MICA 2017 Annual Report

Two words incorporating two concepts best describe MICA: Stability and Consistency. For over four decades, throughout fundamental changes in health care delivery, MICA has provided stability in pricing and availability of medical professional liability (MPL) insurance in its markets and consistency in its high level of service and dedication to its members. The year 2017 . . . indeed the entire last eight years . . . is no exception. Although not the sole driver of change in health care, the adoption of the Affordable Care Act in 2010 accelerated numerous changes in Stability and Consistency

health care delivery encompassing technological infrastructure, the mandatory use of electronic health records, the aggregation of physicians into expanding practice groups and regional and national practice organizations, the employment of physicians by hospitals, and the role of advanced healthcare professionals as they expand their scope of practice. And more changes are on the horizon with the rapidly expanding role of machine learning and artificial intelligence, genetic testing and genetic manipulation . . . not to mention the economic and organizational opportunities arising from the Tax Cuts and Jobs Act adopted in late December 2017. Over this same period, surprisingly considering the unprecedented changes in healthcare delivery, MPL risk has improved and insurance rates and premiums have declined. Fewer claims and lower premiums, alongside the manifold challenges created by the rapid changes in healthcare delivery have, for a few physicians and medical group CEOs and CFOs, reduced the priority of MPL insurance . Coverage and pricing aside, service, carrier stability and long-term protection is merely assumed notwithstanding the recent insolvencies of a few carriers. As recognized for the last 160 years, new medical/surgical techniques create new expectations and new standards of care. And the first breezes of change are being felt. The last few years have seen a resurgence in high

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