Improving health literacy

AVRECO's small-hospital program combines coverage with patient-friendly education

By Phil Zinkewicz

Anyone who has ever had to undergo a surgical procedure knows that the anxiety accompanying the experience begins at the moment the doctor says that surgery is necessary. Depending upon the particular doctor’s manner, the patient will either feel assured that the operation is a routine one with very little risk, or be fearful that scalpels will slip, nurses will forget everything they’ve been taught and the surgeon will show up drunk. Fear fashions frightening fantasies in times such as these. But even the most confident of patients will suffer some level of anxiety because of the “unknown” element.

Usually by the time the patient has returned home, he or she has forgotten half of what the doctor said and is unable to explain to family members why the surgery is necessary, what is going to take place during the surgery and what to expect after the surgery. As a result, family members often become unduly concerned, adding to the patient’s anxiety.

How much better it would be if the patient and the family could sit comfortably in the home environment and hear a soothing voice explain what will happen before, during and after surgery. This would be a voice the patient could listen to over and over again in case something was missed first time around. With the “unknown” element removed, the patient’s anxiety could be reduced, making him or her a better candidate for needed surgery.

An insurance brokerage that writes professional liability coverage for hospitals with 150 beds or fewer has developed a program that includes just that kind of anxiety-reducing element.

AVRECO, founded in 1962 with offices in Chicago and California, is one of the largest independent insurance wholesalers in the United States. It has access to more than 100 carriers and specializes in niche business, including medical malpractice and professional liability insurance, nonprofit and for-profit directors and officers liability, employment practices liability, property insurance for both large accounts and packages, general casualty and excess liability. AVRECO’s Medical Professional Department also has expertise in the formation of captives.

Just this year, AVRECO added a new element to its medical professional liability coverage for small hospitals. Called Heartland Healthcare Hospital (3HP), the new program employs the services of AVRECO as broker on the account, a unit of wholesale underwriting manager Shand Morahan as the insurer and EMMI Solutions to provide risk management services. (EMMI is an acronym for Expectations Management and Medical Information.)

Opportunities for retailers

Sarah Dore, senior vice president of AVRECO Healthcare, says the new Heartland Healthcare Hospital program presents an opportunity for retail agents and brokers to help their local hospitals find affordable comprehensive liability insurance while promoting “cutting-edge” risk management techniques to enhance patient safety and reduce claims.

“Agents can capitalize on their contacts with local hospitals to enter the hospital liability insurance market and take advantage of AVRECO’s professional liability and marketing expertise,” Dore says. “Our staffers are available to accompany agents on sales calls and guide them through placement, whether they are new to the hospital professional liability field or seasoned veterans.”

The professional liability coverage is available to the hospital and its staff doctors. Doctors who are not on staff with the hospital usually have their own malpractice coverage, Dore says.

“Many times, agents have close contacts with their local hospitals, perhaps selling them other kinds of insurance,” she notes. “Now they can add professional liability to the services they provide. Hospitals appreciate dealing with a local agent for all their insurance needs.”

The coverage is available from Shand Morahan, the underwriting manager for Evanston Insurance Company, which has been providing medical liability insurance for more than 35 years. It is offered on a claims-made basis with limits of $1 million/$3 million per location. Excess and umbrella coverage is available up to $15 million over the primary limits from other domestic carriers. There is a $5,000 minimum deductible and a $25,000 minimum premium. Companion coverages for hospitals are also available, including professional liability for staff physicians, errors and omissions, long term care and HIPAA.

One major difference between this product and others in the marketplace is AVRECO’s and Shand’s association with EMMI Solutions, Dore points out. “Hospitals that buy insurance through 3HP can take advantage of online patient education programs created by EMMI, a leader in interactive health care communications,” she says. “Patients and their families can view Web-based programs explaining upcoming procedures, which leads to better informed patients and expectations. Risk management tools like those offered by EMMI have proved to be excellent in their ability to mitigate or reduce liability claims. 3HP-insured hospitals are eligible for a risk management credit of up to two percent of their premium when they purchase EMMI. The credit will be used to reduce the cost of purchasing the EMMI suite of products.”

Improving health literacy

In a recent newspaper interview, EMMI CEO Mark Achler addressed the importance of providing better patient education. “Over 90 million Americans have difficulty understanding and acting on health information,” he said. “Even well-educated people have trouble understanding instructions on pill bottles, discharge sheets, informed consent documents, and the brochures and handouts that are supposedly there to help. Health literacy has huge economic consequences for hospitals. The U.S. health care system spends an average of $993 every year per patient with low health literacy in excess hospitalization expenses. So improving the health literacy level of patients should be on the top of hospital leaders’ to-do lists and action items. It’s fundamental.”

EMMI Solutions is a multimedia, Internet-based tool that educates patients and their families about the details of upcoming surgery. It replaces often-cumbersome hard-copy manuals with a simple online tutorial.

To use EMMI products, patients enter an access code provided by their physician. The system uses a soothing, conversational tone to communicate with patients and employs simple graphics and visuals. Patients can take notes without hurrying and forward questions directly and confidentially to their doctor for later discussion. This alerts the physicians to the patient’s specific concerns. The patient can forward the interaction to friends, partners and family.

“In addition to the patient, the benefits of EMMI to the hospital are many,” Dore says. “The system enhances communication between physician and patient and strengthens the relationship. It streamlines the informed consent process. Studies demonstrate that patients who fully understand what to expect from surgery are more satisfied with the results and less likely to file medical malpractice claims.”

Shand Morahan, Dore observes, brings more to the HP3 product than its 35-year history in the hospital professional liability market. “Shand maintains a hotline twenty-four hours a day, seven days a week for hospitals that have questions about this program,” she says. “They underwrite each exposure individually. There is no cookie-cutter approach here.”

Fran O’Connell, vice president for medical underwriting at Shand Morahan, says that the three-way partnership with AVRECO and EMMI is an excellent approach to servicing smaller hospitals. “One of our specialties is underwriting small community hospitals,” O’Connell says. “We have a strong relationship with EMMI because patient service is important to us. Poor patient understanding of surgical procedures can lead to unnecessary claims. As a registered nurse myself, I have seen that patients receive too little education about medical procedures. EMMI improves that educational process by providing the information needed in a less stressful environment than a doctor’s office. AVRECO has taken the lead on this program, and our role is to provide the necessary insurance coverage and to defray some of the cost of EMMI. I am not aware of any other insurance company offering this approach.” *

For more information:
AVRECO
Web site: www.avreco.com