All nurses should invest in malpractice insurance, but for nurse entrepreneurs who want to operate their own practice, malpractice coverage is essential. If you are planning to venture out on your own and create a healthcare business, you need to protect yourself from potential claims by selecting the right insurance carrier based on the type of practice model you intend to deliver.
Finding insurance companies that recognize standard brick-and-mortar practice options is not hard, but if you want to incorporate the growing field of telehealth into your practice, you should take a close look at the options offered by different malpractice insurance carriers. While each company adopts the same state guidelines (e.g. nurses located in MA cannot provide telehealth services to a patient in FL unless first seeing them for an in-person visit) coverage can vary on the ratio of allowable in-person to telehealth visits. If you already have a malpractice carrier and are thinking about including telehealth within your practice, be sure to assess your plans in this area, consult with your current carrier, and shop around, as coverage varies considerably.
If you’re not yet insured and are just starting to make your business plan, here’s what you can expect regarding coverage: if you are a self-employed individual registered nurse who a) doesn’t work in a correctional facility, b) doesn’t provide cosmetic or medical aesthetics procedures, and c) has not been subject to a medical malpractice claim or disciplinary board action within the last 5 years, your coverage should come to around $250 per year. Such a policy should cover $1 million per incident and $3 million in aggregate. If you are providing a walk-in clinic-type experience where you are seeing most patients in-person, providing services like physicals, blood pressure monitoring, wellness checks, wound care, suture removal, etc. this type of standard coverage ought to fit your needs. However, if you are interested in expanding into telemedicine, keep in mind that many carriers place a limitation on in-person to telehealth visits of 75:25, where three-quarters of your patient visits need to be in-person.
If you intend to provide telehealth services that might include consultations, outpatient visits, nutrition therapy, smoking cessation services, alcohol misuse screening, depression screening, advanced care programs, and annual wellness visits, your malpractice insurance is going to be higher than it would be for an all bricks-and-mortar practice or a practice with limited telehealth options. For a telehealth-focused practice, you can expect your insurance to cost approximately $400 per year. This insurance ought to cover $1 million per incident and $6 million in aggregate coverage. Thus, for that additional $150 per year, your insurer should provide for $3 million of additional aggregate liability, and impose no limitations regarding the ratio of in-person to telehealth visits that are required for an individual policy.
If you are just starting to plot out the parameters of your business, now is the time to decide whether telehealth is a good fit for yourself and your prospective patients. With no end in sight to the nursing shortage and our aging population, telemedicine is no longer just for rural districts; it’s an expanding field no matter where you work and live. For many, the flexibility it offers is highly attractive as telemedicine allows you to work from home and other sites outside a conventional brick-and-mortar office. If you expect to work with patients remotely, estimate what proportion of your practice you want to devote to telehealth, what your expected ratio of in-person-to-virtual visits will be, and start making inquiries among malpractice insurers.
Rob Goodall, MBA is managing director of AlyxHealth. A 20-year financial services industry veteran, Rob is the head of sales and principal financial modeling strategist at AlyxHealth. He provides guidance on fiscal analyses, strategic partnerships, product design, development, and launch. Within this role, he also provides a cost savings analysis to expand profitability and revenue growth for clients and the firm.