The Risk Management Foundation of the Harvard Medical Institutions, Inc.

Abstract

Through its uniquely proactive approach to medical malpractice risk management, the Risk Management Foundation has decreased claims-and premiums-for the Harvard hospitals it insures. The Risk Management Foundation (RMF) is the captive medico-legal insurer of the Harvard medical institutions and affiliated physicians. Over the last two decades, through a combination of active legal defense and medical error prevention, RMF has successfully controlled the medico-legal costs of physicians practicing at the Harvard teaching hospitals; consequently, its insured physicians pay notably lower premiums than similar specialists outside the Harvard system. RMF's success has been due, in large part, to the close working relationships it has cultivated with the insured physicians and hospitals. However, as the hospitals expand their networks into Boston's suburbs, new, less tightly affiliated doctors whose medico-legal risk is higher than those practicing at the hospitals are coming under RMF's umbrella. This case describes RMF's approach to risk management and the challenges its managers face in accommodating these new physicians.