Issue link: https://viewer.e-digitaledition.com/i/1482519
'Doc-in-a-Box' Care Models Demand a Cautious Approach CHRIS ZUCCARINI, MANAGING DIRECTOR, NATIONAL HEALTH CARE PRACTICE, RISK STRATEGIES COMPANY THE POPUL ARIT Y OF RE TAIL AND WALK-IN CLINICS FOR HE ALTHCARE DELIVERY HA S BEEN GROWING AMONG PATIENTS FOR YE ARS AND ACCELER ATED E XPONENTIALLY DURING THE COVID-19 PANDEMIC, BUT THE Y'RE NOT WITHOUT RISK. CONVENIENT AND GENER ALLY quite accessible, these "doc-in-a-box" practices are now an accepted part of the healthcare landscape, and many hospital systems and physician practices are acquiring or developing them in a growing effort to bolster their reach into local communities. The expansion of outpatient delivery systems and its resulting influx of new practitioners a lso presents potentia l risks. Providers must be positioned to address these to reduce liability expo- sures, manage claim and loss activity, and successfully fulfill healthcare missions. PROFESSIONAL OVERSIGHT IS A MUST Diagnosis and treatment at these clinics are often performed by ancillary para- professionals in the medical field, often physician assistants, nurse practitioners or registered nurses. While all possess the cer tif ications a nd qua lif ications necessary to treat most simple medical concerns, patients may not be aware they are not receiving treatment from a fully licensed physician. It becomes imperative for providers — whether a stand-alone clinic or a clinic operated by a hospita l or physicia n group — to ensure rigorous oversight of the licensing, credentials and daily protocols of staff to avoid potentially disastrous malpractice exposures. MONITORING QUALITY OF CARE The scope of ser vices offered at most walk-in clinics has, so far, been limited to routine testing (COVID-19 screen- i ng, strep t h roat cu lt u res, etc.) a nd non-emergency treatments. However, as the number of clinics and practitioners grows, the risk of a provider overstepping these boundaries or creating a failure or delay in diagnosing a more serious condition arises. From a n insurer's sta ndpoint, this creates sig nif ica nt risk for both the prov ider a nd the patient , leading to potentia lly high-cost cla ims on both sides. Implementing, monitoring and maintaining stringent qua lity of care standards, including addressing when care should be elevated to the next level, is essential. PREPARING FOR FUTURE GROWTH Consumer appetites for new models of health care are growing, and the industry is taking notice. Delivery systems are expanding to encompass a wider variety of outpatient models while existing pro- viders and private equity firms look for ways to tap into this market and integrate them into existing healthcare ecosystems. Insurers have taken a cautious approach to underwriting these risks, asking more questions, and carefully reviewing and monitoring interna l protocols. Claim or loss activity directly attributable to these new models is being stringently monitored, and many insureds are seeing an increase in deductibles and premiums to offset the heightened risk to insurers. These new models offer hea lthcare systems exciting ways to g row their patient base and provide a broader range of services in alternative settings. For many, this is the true future of health care. Working closely with specialized brokers to carefully consider potential insurance liability and risk is a critical consideration before diving headlong into this new world. For more information on your insurance options, please contact Jenn Negley, Vice P resident, Risk Strategies Company at 267-251-2233 o r J Negl e y@Ri sk- Strategies.com. M D N E W S . C O M /// M D N E W S C E N T R A L N E W Y O R K n 2 0 2 2 1 7