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Hospital Captives
As we have seen, societal, legislative and market forces have in recent years worked together to encourage hospitals to take hospital-employed physician insurance in-house. Let's stop for a moment and briefly analyze the commercial medical professional insurance market in order to understand if the commercial marketplace is a suitable arena to obtain insurance coverage, or whether there are tipping points that drive business away from these markets and into the hospital captives.
The commercial medical malpractice marketplace is a $10 billion per year industry that has seen several consecutive years of historically low losses and reserve releases. This has been coupled with a severe impairment to investment income, which has shifted insurers' focus back to underwriting profitability. Thus, the industry is in the midst of an extremely “soft market,” characterized by excess supply and not enough demand. There is a greater level of competition than ever before, and insurance rates for physicians are at an all-time low. This is a radical change in the environment from the one we saw during the 2000-2005 shift toward hospital captives, which was plagued by rising insurance costs that were alleged to have driven physicians out of practice. Insurers are now more focused on risk management and loss control, and have excess capital to invest in keeping their infrastructure current.
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