The Medical Professional Liability industry has enjoyed an unprecedented period of decreased claim activity leading to reduced loss costs. Industry executives have debated the reasons for the improvement, ranging from better patient safety to tort reform, the reality is no one has been able to pinpoint or quantify the exact cause.

The main goals of the Patient Protection and Affordable Care Act (PPACA) are to improve both access to, and the quality of health care as well as to reduce costs. It does not, however, address tort reform. Just as the Medical Professional Liability industry has tried to determine what drove decreased loss trends over the past eight years, they have similarly been debating the potential impact of PPACA on their insured base in an attempt to predict the future direction of loss costs.

While it is easy to argue for decreases in malpractice claims from elements of PPACA, it is just as easy to speculate that the same provision could lead to an increase in claim activity. Electronic medical records (EMRs) will mean better records and continuity in care, but will also provide better discovery to plaintiffs. Access will provide for earlier treatment, but providing care to 30-35 million new insureds will strain current health delivery resources, perhaps leading to more errors.

While not everyone agrees on PPACA itself, what everyone does agree on is there is far too much cost in our healthcare system. As a country, we must finds ways be more efficient and wring cost out of the system. Elements of PPACA, such as EMRs and a more integrated delivery, will continue to improve care due to better information and continuity of treatment, while attempting to accomplish it at a reduced cost.

Medical Professional Liability (re)insurers need to adapt to the real and fundamental changes in the healthcare system of physician consolidation, physician and hospital integration and hospital system consolidation to be able to provide unique and creative (re)insurance products to a changing risk and client base.