Medical Malpractice:

Maine's Use of Practice Guidelines to Reduce Costs

HRD-94-8: Published: Oct 25, 1993. Publicly Released: Oct 25, 1993.

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Pursuant to a congressional request, GAO reviewed Maine's medical malpractice demonstration project, focusing on the: (1) factors that led to its establishment; and (2) development of practice guidelines that define care standards and reduce health care costs.

GAO found that: (1) in an attempt to reduce health care costs and improve health care services, Maine has initiated a malpractice reform demonstration project designed to resolve malpractice claims and set standards of care; (2) successful implementation of Maine's demonstration project depends on gaining support from those affected by the guidelines, ensuring that the guideline developers are accountable to the public, and ensuring that physicians using the guidelines are protected; (3) the project is overseen by health care providers, payers, and consumers; (4) the project's oversight committee and four specialty advisory committees focused on four high-risk specialties to maximize savings and deter physicians from practicing defense medicine in developing practice guidelines; (5) practice guidelines have succeeded in protecting physicians from future malpractice lawsuits; (6) the guidelines include risk management programs that are intended to prevent accidents, clinical-practice requirements that set standard procedures, and data-collection requirements that require physicians to document a patient's condition; and (7) the advisory committees have based most of the project's guidelines on national standards to obtain physician acceptance and to ensure quality.

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