Blow your own horn to prove you’re the best risk
Risk managers can’t stop the insurance industry from raising insurance premiums, but you can make sure you get the very lowest rates available. R. Stephen Trosty, JD, MA, director of risk management at American Physicians Assurance Corporation in East Lansing, MI, says this is no time to be shy.
Premiums are going up, but they’re not going up at the same rate for every hospital. If you deserve the better rate, now is the time to say so.
"You have to blow your own horn," he says. "Don’t be content to let the insurer just look at claims and severity, especially if they’re not all that great. You must take the initiative and make your case for a lower rate, because if you don’t, you’ll just be one more provider getting hit with a huge increase." Trosty suggests these moves to get the lowest available premium:
• Review your policies and procedures (P&P), then show them off. Review your P&P to make sure you’re handling potential litigants in the most proactive way possible. Analyze the approach your staff take when there is an adverse event. Do you have mechanisms in place for talking honestly to the patient without necessarily indicating that malpractice has occurred? Do you trace problems to their origin and learn how to prevent them?
"Show the insurer that these are more than just policies in a big book on the shelf," Trosty says. "Show that you actually use them. Show the corrective action you take after an incident and how you use your policies and procedures to respond and learn from them."
• Avoid admitting fault too soon. There has been a lot of emphasis lately on communicating with patients after adverse events and honestly conveying the facts. That’s a fine attitude, but Trosty cautions that you must not be too eager to admit fault. Your insurer will be reassured to hear that you don’t jump the gun.
"Sometimes when the pendulum has been too far on one side, it goes far in the other direction when we try to correct the situation," he says. "Take the time to investigate."
• Investigate near misses. Risk managers should do a better job of collecting data, especially on events that never result in a lawsuit. The near misses deserve serious investigation and can offer major lessons. Make sure your insurer knows that you investigate those near misses and try to learn from them.
• Show your works in progress. Many significant improvements are long-term projects, so you may not be able to point to them yet as a completed effort with proven results. But you still should point them out to your insurer. Moving to electronic records, for instance, can take years to implement. While you’re working on it, show the insurer what you’re doing and why. "Some things can’t be done overnight, but show that you’re working toward them and have a timetable for implementing them," he says. "That matters."
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