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Related Experiment Videos

Understanding managed care organizations' liability exposure.

S Huntington1

  • 1Executive Risk, Simsbury, CT, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|January 7, 1998
PubMed
Summary

Managed care organizations can reduce liability risks by understanding industry shifts and using robust risk management. Key exposures include directors and officers liability, errors and omissions, and provider excess financial loss.

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Area of Science:

  • Healthcare Management
  • Risk Management
  • Organizational Liability

Background:

  • Managed care organizations (MCOs) face significant liability exposures.
  • Understanding these exposures is crucial for minimizing financial and legal risks.
  • Proactive risk management is essential for MCO sustainability.

Purpose of the Study:

  • To identify and categorize the primary liability exposures faced by managed care organizations.
  • To provide insights into strategies for mitigating these risks.
  • To inform MCOs on best practices for comprehensive risk management.

Main Methods:

  • Analysis of typical liability exposure areas within the managed care industry.
  • Categorization of risks into directors and officers liability, errors and omissions, and provider excess.

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  • Review of industry changes impacting MCOs.

    • Main Results:

    • Managed care organizations commonly face three main liability exposure areas.
    • Directors and officers liability relates to nonclinical organizational aspects.
    • Errors and omissions cover daily operational risks in member healthcare management.
    • Provider excess addresses financial peril from catastrophic events.

    Conclusions:

    • Implementing a comprehensive risk management program is vital for MCOs.
    • Staying informed about industry changes helps minimize liability.
    • Addressing directors and officers liability, errors and omissions, and provider excess is key to robust risk management.