Impact of state tort reforms on physician malpractice payments

Health Affairs

Volumn 26, Issue 2, 2007, Pages 500-509

  Waters, Teresa M ^a   Budetti, Peter P ^b   Claxton, Gary ^c   Lundy, Janet P ^d  

^a UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER   (United States)

^b UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER   (United States)

^c HENRY J KAISER FAMILY FOUNDATION   (United States)

^d NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ECONOMICS; EPIDEMIOLOGY; EXPERT WITNESS; FEE; GOVERNMENT; HUMAN; INSURANCE; LEGAL ASPECT; MALPRACTICE; MEDICOLEGAL ASPECT; MULTIVARIATE ANALYSIS; NATIONAL PRACTITIONER DATA BANK; POLICY; PROBABILITY; STATISTICS; UNITED STATES;

EXPERT TESTIMONY; FEDERAL GOVERNMENT; FEES AND CHARGES; HEALTH CARE SURVEYS; HUMANS; INSURANCE, LIABILITY; LEGISLATION, MEDICAL; MALPRACTICE; MULTIVARIATE ANALYSIS; NATIONAL PRACTITIONER DATA BANK; PROBABILITY; PUBLIC POLICY; STATE GOVERNMENT; UNITED STATES;

EID: 33947320425     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.26.2.500     Document Type: Article

References (40)

1. National Conference of State Legislatures, "Medical Malpractice Tort Reform," 31 August 2005, http://www.ncsl.org/standcomm/sclaw/medmal overview.htm (accessed 28 November 2005).
2. See White House, "Medical Liability," http://www.whitehouse. gov/infocus/medicalliability (accessed 28 November 2006);
3. and Lawsuit Abuse Reduction Act, H.R. 420.
4. M. Norbut, "Liability Premiums Stabilizing, but Still Painfully High-Priced," American Medical News 48, no. 41 (2005): 1-2.
5. See U.S. Congress Office of Technology Assessment, Impact of Legal Reforms on Medical Malpractice Costs, Pub. no. OTA-BP-H-119, September 1993, http://www.wws.princeton.edu/ota/ns20/year_f.html (accessed 1 December 2006).
6. This section draws upon P.P. Budetti and T.M. Waters, Medical Malpractice Law in the United States, May 2005, http://www.kff.org/ insurance/7328.cfm (accessed 28 November 2006).
7. West Virginia Code, sec. 55.7B.7.
8. Alaska Statutes, sec. 09.55.536.
9. Connecticut General Statutes, Chapter 697, secs. 38a-33 and 38a-36.
10. California Civil Code, sec. 3333.2.
11. See also D.M. Studdert, Y.T. Yang, and M.M. Mello, "Are Damages Caps Regressive? A Study of Malpractice Jury Verdicts in California," Health Affairs 23, no. 4 (2004): 54-67.
12. Arizona Statutes, sec. 12-568.
13. Such a defendant can generally try to force the other defendants to reimburse them in proportion to each one's share of the fault.
14. Kansas Statutes, sec. 60-258a(d);
15. and 42 Pennsylvania Consolidated Statutes, sec. 7102(b.1).
16. Utah Code Annotated, sec. 78-14-9.5 (1996).
17. See, for example, Florida Statutes, sec. 768.76.
18. Nebraska Revised Statutes, sec. 25.222.
19. See, for example, 735 Illinois Compiled Statutes, sec. 5/13-215, which extends the time for bringing an action in cases of fraudulent concealment.
20. See, for example, K.E. Thorpe, "The Medical Malpractice 'Crisis': Recent Trends and the Impact of State Tort Reforms," Health Affairs 23 (2004): w20-w30 (published online 21 January 2004; 10.1377/hlthaff.w4.20);
21. and S. Zuckerman, R.R. Bovbjerg, and F. Sloan, "Effects of Tort Reforms and Other Factors on Medical Malpractice Insurance Premiums," Inquiry 27, no. 2 (1990): 167-182.
22. For detailed discussion of early empirical studies, see OTA, Impact of Legal Reforms, 64.
23. Sloan and colleagues found collateral-source rules associated with 21 percent reduction in the average award. F.A. Sloan, P.M. Mergenhagen, and R.R. Bovbjerg, "Effects of Tort Reforms on the Value of Closed Medical Malpractice Claims: A Microanalysis," Journal of Health Policy, Politics and Law 14, no. 4 (1989): 663-689.
24. Danzon found that states with collateral-source offsets were associated with 11-18 percent lower claims payment amounts and 14 percent lower claims frequency. P.M. Danzon, "The Frequency and Severity of Medical Malpractice Claims: New Evidence," Journal of Law and Contemporary Problems 29, no. 5 (1986): 57-84.
25. Zuckerman and colleagues found that mandatory or voluntary collateral-source offsets had no effect on premiums but that mandatory, not voluntary, collateral-source offsets reduced claims severity. Zuckerman et al., "Effects of Tort Reforms," pp. 176, 179.
26. D.P. Kessler and M.B. McClellan, "Do Doctors Practice Defensive Medicine?" Quarterly Journal of Economics 111, no. 2 (1996): 353-390.
27. The Congressional Budget Office (CBO) notes that Kessler and McClellan's indirect reforms appear to be associated with a 2 percent increase in spending over the short term, but this is not explained in the study. CBO, Limiting Tort Liability for Medical Malpractice (Washington: CBO, 8 January 2004), 6-7.
28. More recently,Hellinger and Encinosa found that state malpractice award caps appear to be associated with modestly lower (3-4 percent) per capita health care spending. See F.J. Hellinger and W.E. Encinosa, "The Impact of State Laws Limiting Malpractice Damage Awards on Health Care Expenditures," American Journal of Public Health 96, no. 8 (2006): 1375-1381.
29. American Medical Association, Physician Characteristics and Distribution in the U.S. (Chicago: AMA, 1995-2003);
30. Centers for Medicare and Medicaid Services, "Health Expenditures by State of Residence," http://www.cms.hhs.gov/NationalHealthExpendData/ 05_NationalHealthAccountsStateHealthAccounts.asp#TopOfPage (accessed 17 January 2007);
31. and Bureau of Labor Statistics, "Consumer Price Index - All Urban Consumers, All Items, U.S.," available at http://www.bls.gov/cpi (accessed 1 December 2006).
32. For further detail, see the Appendix, online at http://content. healthaffairs.org/cgi/content/full/26/2/500/DC1.
33. Scales omitted to avoid collinearity: attorneys' fees as the fiftieth and seventy-fifth percentile (twenty-fifth-percentile scale kept in specifications) and res ipsa loquitur.
34. See Appendix, as in Note 21.
35. See, for example, U.S. Government Accountability Office, National Practitioner Data Bank:Major Improvements Needed to Enhance Data Bank's Reliability, Pub. no. GAO-01-130 (Washington: GAO, November 2000).
36. See also L.E. Smarr, "A Comparative Assessment of the PIAA Data Sharing Project and the National Practitioner Data Bank: Policy, Purpose, and Application," Law and Contemporary Problems 60, no. 1 (1997): 59-79.
37. See, for example, T.M. Waters et al., "Usefulness of Information Provided by the National Practitioner Data Bank," Joint Commission Journal on Quality Improvement 29, no. 8 (2003): 416-424.
38. R2 = 0.27 in Exhibit 1 for average payment per claim.
39. T.M. Waters et al., "Impact of the National Practitioner Data Bank on Resolution of Malpractice Claims," Inquiry 40, no. 3 (2003): 283-294.
40. P.P. Budetti, "Tort Reform and the Patient Safety Movement: Seeking Common Ground," Journal of the American Medical Association 293, no. 21 (2005): 2660-2662.