Precision Medicine and Medication Adherence Tools

 Could Precision Medicine and Advanced Medication Adherence Tools Justify Lower Medical Liability Premiums Over Time?

By Jackie Iverson and Philip Morisky

A few years ago, I was surprised to see a substantial increase in my auto insurance premiums. When I reached out to my insurer for an explanation, I was told the increase was due to a 30% surge in automobile accidents in my area. It got me thinking—what if the same logic applies to medical liability insurance? If more claims are being filed, could that be driving premiums higher for physicians and healthcare providers across the board?

In May 2023, the American Medical Association (AMA) published an article titled, "Medical Liability Premium Hikes Continue for 4th Straight Year," and it raised some important questions. Is the spike in medical liability premiums a direct reflection of rising malpractice claims? Digging deeper, I found an AMA "Policy Research Perspectives" report which suggested that insurers are raising premiums due to deteriorating underwriting results, shrinking loss reserve margins, and lower investment returns. But the rising premiums aren't just about economics—there's also an increasing risk landscape driving this trend.

An independent insurance practice, Medpli, outlined key factors pushing medical malpractice premiums higher in 2023, including:

1. The severity of claims with larger payouts

2. Rising legal costs

3. Economic inflation

Medpli also highlighted an important point: while insurers typically increase premiums across the board to mitigate unexpected losses, healthcare providers can actively reduce their own malpractice risk. By improving communication with patients and raising the level of clinical excellence in their practice, physicians can potentially avoid lawsuits and steep premium hikes.

This focus on proactive measures and clinical excellence got me thinking about the role precision medicine could play in reducing malpractice risks—and by extension, medical liability premiums. Precision medicine enables providers to tailor treatment plans to individual patients based on genetic, environmental, and lifestyle factors. This personalized approach helps reduce negative outcomes, which is a critical driver of malpractice claims.

Precision Medicine Meets Medication Adherence: A Powerful Combination

One of the most overlooked but vital aspects of precision medicine is ensuring that patients stick to and maintain their prescribed treatment plans. Especially when it comes to their medication regimens. Now we introduce the Morisky Medication Adherence Scale (#MMAS), a psychometrically validated tool that has become the gold standard for measuring and improving medication adherence. The MMAS doesn't just track whether patients are taking their medications as prescribed; it provides real-time, actionable insights that help healthcare professionals adjust treatment plans and proactively address adherence issues before they lead to more intense situations.

The MMAS has really found its home within the broader framework of precision medicine. By using MMAS as part of a comprehensive ePRO platform, Health Care Professionals (HCPs) can monitor and enhance medication adherence in real-time, reducing the likelihood of medication errors, adverse drug reactions, and preventable complications. These are often the most common reasons that lead to malpractice claims in the first place. Take for example, pharmacogenomics, one of the pillars of precision medicine. This concept allows providers to prescribe medications that are tailored to a patient's genetic makeup. Yet even the most precisely targeted treatment will fail if the patient isn't adherent to the regimen. The MMAS helps ensure that patients stay on track, mitigating the risk of adverse outcomes and reducing the chances of litigation.

The Case for Lower Medical Liability Premiums

As precision medicine continues to advance, integrating tools like the MMAS into clinical workflows can significantly lower the risk profile for healthcare providers. By improving patient adherence, reducing medication errors, and optimizing treatment outcomes, providers can reduce their exposure to malpractice claims. In theory, this should justify lower medical liability premiums over time. Tools like the MMAS align with Medpli's advice to take steps that prevent negative patient outcomes. By improving communication, addressing adherence issues early, and leveraging the predictive power of precision medicine, HCPs can not only deliver better patient care but also lower their malpractice risk. In the past two decades, I've met countless physicians who have left the profession due to skyrocketing medical liability insurance premiums. Newer physicians are entering the field already burdened by heavy insurance costs, and many are worried about the financial sustainability of their practice. It's clear that something needs to change to stabilize these rising premiums. The AMA has warned that if the current trend of increasing premiums continues, we could see an increase in defensive medicine, fewer physicians in practice, and reduced access to care for patients. The solution? A proactive, precision-based approach to medicine that integrates advanced tools like the MMAS to mitigate risk and improve patient outcomes.

Looking Ahead: A Future with Lower Risk and Better Care

By uniting precision medicine and medication adherence tools, the healthcare industry can not only improve patient care but also build a compelling case for lower medical liability premiums. As more providers adopt these tools and improve outcomes, insurers may recognize the reduced risk and adjust premiums accordingly.

The path forward is clear: integrating personalized, data-driven solutions like the MMAS into precision medicine workflows has the potential to reshape the medical liability landscape, resulting in healthier patients, fewer claims, and more sustainable insurance premiums for healthcare providers.

To learn more about the MMAS, visit www.adherence.cc