A $2.9 million grant from the federal Agency for Healthcare Research and Quality (AHRQ) to New York State (roughly $500,000 of which will go to the Unified Court System) to conduct a pilot program to reduce expenses associated with medical malpractice lawsuits by encouraging early settlement and by improving patient safety to reduce preventable medical injuries. Five New York City hospitals will participate in the initiative: Beth Israel Medical Center, Maimonides Medical Center, Montefiore Medical Center, Mount Sinai Medical Center, and New York Presbyterian Hospital Columbia Presbyterian Center.
The hospitals will receive funds that can be applied to patient safety initiatives and will contribute significant in kind funds to implement their functions under the grant. The grant is one of the $25 million in grants set to be handed out to states and health care systems under the health care reform bill. The project consists of four major components:
- Each hospital will develop and promote a culture of patient safety;
- Four hospitals will initiate safety interventions in obstetrics; one hospital will initiate safety interventions in general surgery;
- Each hospital will implement a program whereby it will provide early disclosure to a patient and/or patient’s family when a medical error occurs and make an early (pre-litigation) offer of compensation if appropriate;
- A courtroom will be established to achieve early settlement through Judge-Directed Negotiations for medical malpractice cases from the five hospitals that do not settle early and lead to lawsuits. The judges for those proceedings will be carefully selected and trained according to a curriculum designed specially for this function, with support from the medical associations.
The Judge-Directed Negotiations approach is based on a model developed by the Hon. Douglas McKeon of Bronx County Supreme Court, who is also Chief Judge of Appellate Term, First Department. Judge McKeon presides over all medical malpractice cases involving Health and Hospitals Corporation (HCC) hospitals in the Bronx and Manhattan. The goal of the project is to reduce medical malpractice “transaction costs,” which are estimated to make up approximately 60 percent of medical malpractices costs. Under Judge McKeon’s project, savings of up to $50 million annually have been achieved.
According to the state’s grant proposal, the city hospital agency reports that it has saved some $50 million a year in medical malpractice expenses as a result of this aggressive settlement approach. The agency says it has reduced its open claims to just over 1,000 from 1,400. According to figures from the Office of Court Administration, 3,961 medical malpractice cases were filed last year in New York state. Of those, 2,418 were brought in New York City. Judges selected to participate in the program will receive training in targeted areas of medicine and in negotiation and mediation skills. Their goal will be to achieve rapid settlements whenever possible.
The grant will allow the court system to hire someone with a joint law and nursing degree to assist the judges in handling the case. New York State has among the highest medical malpractice premium rates in the nation and led the country in the number of medical malpractice claims filed with the National Practitioner Data Bank for the decade ending in 2009. Hospitals in New York State spend over $1 billion annually on medical malpractice expenses, representing 3 percent of total revenues.
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