title: Hospitals' behavior in a tort crisis: observations from Pennsylvania.
abstract: Pennsylvania, like many states around the country, is in the throes of a "tort crisis." The cost of professional liability insurance for physicians and hospitals is escalating rapidly, as its availability shrinks. Many hospitals are poorly situated to bear these rising costs, especially in an environment of flat reimbursement rates and poor investment returns. This paper examines the impact of the liability crisis on Pennsylvania hospitals and the strategies being used to weather the storm, including alternative risk financing and closer ties between hospitals and affiliated physicians. It concludes by connecting these trends to larger medical malpractice policy issues.
authors.affiliation: Department of Health Policy and Management, Harvard School of Public Health, Boston, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Mello
authors.forename: Carly N
authors.initials: CN
authors.lastname: Kelly
authors.forename: David M
authors.initials: DM
authors.lastname: Studdert
authors.forename: Troyen A
authors.initials: TA
authors.lastname: Brennan
authors.forename: William M
authors.initials: WM
authors.lastname: Sage
mesh_terms: D004470:Economics, Medical; D005249:Fees and Charges / Q000639:trends; D005377:Financial Management, Hospital / Q000379:methods*; D006280:Health Workforce; D018578:Hospital-Physician Relations; D007351:Insurance, Liability / Q000191:economics* / Q000639:trends; D007407:Interviews as Topic; D016365:Liability, Legal / Q000191:economics; D008318:Malpractice / Q000191:economics / Q000331:legislation & jurisprudence; D008505:Medical Staff, Hospital / Q000191:economics / Q000600:supply & distribution; D016134:Organizational Policy; D010414:Pennsylvania; D012308:Risk Management / Q000379:methods; D013038:Specialization