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Willis Group Holdings PLC : Willis Announces Accountable Care Organization Insurance Liability Policy

03/29/2012 | 12:20pm US/Eastern

Innovative Solution Offers Unique Coverage for Health Care Organizations Facing New Risks Associated with Forming ACO's

As the health care industry moves to adapt its health care delivery models following the Patient Protection and Affordable Care Act of 2010, Accountable Care Organizations (ACO) have landed squarely at the center of the discussion. Many organizations are planning to form Accountable Care Organizations (ACO), defined as networks of health care providers that band together to provide the full continuum of health care services for patients. This model employs various payment methodologies to reward health care organizations such as hospitals, physicians and payors based upon the delivery of high-quality care to improve health outcomes while slowing growth in expenses.

While adoption of this model will vary in execution, forming an ACO will bring together affiliated and non-affiliated stakeholders in a variety of structures creating new risks and insurance challenges for health care organizations. Participants or owners of an ACO could face increased exposures in the form of:

  • Privacy Issues
  • Regulatory Risks
  • Vicarious Liability
  • Employment Issues
  • IT Network Development
  • Group Billing Challenges
  • Capital Investment Needs
  • Legal challenges created by interplay of State and Federal Laws
  • Distribution of Shared Savings and/or Loss Payments to stakeholders

Because these new exposures will be shared among multiple stakeholders, reliance on contractual arrangements and traditional insurance and risk management programs maintained by the individual stakeholders fall short of providing the necessary asset protection for these new structures. As an example, most risk management programs for health care organizations and physicians do not customarily include coverage for health care administration services such as claims administration, selection and de-selection of providers and/or distribution of payments to providers. In addition, the direct and/or vicarious liability created by the acts of the entity also creates coverage issues for individual stakeholders in their individual insurance and risk management programs.

To meet the demand from the health care industry, Willis today introduced the Accountable Care Organization Liability Insurance Policy. This innovative product, developed in conjunction with IronHealth, a unit of Ironshore, offers a robust solution for stand-alone ACO's addressing the risks and insurable liabilities associated with forming an ACO. This product delivers a range of solutions including coverage for:

  • Directors & Officers Liability
  • Managed Care Operations Liability
  • Medical Professional Liability
  • General Liability
  • Third Party Privacy Protection and First Party Privacy Protection
  • Fiduciary Liability
  • Billing Errors & Omissions Liability Option

Additional coverage features include a broad definition of insured, coverage for ACO managed care/claims administration services, and affirmation of the policy as primary for the ACO regardless of the existence of other insurance. The program also includes protection against antitrust and regulatory issues.

"This product is the first of its kind available on the market, underscoring Willis' commitment to innovation and helping our clients prepare for industry trends," said Frank Castro, National Health Care Practice Leader, Willis North America. "Willis is dedicated to understanding our clients' industries and their needs and stands ready to deliver the best solutions possible. Health care delivery model changes will happen regardless of the fate of health care reform and we are very excited to partner with IronHealth to meet this client need."

ABOUT WILLIS

Willis Group Holdings plc is a leading global insurance broker. Through its subsidiaries, Willis develops and delivers professional insurance, reinsurance, risk management, financial and human resource consulting and actuarial services to corporations, public entities and institutions around the world. Willis has more than 400 offices in nearly 120 countries, with a global team of approximately 17,000 employees serving clients in virtually every part of the world. Additional information on Willis may be found at www.willis.com.

Willis Group Holdings plc
Media:
Colleen McCarthy, +1 212-915-8307
colleen.mccarthy@willis.com
or
Investors:
Peter Poillon, +1 212-915-8084
Peter.Poillon@willis.com


© Business Wire 2012
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