Captives must leverage data for medical risks
Captives that cover medical practices, hospitals and physicians need to get a good understanding of the way that the risks that they cover can be mitigated and even managed by analysing the data that emerges from them.
That was the message from a session at the 2024 Vermont Captive Insurance Association conference that featured Larry Van Horn, founder & chief executive of medical data company Preverity and Stacey Donegan, chief risk officer of Ardent Health Services.
Clinical practice is constantly changing, both pointed out, with millions of operations and other procedures being carried out every year – which in turn is resulting in a vast amount of medical / clinical data that can be analysed to identify trends.
There is a hard return on investment associated with targeted risk management, Van Horn said. A partnership between a CFO, owning balance sheet risk, with the CMO owning clinical risk. He stressed that physicians would respond to comparative information and change their behaviour when presented with hard data.
One the trends that can be identified has a direct relation to medical malpractice. Donegan & Van Horn underlined that it is important to mitigate obstetrician (OB) risks to also mitigate malpractice rates.
AI can help to analyse individual OBs – if they have a higher rate of issues, such as postpartum haemorrhages, increased caesarean rates, etc, they can be alerted to the fact that they can be sued & therefore they can change their practices & clinical care.
The data can also be mined to highlight to captive managers how up to date are doctors that they might be covering? Are they using the most modern drugs? The data can also be examined to identify regional trends in emergency caesareans & infant birth injuries and excess opioid prescribing after caesareans. The panel stressed that it is important to have real-time data on injuries – and therefore the litigation that could result in some cases.
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