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Insurance related topics, working with insurers to implement CRP

Institution/Organization/Business
Reference to primary CRP related organization (e.g. CAI website)
Web resource/Digital Article
General website that contains CRP related information, may be non-specific or general or mixed resources on a website. Article published on-line. Not available as paper version.
Agency for Healthcare Research and Quality (AHRQ)

The Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with improving the safety and quality of America’s health care system. AHRQ develops the knowledge, tools, and data needed to improve the health care system and help Americans, health care professionals, and policymakers make informed health decisions.


Learning Community
Resources associated with CAI Learning Community
Presentation/Webinar
Recorded webinars and presentations
Video
CRP related video, movie
CAI Webinar: CRPs: Why the insurance industry hasn’t embraced them . . . and why it should

CRPs: Why the insurance industry hasn’t embraced them . . . and why it should presented by Richard Boothman, JD

The driving ideas behind CRPs continue to draw interest and debate, now twenty years after Steve Kraman and Ginny Hamm published their Lexington, KY VA experience with “Extreme Honesty”.  After more than 17 years, the University of Michigan continues to draw attention transparent with their “Michigan Model”, the most successful and longest continual example of a principled, and proactive approach to patients injured in unexpected clinical outcomes.  After years of balking at abandoning “deny and defend” more health systems around the country and around the world are exploring the transition, but a skeptical insurance industry continues to hold back and sometimes, frustrate the desires of their insureds to move in this direction.  Why?  Is the industry’s skepticism well-founded and prudent?  Or is it missing a valuable opportunity?

Rick Boothman, the architect of the “Michigan Model” will initiate a long-deserved discussion into this topic.  His experience suggests that there are multiple insurance advantages in the CRP approach and the insurance industry should rethink old beliefs, practices and prejudices and embrace this model.

Outline

  1. Insurance 101 – a dummy’s guide to the construct
  2. True CRPs – the essential elements and how the model differs from “deny and defend”
  3. What holds the insurance industry back from jumping on board?
  4. What is the insurance industry missing and why should it matter?

Learning Objectives

  • That too many equate CRPs only with selective, early resolution of potential and asserted claims – what are the essential elements that distinguish a true CRP from established, traditional risk management practices?
  • What are the unique outcomes of a CRP and why do they matter?
  • Why a CRP better serves the interests of healthcare insureds?
  • What unique consequences of a CRP would benefit the insurance industry especially?

Institution/Organization/Business
Reference to primary CRP related organization (e.g. CAI website)
Tool/Toolkit
CRP resource or tool (e.g. CANDOR)
COPIC Insurance: 3Rs Program – Recognize, Respond, and Resolve

COPIC is an insurance company that covers medical liability expenses. The company developed the 3Rs (Recognize, Respond, and Resolve) Program to prevent adverse events and increase patient safety. The goals of the 3Rs Program are 1) to maintain a healthy and professional relationship between the  physician and patient, 2) foster honest conversation, and 3) reimburse the patient for pertinent medical fees.

 

 


Institution/Organization/Business
Reference to primary CRP related organization (e.g. CAI website)
Web resource/Digital Article
General website that contains CRP related information, may be non-specific or general or mixed resources on a website. Article published on-line. Not available as paper version.
Institute for Healthcare Improvement (IHI) and the National Patient Safety Foundation (NPSF)

The Institute for Healthcare Improvement (IHI) and the National Patient Safety Foundation (NPSF) started collaborating together to utilize its combined resources and knowledge to further  patient safety efforts and create safety systems in various healthcare settings.


Meeting/Conference Proceedings
Meeting/Conference Proceedings
Northwest Communication and Resolution Program Leader Retreat, Sept 2017

The Collaborative for Accountability and Improvement and the Foundation for Healthcare Quality hosted a two-day retreat in Seattle, Washington (09/2017) in which administrators and healthcare providers discussed ways to advance communication and resolution programs (CRPs) and other resources in Northwest Hospitals to increase patient safety and communication among hospital leadership, attorneys, and health insurers.


Communication-and-resolution programs (CRPs) are used by healthcare providers, administrators, and insurers to effectively communicate with and apologize to patients in the wake of adverse incidents; to investigate the occurrence; and offer compensation if appropriate. Researchers examined the effects of CRPs in two community hospitals and two academic medical centers in Massachusetts. They analyzed surveys and recorded data gathered by program members and clinicians at the hospitals. Researchers concluded, that CRPs are effective in increasing patient safety, but there were some barriers in implementing these programs. Barriers included lack of patient participation in disclosing data, as well as some compensation needs not being fulfilled.