Medical malpractice reform by President Obama and the White House

by Emily P. Walker, Washington Correspondent, MedPage Today

The White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases.

In his Sept. 9 speech before Congress, the president announced he would direct Kathleen Sebelius, Health and Human Services secretary, to launch pilot programs meant to cut down on physicians practicing “defensive medicine” to avoid lawsuits.

Republicans have long made this an issue, largely by pushing for caps on jury awards in malpractice cases. Democrats have just as vehemently opposed these limits.

In that context, Obama’s announcement that the government would back state-level pilot programs to find alternative ways to deal with the problem was widely seen as an attempt to win GOP support for his overall health reform effort.

The White House today provided some details about its proposal, saying it would award grants to states or health systems for programs that do the following:

* Put patient safety first
* Work to reduce preventable injuries
* Foster better communication between doctors and patients
* Ensure that patients are fairly and quickly compensated for medical injuries
* Reduce the incidence of frivolous lawsuits
* Reduce medical liability insurance premiums

The awards will be made in a “competitive three-pronged initiative” with these components:

* Grants for up to $3 million for three years to states and health systems to implement and evaluate evidence-based patient safety and medical liability demonstrations
* One-year grants of up to $300,000 to states or health systems to help the planning process of implementing such programs
* A review of existing initiatives that improve healthcare quality and patient safety and decrease medical liability. This report will be issued in December 2009

The effort will measure, among other things, the effectiveness of strategies such as expedited claim resolution, adoption of early mediation and disclosure protocols, and patient and provider satisfaction with interventions.

Grant applications will be due sometime at the end of 2009, and the Agency for Healthcare Quality and Research, which is part of HHS, will make award decisions in early 2010.

“We should explore medical liability reform as one way to improve the quality of care and patient-safety practices and to reduce defensive medicine,” Obama said in a memorandum.

“But whatever steps we pursue, medical liability reform must be just one part of broader health insurance reform — reform that offers more security and stability to Americans who have insurance, offers insurance to Americans who lack coverage, and slows the growth of healthcare costs for families, businesses, and government.”