Health & medmal trends – what you need to know

Vanessa Rogers on behalf of Natmed Medical Defence

There’s a crossover between the experiences of medical health schemes and those of professional indemnity insurers that can aid the approach of a medical specialist. Read on for the latest research and how it relates to you.

The latest Global Medical Trends Survey, published annually by Willis Towers Watson, provides feedback on medical costs from a global network of 209 insurers in 61 countries. A brief synopsis of the survey results is provided below.

The survey reveals that the unpredictable course followed by the pandemic across the world has resulted in “considerable volatility in healthcare utilisation and costs”. Healthcare costs dropped to an average of 4.8 percent in 2020 and ricocheted to 8.1 percent by the end of 2021 when the report was published.

The anticipated healthcare-benefit-to-cost trend is likely to continue at more or less this rate. Another nugget from the report: “Three quarters of health insurers anticipate a higher, or significantly higher medical trend, over the next three years” – probably due to the unpredictable trajectory of COVID-19 across countries.

Key findings cover four main areas, as follows:

• Claims related to musculoskeletal disorders soared, most likely due to poor ergonomic set-up in the work-from-home office – followed closely by cardiovascular and respiratory conditions. The cancer appeared to drop in significance, despite it being a top condition affecting medical cost – most likely due to a deferral of treatments over the pandemic. Notably, insurers expect mental and behavioural disorders to be on the rise in terms of claims over the next 18 months, which could prove a factor in the work of many medical specialities.
• If you’ve not yet begun offering telehealth in your practice, which allows specialists (including obstetricians and gynecologists) to examine, remotely diagnose and treat their patients, you may like to get on the bandwagon. Insurers and patients alike are noticing the improved cost management of this medical offering, which can serve to swell the scope of your potential patient base.
• Medical practitioners should be wary of the overuse of care. Sixty-four percent are suggesting too many different types of treatments, and costs are rising in tandem. The report also shows that 58 percent of insurers believe overuse of care by insureds is rendering the care that bit more costly.
• Last up, it goes without saying that some nations are seeing a heightened demand for services now that it is safer to sit in that waiting room or schedule that procedure in a hospital – especially if you are a high risk patient, such as a diabetic, pregnant, or undergoing oncology treatment, for example. Others may only witness this resurgence in 2023 or beyond. What’s good news for medical practitioners is that a waning pandemic can only be beneficial in terms of the volume of future treatments they will be called upon to perform.

Spotlight on medical malpractice indemnity

Moving on from medical schemes to the insurers offering professional indemnity (PI), here’s a look at trends of relevance to the medical malpractice sector.

Firstly, it’s important to state that PI is a necessary illness for all professionals. Therefore, many of the sentiments expressed in Thomas Harban’s piece for DeRebus (aimed at legal practitioners and practices), refer equally well to the medical profession and its specialists; especially those in private practice.

Harban writes: “The effects of the COVID-19 pandemic on PI claims will only become known in time when there is sufficient data on which to analyse the trends. It will be appreciated that the nature of PI claims is long-term …, as there will be a long lapse of time between the plaintiff becoming aware of the breach of the mandate or duty of care on the part of the … practitioner and them embarking on the process to pursue a claim against [him/her]. Many … practices were not able to operate optimally for long periods since the onset of the pandemic. The change in the operating environment also affected the risks that firms face.”

The second point of relevance across the professions, including medical practitioners, is this one: “Practitioners pursuing practice in high-risk areas must reinforce their internal risk management measures. Many of the claims arise from mistakes that could have been avoided had a common-sense, prudent risk management approach been applied.”

The gist of his piece is that professionals in private practice across the board should chat to their PI brokers or insurers to mitigate falling victim to these risks, which could range from the need for more accurate record-keeping to ensuring that informed consent is taken in the most protective way.

Click here for the full Willis Towers Watson “Global Medical Trends Survey”.

_{Other sources:}

_{https://www.derebus.org.za/the-professional-indemnity-claims-trends/}

_{https://www.fanews.co.za/article/short-term-insurance/15/commercial/1006/trends-affecting-professional-indemnity-cover/30564}