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Updated: May 4, 2026

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The Tail Suspension Test
Published on: January 28, 2012
81.8K
Managing 'tail liability'.
Richard C Frese1, Ryan J Weber
1Milliman, Chicago, USA. richard.frese@milliman.com
Summary
Hospitals can control tail liability by using self-insurance and combined limits. Effective communication with auditors and continued risk management are crucial for managing medical malpractice programs.
Area of Science:
- Healthcare Administration
- Risk Management
- Medical Malpractice
Background:
- Tail liability represents a significant financial risk for healthcare organizations.
- Effective management strategies are essential for mitigating long-term medical malpractice exposure.
Purpose of the Study:
- To outline key strategies for hospitals to reduce and control tail liability.
- To provide actionable recommendations for financial and operational risk mitigation.
Main Methods:
- Review of best practices in healthcare risk management.
- Analysis of financial and insurance mechanisms for liability control.
Main Results:
- Implementing self-insurance vehicles can reduce overall liability costs.
- Combined insurance limits between hospitals and physicians offer financial protection.
- Clear communication with actuaries, underwriters, and auditors is vital.
- Sustained risk management and safety programs are fundamental.
- Crediting internal medical malpractice programs enhances liability control.
Conclusions:
- Hospitals can proactively manage tail liability through strategic financial and operational approaches.
- A multi-faceted approach involving insurance, communication, and risk management is recommended.
- These strategies contribute to the long-term financial stability and operational integrity of healthcare facilities.
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