Stevens & Lee
CIT talks to Steven Dyer of the law firm Stevens & Lee about its quality and safety partner, Surgical Excellence, and risk management and medical malpractice insurance in the new healthcare environment
How did Surgical Excellence come about?
Surgical Excellence was created by Dr Phil Schauer, a world-renowned bariatric surgeon at the Cleveland Clinic, and several other leading surgeons who saw the need to help surgery programmes in the US, and around the world, to improve the quality and safety of the care that they provide and reduce the occurrence of adverse events. Stevens & Lee’s Jim Saxton, a nationally known legal expert in medical malpractice risk reduction, healthcare quality and safety improvement, worked with these surgery thought leaders to create Surgical Excellence to achieve these goals.
Surgical Excellence’s mission of improving healthcare quality and safety quickly evolved into other surgical specialties such as spine surgery and orthopedic surgery, as well as non-surgical specialties, including obstetrics and gynecology (OB/GYN), endoscopy and primary care. Surgical Excellence has developed cutting edge clinical quality metrics, best practices and quality and safety compliance dashboards. Surgical Excellence also works with national and international providers on specific clinical and programmatic quality (peer review) engagements and projects. The Surgical Excellence board is directly involved in this work.
How does your offering differ from others in the captive insurance industry?
Surgical Excellence’s focus is on helping physicians, hospitals and other providers succeed in the new healthcare environment through best practices, something which concurrently reduces liability exposure but goes beyond traditional risk management. Surgical Excellence’s research has shown that to participate in the new reimbursement models being developed by public and private payer providers will be expected to provide high quality, high value care.
Surgical Excellence’s quality and safety tools and services are tied into the new ‘accountable care organisation-ish’ reimbursement metrics and can help providers to improve quality and safety performance, enhance the value of care and concurrently reduce the risk that is associated with that care. Surgical Excellence can help physicians to be attractive to payers and patient-centered medical homes/neighbourhoods. Surgical Excellence can also help physicians to be attractive to hospitals that may want to employ them, or achieve the success that they need to remain independent.
How is the medical malpractice line looking right now?
In light of the dramatic changes in healthcare over the next few years, an uptick in frequency and severity around the US is expected. This makes helping healthcare providers (and the medical malpractice captives that insure them) to prepare through aggressive, robust risk reduction efforts all the more important.
We are working with some clients to establish risk retention groups (RRGs) with this safety infrastructure embedded in them, creating a culture of collaboration and meeting the dual goal of preparing for the new environment and reducing risk.
What sorts of specialties are RRGs covering?
Bariatric surgery, OB/GYN, and long-term care are some of the specialty-specific RRGs that we have helped to form. We have also helped to create geographically-specific, multi-specialty RRGs. In addition, embedded in these RRGs are top-notch risk management services that include required baseline risk assessments, risk reduction tools and services, ongoing implementation support and timely risk education for physicians, mid-levels and staff.
With the US Accountable Care Act firmly in place, what is on the cards for healthcare captives?
Healthcare captives have a vital role to play in the new healthcare environment: they have the opportunity now to become platforms for the continued economic viability and future success of their insureds. We are working with medical professional liability companies that are, in a variety of different models, successfully differentiating themselves from their competition by providing Surgical Excellence’s quality and safety services to their insureds as a significant value-added service. We also work with existing RRGs in helping their insureds to understand the new risk that has been created by healthcare reform and preparing for that risk. Surgical Excellence has also talked with several RRGs about supplementing their existing risk management services with credible, data-driven, quality safety tools and strategies.
