Mo. Malpractice Claims Fall But Premiums Rise

The number of medical malpractice claims filed and paid is declining in Missouri, yet physicians’ premiums are rising, according to a report from the state Insurance Department.

New medical malpractice claims dropped 14 percent in 2003 to what the department said was a record low, and total payouts to medical malpractice plaintiffs fell to $93.5 million in 2003, a drop of about 21 percent from the previous year.

“Payments in 2002 took an unexplained jump that vanished in 2003. Unfortunately, this data does not explain why the current medical malpractice crisis in cost and availability has occurred,” said Insurance Department Director Scott Lakin.

The report found that doctors’ malpractice insurance premiums rose by 121 percent between 2000 and 2003 while payouts to plaintiffs rose 14 percent during that time.

A state physicians’ group, which has been lobbying for more restrictions on medical malpractice claims as a way to control rising insurance premiums, said the Insurance Department data should not be used as evidence of statewide trends.

“The data that the Department of Insurance collects is significantly incomplete,” said Tom Holloway, a lobbyist for the Missouri State Medical Association.

For example, the report does not include claims data from some of the state’s largest hospital systems, including BJC HealthCare and Tenet Healthcare Corp. That’s because those systems are self-insured and declined to submit data for their hospitals, said Randy McConnell, a spokesman for the Insurance Department.

In recent years, a growing number of hospitals have been self-insuring rather than buying insurance in the commercial market. This trend could skew the results of the database, McConnell said, but he could not quantify how much.

Holloway said the impact could be significant, noting that “the more people that go self-insured, the fewer claims the department is going to know about.”

But there’s additional evidence that the number of malpractice claims paid in Missouri is declining and the average payout is increasing at a slower rate than premiums.

The National Practitioner Data Bank, a federally mandated database of malpractice claims against physicians, found that the number of paid claims in Missouri fell by about 30 percent since 1991. The insurance department’s database found that paid claims against physicians fell 42.3 percent during the same time period.

Both databases also found increases in average medical malpractice payouts over the 12 years.

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