CHICAGO—Insurers and health care organizations need to devise detailed policies on how they and their employees use social media to reduce their risks of violating medical privacy law and damaging their reputations, experts say.
Insurer use of social media was one of several topics covered during the Professional Liability Underwriting Society's annual Medical PL Symposium last week in Chicago.
During a panel discussion on social media, speakers said insurers and health care providers should give employees detailed online procedures to help protect their organizations. That includes detailing the types of online posts, pictures and statements that are appropriate and inappropriate.
Devising such a plan provides a proactive risk mitigation approach rather than using the “head-in-the-sand” tactic of prohibiting employees from using social media during work hours, said Michael Carr, Chicago-based senior vp of errors and omissions underwriting for Argo Pro, a unit of Hamilton, Bermuda-based Argo Group International Holdings Ltd.
“You have to assume that you're going to be using these tools and give them some rules about what is and what is not appropriate,” Mr. Carr said.
Mr. Carr said health care providers should make certain their insurance protects them from accidental dissemination of private medical information via social media, or online statements made by outside providers that work with the health care firm.
In a separate session, experts discussed various risks associated with forming accountable care organizations. ACOs, introduced as part of the Patient Protection and Affordable Care Act, are networks of health care providers—such as hospitals systems and independent physicians—that are held accountable for the overall care of health plan members in exchange for additional compensation to improve outcomes and reduce medical costs.
The structure of such models is likely to shift over time as providers and insurers become more accustomed to ACOs, said Kristin McMahon, Simsbury, Conn.-based chief claims officer for IronHealth, a unit of Hamilton, Bermuda-based Ironshore Inc.
“You'll see health systems and medical groups forming their own ACOs and, depending on how successful they are, I think you're going to see more configurations where more self-insured employers are going to be forming their ACOs,” Ms. McMahon said.
ACOs can face liability issues based on factors such as effective coordination of care between ACO partners or meeting accountability standards that measure treatment quality, said Ciara Ryan Frost, another panelist and Chicago-based partner with law firm Kerns Frost & Pearlman L.L.C.
Other potential liability claims can include disputes regarding treatment billing and employment practices among ACO members, she said.
“Generally speaking, ACO liability exposures are a mixed bag,” Ms. Frost said. “They're as diverse as the ACO variations themselves. So it's very important when you're trying to value liability exposures to look at each particular risk.”
In a panel focusing on liability exposures for health care executives, David N.T. Watson, senior vp and chief financial officer of Chicago-based National Surgical Hospitals Inc., contended that ACOs have an “unclear” structure that raises questions on how future medical liability cases will play out.
“If the medical home is coordinating patient care, who's ultimately responsible for a malpractice incident—the ultimate provider (or) the provider that sent that patient for care? And how is that going to be insured—insured individually (or) by group?” Mr. Watson asked.