Damage caps and defensive medicine, revisited

Paik, Myungho; Black, Bernard; Hyman, David A.

doi:10.1016/j.jhealeco.2016.11.001

Cited by 37 publications

(38 citation statements)

References 24 publications

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“…However, tort reform is aimed at a problem that has little to do with the malpractice crises that prompted Illinois to take action in the first instance. In other work, we find that damage caps have limited, if any, potential to reduce health‐care spending and attract physicians (Paik et al , ). Those looking for a magic bullet for the ills that beset the health‐care system would be well advised to look elsewhere.…”

Section: Resultsmentioning

confidence: 52%

Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010

Rahmati

Hyman²,

Black³

et al. 2016

J Empirical Legal Studies

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Since 1980, Illinois has experienced three medical malpractice insurance crises—in the mid‐1980s, mid‐1990s, and early‐2000s. Each time, Illinois responded by enacting tort reform. Using a previously unavailable database of closed medical malpractice (med mal) claims, maintained by the Illinois Department of Insurance, we analyze statewide trends in med mal claiming from 1980–2010, covering all three crises. Paid claim rates rose sharply from 1980–1985, roughly leveled off from 1986–1993, and then began a sustained decline. By 2010, paid claims rates were 75 percent lower than in the peak year (1991). Payout per claim has steadily increased since 1980, but these increases can be entirely explained by the virtual disappearance of smaller paid claims and claims involving less severe injuries. The total direct cost of med mal litigation (payouts and defense costs) rose sharply from 1980–1992, with a jump in 1991, and then declined steadily, with a more modest jump during 2000–2002, which persisted through 2006. Thus, of the three Illinois insurance crises, only the first coincided in time with a major change in claiming. Rather than becoming more generous over time, the Illinois med mal system has squeezed out claimants with less severe injuries and smaller claims.

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Section: Resultsmentioning

confidence: 52%

Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010

Rahmati

Hyman²,

Black³

et al. 2016

J Empirical Legal Studies

Self Cite

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“…These variables reflect the financial resources and health resources that influence beneficiaries’ health care demand, access, and utilization (Zuckerman et al. ; Paik, Black, and Hyman ; Young et al. ).…”

Section: Methodsmentioning

confidence: 99%

Effects of Early Dual‐Eligible Special Needs Plans on Health Expenditure

Zhang

Diana

2017

Health Services Research

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Involving Medicaid services in D-SNPs may be crucial to improve coordination between Medicare and Medicaid programs and control Medicaid spending among dual-eligible beneficiaries. Starting from 2013, D-SNPs were mandated to have contracts with state Medicaid agencies. This change may introduce new effects of D-SNPs on health care spending. More research is needed to examine the impact of D-SNPs on dual-eligible spending.

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“…Our results for overall Medicare spending can usefully be compared to those of Paik et al (2017). They have only county-level data (rather than the patient-level data we rely on) but smaller standard errors because they have data for the entire Medicare population; we have only a 5 percent sample.…”

Section: Results For Medicare Spendingmentioning

confidence: 99%

“…N otes : Figures compare our results for Part A and Part B Medicare spending from Figure 3 (converted from dollars to percent of 2002 spending) to results from Paik et al (2017), who have county-level data on Part A and Part B spending, and regress In (Medicare spending per enrollee) on leads and lags relative to reform year, county and year fixed effects, covariates, and constant term, with weights based on average number of enrollees in each county over 1998–2011. The figure shows coefficients on leads and lags relative to year ( t −4), which is set to zero.…”

Section: Figurementioning

confidence: 99%

Damage Caps and Defensive Medicine: Reexamination with Patient‐Level Data

Moghtaderi¹,

Farmer²,

Black³

2019

J Empirical Legal Studies

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Physicians often claim that they practice “defensive medicine,” including ordering extra imaging and laboratory tests, due to fear of malpractice liability. Caps on noneconomic damages are the principal proposed remedy. Do these caps in fact reduce testing, overall health-care spending, or both? We study the effects of “third-wave” damage caps, adopted in the 2000s, on specific areas that are expected to be sensitive to med mal risk: imaging rates, cardiac interventions, and lab and radiology spending, using patient-level data, with extensive fixed effects and patient-level covariates. We find heterogeneous effects. Rates for the principal imaging tests rise, as does Medicare Part B spending on laboratory and radiology tests. In contrast, cardiac intervention rates (left-heart catheterization, stenting, and bypass surgery) do not rise (and likely fall). We find some evidence that overall Medicare Part B rises, but variable results for Part A spending. We find no evidence that caps affect mortality.

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Damage caps and defensive medicine, revisited

Cited by 37 publications

References 24 publications

Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010

Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010

Effects of Early Dual‐Eligible Special Needs Plans on Health Expenditure

Damage Caps and Defensive Medicine: Reexamination with Patient‐Level Data

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