Company Vice Chair provides rural health care perspective to national underwriters' association conference.
At the 2023 MPLA's Underwriters Workshop in Pittsburgh, PA, David B. McDermott, MD, Vice Chairman of the Board of Medical Mutual gave a report on emerging trends in rural healthcare, identifying opportunities and risks, and addressing their potential impact on underwriting.
McDermott highlighted access as one of the most critical issues in rural health care due to a staggering number of hospital and service line closures—OB and surgery services, for instance—due to financial instability and staffing issues. Many residents of rural areas must travel 30 minutes just to access everyday care. And an abundance of rural areas are classified as ambulance deserts. Opportunities that could improve the state of rural medicine include the rise of Telemedicine, which has grown exponentially since 2020, and offers improved access. In addition, new accelerated education tracks, training modules, and opportunities for immersion education have made it easier to train and recruit nurses to rural areas, and have greatly expanded the pool of talent.
McDermott also identified red flags and potential pitfalls for underwriting as a result of these trends. For example, nonphysician practitioner training is already on average 5+ years less than physicians and many accelerated NPP education programs are online (Purdue Global). Both could raise the specter of a potential increase in medical errors over time. While the trend toward increasing numbers of physician assistants and nurse practitioners is not new—and is important to ensuring proper staffing and patient access to care—the relative concentration of such extended service providers could factor into underwriting decisions by medmal carriers in the future, if they haven't already.