Poll: Malpractice premium expenses on the rise since 2020

The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Since 2020, your doctors' malpractice premiums have: increased/stayed the same/decreased?” The majority (62%) said “increased,” while 33% said “stayed the same,” and another 5% responded “decreased.”
 
The poll was conducted June 28, 2022, with 384 applicable responses. Those who responded “yes” were then asked by what percentage has it increased? The average was 14.3%, and the range was as follows:

• 28.9% said less than 10%
• 47.8% responded 10% to 19%
• 15.6% noted 20% to 29%
• 7.8% stated 30% or more.

The poll results are markedly higher than what respondents reported in a Jan. 14, 2020, MGMA Stat poll in which 41% of healthcare leaders stated malpractice premiums increased for their physicians from the previous year. This came on the heels of a five-year period (2013-2018) during which professional liability insurance costs dropped 21.5%.1
 
However, there has been a sea change in the past couple years. Based on data from the 2020 and 2021 MGMA DataDive Cost and Revenue, multispecialty practices reported that median professional liability insurance expenses increased 11.2% from 2019 to 2020 per full-time-equivalent (FTE) physician.2 Data for 2021 will be available in mid-July, with the release of the 2022 MGMA DataDive Cost and Revenue.

Why are malpractice premiums increasing?

As seen in a June 21, 2022, MGMA Stat poll, malpractice premiums are just one area where costs are on the rise for medical group practices. With revenue still lagging for many practices, most recently documented in a Feb. 22, 2022, poll in which 40% of respondents said they did not hit their revenue goals in 2021, added expenses certainly don’t help financial health.
 
For some specialties, the rate at which malpractice premiums have risen recently is distressing. A 2022 American Medical Association report showed that medical professional liability insurance premiums increased during the past three years (2019-2021), reaching a level not experienced since the early 2000s.
 
According to the AMA, there is no hard market yet nationwide, but individual states such as Illinois are reaching that threshold, with premium increases of 10% or more each of the past three years. Per the AMA report, 12 states’ premiums increased 10% or more over the previous year. The top five were:

1. Illinois (58.9%)
2. West Virginia (41.7%)
3. Missouri (29.6%)
4. Oregon (20.0%)
5. South Carolina (16.7%).

All told, nearly half (24) of all states’ premiums increased in 2020 and 2021.3
 
Drilling down to the specialty level, the Medscape Malpractice Report 2021, which surveyed more than 4,300 physicians in 29 specialties throughout the United States, chronicled the percentage of physicians by specialty who have been named in a malpractice lawsuit. Leading the way were:

1. Plastic surgery (83%)
2. Surgery, general (83%)
3. Orthopedics (81%)
4. Urology (80%)
5. OB/GYN (79%).4

During the past two to three years, premiums for some specialists, such as OB/GYN, have more than doubled, causing some physicians to question whether they can continue to practice in the state they reside. Other specialists are used to paying higher premiums; though rates continue to accelerate. For example, premiums for general surgeons in the Miami-Dade County area have increased from $190,829 in 2018 to $215,649 in 2021.5
 
Higher premiums are often tied to frequency of lawsuits. As such, the Medscape report ranked states by the percentage of participating physicians who have been sued. The top five were:

1. Indiana (64%)
2. New York (61%)
3. Pennsylvania (61%)
4. Illinois (59%)
5. New Jersey (59%).6

That said, although premiums have risen during this period, overall claims throughout the United States have dropped. According to a recent Medscape article, for example, tort filings in Illinois fell 43% between 2016 and 2020. But this isn’t a regional phenomenon; the aforementioned Medscape report detailed that 42% of primary care physicians surveyed were sued between 2020 and mid-2021, 10% less than 2019. Likewise, specialists were sued 6% less frequently during that period — dropping from 62% to 56%.7
 
Even though claims and payouts have dropped, severity — in the form of high-dollar verdicts and settlements — is on the rise. Moreover, while these verdicts were once concentrated in certain parts of the country, they are now becoming more widespread. Add to this a backlog of cases delayed by the COVID-19 pandemic and the anticipation of additional claims as care volumes increase amid COVID-19 cases dropping, and physicians are forced to pay higher premiums.
 
Compounding the issue is that once a verdict or settlement is reached, it establishes a baseline for future awards. And amounts are trending higher because insurance companies are earning record profits, which, thanks to financial and social inflation, often plays a part in plaintiff awards.8
 
Ultimately, as reported by Medscape, this could force some physicians to leave the area where they are practicing, become a hospitalist or even switch to locum tenens work.9
 
To find out how your practice stacks up regarding professional liability insurance rates and to gain insight on other baselines for benchmarking practice operations, learn how to purchase the 2022 MGMA DataDive Cost and Revenue.   

JOIN MGMA STAT 

Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit mgma.com/stat. Polls will be sent to your phone via text message. 
 
Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at connection@mgma.com.  

Additional resources 

• Policy Research Perspectives: Prevalence of Medical Liability Premium Increases Unseen Since 2000s Continues for Third Year in a Row — The American Medical Association’s (AMA) annual report on medical professional liability insurance reflects a trend of increasing premiums; though the United States has yet to reach a hard market, as it did in the early 2000s.  
• MGMA Stat: An almost universal financial pinch on medical practices as inflation rises — The impacts of inflation and rising expenses are being felt heavily by medical group practices, according to a June 21, 2022, MGMA Stat poll.  

Notes:
1. Gans D. “Data Mine: Quo vadis? 20 years of cost and revenue data help point to what’s to come.” MGMA. June 10, 2020. Available from: bit.ly/3nlrCkg.
2. 2020 and 2021 MGMA DataDive Cost and Revenue (based on 2019 and 2020 data).
3. Guardado JR. “Policy Research Perspectives: Premium Increases Unseen Since 2000s Continues for Third Year in a Row.” American Medical Association, February 2022. Available from: bit.ly/3QWTo40.
4. Gallegos A. “Medscape Malpractice Report 2021,” Medscape, Nov. 19, 2021. Available from: wb.md/3HYRlZi.
5. Guardado JR.
6. Gallegos A. “Medscape Malpractice Report 2021.”
7. Gallegos A. “‘My Malpractice Insurance Doubled!' Why, When Fewer Patients Are Suing?” Medscape, June 10, 2022. Available from: wb.md/3u3KR5J.
8. Ibid.
9. Ibid.