The Affordable Care Act (ACA)

I’m sure many of you took note of the Supreme Court’s decision last month upholding the constitutionality of the Affordable Care Act (ACA). Anyone working in healthcare has a stake in how the US healthcare system will change as the law is implemented over the next several years.

Medical professional liability insurance companies have been studying the law and its implications for our business. Yesterday, a number of our staff at PRMS attended a webinar put on by the Physician Insurers Association of America (the PIAA,, a trade association of the 50+ medical liability companies which are owned or controlled by physicians or medical societies. (PRMS is an associate member.) The panelists presenting the webinar all had many years of experience in the medical liability insurance business.

Predicting the future is always interesting and risky (after all, many commentators predicted that the Supreme Court would find the ACA unconstitutional). Here are a few of the predictions the panel had on how ACA might change medical practice and medical malpractice:

– There will be greater reliance on “telemedicine” in the coming years.

– There will be increased reliance on “physician extenders,” (e.g., nurse practitioners, physician assistants) in providing treatment.

– Healthcare providers of all kinds will be pressured to reduce “defensive medicine” and appropriately manage patient expectations.

– With more patient encounters (because previously uninsured people will now seek care), the industry will likely see more claims.

– On the other hand, because almost everyone will have access to coverage, there may be less incentive for those who believe they have been harmed to sue to recover the costs of future medical care.

– With doctors and hospitals working together in Accountable Care Organizations (ACO’s), defending medical malpractice claims may become more complex because of the sometimes conflicting interests of the defendant parties.

Of course no one knows, and no one will know for years to come, what will actually happen as all the provisions of ACA become reality. Stay tuned.