Major Insurance Company Offers Discount to Customers Adopting AHRQ-Styled Product

November 2017

BETA Healthcare Group, a large medical liability insurer in California, offers up to a 10 percent discount on annual insurance premiums to customers who adopt the company’s BETA HEARTSM patient safety program, which is based on AHRQ's Communication and Optimal Resolution (CANDOR) toolkit.

The CANDOR toolkit offers methods and tools for hospital systems and physician groups to respond immediately when patients are unexpectedly harmed by the medical care they receive. Research shows about 1 in 10 patients is harmed by medical care, despite the best efforts of doctors, nurses, and other health care professionals.

The CANDOR process demonstrates that by engaging in candid, empathetic communication with patients and families and reporting on the circumstances within 60 minutes of the adverse event, hospitals can provide a timely resolution and make sustainable changes in care models to prevent similar events from happening in the future.

"BETA HEART offers a holistic approach to reducing harm in health care," said Tom Wander, BETA Healthcare's chief executive officer. "It's a coordinated effort designed to guide our member organizations in implementing a reliable and sustainable culture of medical safety that’s grounded in a philosophy of transparency."

Wander said that when the BETA HEART program was introduced in September 2016, "Our expectation was that perhaps four insured companies might be interested in joining, so it was a great surprise when 21 of our member organizations stepped forward."

"We've seen a transformation among BETA HEART participants—going from a degree of initial uncertainty to a complete change in mindset—who unanimously agree that this program of open and honest communication with patients can make a real difference in advancing safety and improving the quality of health care."

Heather Gocke, M.S., RNC-OB, BETA Healthcare's vice president of risk management and safety, explained, "BETA HEART participating organizations use a survey instrument to measure their employees' perceptions about health care safety and other aspects of patient care. The data, and the associated discussions with staff, help set organizational priorities."

"When you improve a hospital’s culture of safety, you create an environment where you learn of health care system defects before they ever reach the patient. Improving patient safety leads to risk reduction, which is every insurer's goal. Though initial data are still being tabulated, we expect BETA HEART will result in increased reporting of error-prone processes by hospital personnel, resulting in fewer malpractice claims by patients," Gocke said.

Added Deanna Tarnow, B.A., R.N., BETA Healthcare’s director of risk management and patient safety, "We've seen ample anecdotal evidence that our members and insureds find value in BETA HEART. At our workshops, several physician and nurse leaders have strongly endorsed the program."

Two of BETA Healthcare’s insured groups described the benefits of participating in the program.

"Developing the rapid response system has helped us greatly, as has improving communication with patients and families," said Michael Anderson, M.D., M.B.A., president of USCF Benioff Children's Hospitals. "It has also had the effect of bringing us closer together as a team and infused a sense of positive energy in our dealings, knowing that everyone is going to try their best to make things right."

"To create or change a culture, we need to involve all levels of our organization," said Charles H. Harrison, M.B.A., C.P.A., chief executive officer, San Bernardino Mountains Community Hospital District. "BETA HEART is an excellent multi-disciplinary program that engages all of our personnel toward a common vision and implementation of a better way to deliver health care by putting safety and patient consideration in the forefront."

Impact Case Study Identifier: 
2017-13
AHRQ Product(s): CANDOR Toolkit
Topics(s): Patient Experience, Patient Safety, Medical Errors, Health Care Quality, Costs, Outcomes, Policy, Medical Liability
Geographic Location: California
Implementer: BETA Healthcare Group
Date: 11/21/2017
Page last reviewed November 2017