STATUS Health Partners is a full-service physician practice management firm whose primary purpose is to support community health by engaging and deploying qualified healthcare professionals. Our entire organization strives to meet this purpose daily.
This case study demonstrates how STATUS embodies our purpose to ensure that community health is protected through our risk management strategy and physician engagement.
Background
Over the past several years the Emergency Medicine Sector of the healthcare industry has become highly litigious, which has caused the medical malpractice market to harden. This shift has caused premiums to skyrocket and the severity of cases to increase each year. The reason for the market changes is multifactorial and includes the following key factors:
- Severity of claims
- Increase in defense costs
- Plaintiff’s attorneys (Greed)
- Inflation
Additional factors contribute to these market changes; however, the four listed above are the primary drivers of the increases. This increase has had a larger impact on rural hospitals because their resources are already strained. A compounding factor is the influx of private equity groups entering the rural market, often compromising patient safety for higher profits and increased market share.
Solution
STATUS is veteran physician owned and has operated for 35 years. Our organization has developed a deep connection to rural community health and is able to quickly adapt to changes in the environment. STATUS developed the following risk management strategies to protect our partner facilities from increasing risk and cost.
STATUS risk mitigation strategy starts at the frontline with our clinical recruitment team. Prior to moving forward with a candidate, the recruitment team administers a prescreen to ensure the provider meets the standards of STATUS. This assessment includes a review of all certifications, number of hours worked in an ED setting, experience in a single coverage rural setting, and any issues with their background that might hinder their ability to meet our partners’ needs. The final step of our recruiting strategy is to review the specific physician responsibilities required by the hospital they will be working at to ensure the candidate can perform all duties.
The next phase of our risk mitigation strategy is handled by our credentialing team. Prior to the application process, our team runs an NPDB report (National Practitioner Data Bank). If the reports come back clean, we require at least 3 peer references with positive reviews. After these steps, we begin the full credentialing process, which entails primary source verifications and independently verifying the providers qualifications.
While the credentialing team is performing verifications and a risk management overview of the potential provider, our Performance Improvement department (PI), led by an EM residency trained board certified, physician Lenard Kerr, DO, FAAEM, begins its process, starting with a review of the provider’s claim history. If the provider has anything other than a low dollar settled claim, we do not move forward. PI conducts a thorough background check using publicly sourced information and government sites prior to interviewing the candidate. If the candidate passes these checks, they will interview with Dr. Kerr, as indicated. The interview consists of different scenarios to assess the physician’s knowledge.
After our due diligence process is complete and the physician is granted privileges, our PI department will complete a first shift follow up with the provider. This follow up includes a call with the facility to determine how the shift went and if there were any immediate issues that need to be addressed. Once the physician has worked a few shifts, PI requests randomized charts for review to ensure proper compliance with best practices. This step is crucial, as studies have shown providers identify better documentation as a primary way they could have avoided their own malpractice claims.
Results
The results from this initiative have been extremely positive. STATUS physicians have not had a claim in over one million hours staffed and five hundred thousand visits. Additionally, in a market where most practices have experienced rate increase, our premium has decreased by 15% allowing STATUS to reduce costs while increasing patient safety.
In conclusion, proactively developing our risk mitigation strategy through an enhanced screening process and physician engagement demonstrates one area where STATUS’ dedication to the hospitals and communities we serve allows us to achieve improved patient safety and satisfaction, while maintaining overall cost control.