Leveraging Analytics to Lower Medical Malpractice Costs

As the healthcare industry continues to evolve, radiology groups face mounting pressures to simultaneously improve clinical care, increase their bottom line and enhance productivity. Add to the mix changing reimbursement models, better informed healthcare consumers, and rising costs, and it is easy to see why some radiology leaders are scrambling to innovate and generate new solutions in this highly dynamic marketplace.

As the industry transitions to a value-based care model, analytics platforms have emerged as a way to integrate, organize and analyze data to better understand how organizations are performing, what clinical results need improvement, and whether patient needs are being met. In addition, if radiology leaders leverage the right data points, they can generate significant cost savings for their practice.

According to a 2015 survey from the Deloitte Center for Health Solutions, however, fewer than half of the health systems surveyed have a clear analytics strategy, and one in four do not have a data governance model in place. And yet, health systems seem to recognize the importance of analytics capabilities. More than half of the systems surveyed identified population health analytics as the top investment focus moving into 2016, and more than three in five reported they will invest in advanced analytics capabilities for clinical and population health functions.

The application of analytics will allow for the identification and management of specific procedural protocols and their underlying risk profiles. This provides radiologists access to leading insurance underwriters offering premium coverage, long-term rate stability and the ability to create a custom risk management program.

A key player at the forefront of medical malpractice innovation is Chicago-based Arthur J. Gallagher & Co., a risk management firm developing these programs and identifying new ways physicians can save on malpractice insurance costs. According to Lee Newmark, area senior vice president at AJ Gallagher, physician groups need to combine a collaborative model with advanced analytics capabilities to achieve full cost-savings when it comes to insurance.

“At a certain size threshold, pricing for a radiology group will shift toward being based on their overall claims performance vs. the more traditional crediting methods,” Newmark said. “When the group hits that threshold, comprehensive analytics can help to identify key areas for a practice to focus on in terms of their risk management. Doing so should ultimately lead to a reduction in risk and therefore more competitive pricing.”

By tracking key metrics, radiologists can work with insurance carriers to build a superior medical malpractice program based on documented, detailed proof of the group’s performance. Two key metrics to track are the number of incidents and number of misdiagnoses; these can significantly impact the program’s price, and low or declining numbers over time can reduce costs for radiology groups.

“If analytics are proven and they trend in the right direction, the radiology group makes the case that they are a better risk and deserve to have their pricing evaluated in a more competitive manner,” Newmark explained. “These analytics can also give radiologists information and feedback regarding ways they can alter or modify their behavior to mitigate risk.”

In the event of a claim, groups can collect data regarding the suit, such as who is being sued and why. This can then encourage and inform risk management discussions among providers to drive better outcomes, cost savings and fewer claims in the future.

It has never been more critical for radiologists across the country to leverage the power of analytics to achieve greater efficiencies and lower costs. The utilization of clinical information to drive business and clinical decisions is essential to thrive in the highly dynamic and competitive healthcare landscape. By leveraging an advanced analytics platform, radiology leaders can experience significant cost savings and improve the quality of care they provide their health system and patient community.

For more information, please contact us at ContactIRP@IntegratedRP.com.