referrals are provided very often for fear of medical liability. An additional 56 percent reported that such care is sometimes provided because of liability concerns. 1 A study by PriceWaterhouseCooper (PwC) 2 estimates that roughly 10 percent of the health coverage premiums used for medical services is attributable to the costs of liability, specifically litigation and defensive medicine. These costs are distributed across health service categories as shown above. Federal officials have projected that billions of dollars in potential savings could occur if defensive medicine were curtailed through limits on non-economic damages in liability cases. A national study published in the journal Inquiry, 3 also supports these projections. 2 of 7

3 Tracking Medical Liability Premiums Each year, the Medical Liability MONITOR continuously conducts a survey among major medical liability insurers across the nation and is considered the most comprehensive physician malpractice premium data source available. Annual malpractice premiums for three specialties internal medicine, general surgery, and obstetrics and gynecology are reported on the following three pages to portray the wide range of rates. While every attempt is made to include the leading writers in each state, some are excluded. The survey comprises an estimated percent of the entire market. The remainder of this fact sheet summarizes the MONITOR s results for, highlighting states with higher and lower premium rates than New York s highest and lowest rates. Also displayed are Medical Liability Mutual Insurance Company's (MLMIC) rates in New York state for the same three specialties: internal medicine, general surgery and obstetrics gynecology. Comparisons across states must be cautiously interpreted because of the way various policies are sold and how credits, discounts and experience factors are calculated. For example, many of the policies used in the survey relate to different liability limits per injury and total coverage amount for the policy year. Typical standard premiums cited for New York State are for occurrence policies, and liability coverage refers to $1.3 million per injury and $3.9 million in coverage for the policy year. Generally, the data indicates that some regions of New York have among the highest malpractice premium rates and other regions have among the lowest rates in the country. Physicians in the downstate region pay closer to the highest rates reported by the states, and those in upstate pay premiums similar to what physicians pay in states with the lowest rates. 3 of 7

4 National Medical Malpractice Rates : Internal Medicine States with higher rates than New York's highest rate* Florida (Dade) $55,055 Michigan (Wayne) $38,942 Illinois (Cook) $37,688 Connecticut $34,700 Texas (Bowie) $31,660 *Source: Medical Liability MONITOR, October, Vol. 31, No. 10. New York State medical malpractice rates: and 2007* 2007 Long Island $26,847 $33,360 Bronx, Kings, Queens $26,859 $30,620 and Richmond Manhattan and Suburban $22,643 $25,814 Lower Hudson River $13,900 $15,846 Buffalo area $8,736 $9,959 Other Upstate $8,249 $9,404 Rochester area $6,150 $7,011 *Source: Medical Liability Mutual Insurance Company. Internist premiums cited exclude cardiac catheterization. Rates effective from July 1, 2007 through June 30, States with lower rates than New York's lowest rate* Minnesota $3,375 South Dakota $3,697 Idaho $3,770 Wisconsin $5,147 Oregon $5,930 *Source: Medical Liability MONITOR, October, Vol. 31, No of 7

5 National Medical Malpractice Rates : General Surgery States with higher rates than New York's highest rate* Florida (Dade) $178,841 Michigan (Wayne) $140,678 Missouri (Kansas City) $132,314 Illinois (Cook, Madison, St. Claire) $126,390 Ohio (Cuyahoga, Lorain) $95,122 *Source: Medical Liability MONITOR, October, Vol. 31, No. 10. New York State medical malpractice rates: and 2007* 2007 Long Island $85,772 $106,583 Bronx, Kings, Queens $83,812 $97,828 and Richmond Manhattan and Suburban $72,343 $82,473 Lower Hudson River $44,408 $50,626 Buffalo area $27,910 $31,818 Other Upstate $26,355 $30,045 Rochester area $19,648 $22,400 *Source: Medical Liability Mutual Insurance Company. General surgeon premiums cited exclude those who perform bariatric surgery. Rates effective from July 1, 2007 through June 30, States with lower rates than New York's lowest rate* Minnesota $11,306 South Dakota $12,569 Idaho $14,514 Wisconsin $18,015 *Source: Medical Liability MONITOR, October, Vol. 31, No of 7

6 National Medical Malpractice Rates : Obstetrics & Gynecology States with higher rates than New York's highest rate* Florida (Dade) $247,945 *Source: Medical Liability MONITOR, October, Vol. 31, No. 10. New York State medical malpractice rates: and 2007* 2007 Long Island $156,032 $177,880 Bronx, Kings, Queens $143,215 $163,269 and Richmond Manhattan and Suburban $120,736 $137,642 Lower Hudson River $74,114 $84,492 Buffalo area $46,580 $53,102 Other Upstate $43,984 $50,143 Rochester area $32,792 $37,384 *Source: Medical Liability Mutual Insurance Company. Rates effective from July 1, 2007 through June 30, States with lower rates than New York's lowest rate* Idaho $19,320 Minnesota $19,643 South Dakota $21,072 Wisconsin $23,677 California (San Mateo, Santa Clara, $30,463 Santa Cruz, Fresno, Monterey ) *Source: Medical Liability MONITOR, October, Vol. 31, No of 7

7 Notes 1 Harris Interactive: Most doctors report fear of medical liability has harmed their ability to provide quality care (Health Care News): Volume 2; Issue PriceWaterhouseCoopers: The factors fueling rising healthcare costs. Sponsored by America s Health Insurance Plans. 3 Kilgore, MI, Morrisey MA, Nelson LJ: Tort law and medical malpractice insurance premiums; Inquiry; 4, 3: Fall. 7 of 7