The Massachusetts Alliance for Communication and Resolution following Medical Injury is a healthcare alliance formed in 2012 and comprising some of the most notable health and medical groups in the Commonwealth of Massachusetts. These include major teaching hospitals and their insurers, statewide provider organizations, and patient advocacy groups listed here. Six hospitals are participating as pilot sites, committed to rolling out the Communication, Apology, and Resolution (CARe) model and sharing their experiences and lessons learned to aid in the dissemination of this model throughout Massachusetts, and eventually in other states.
MACRMI is committed to the implementation of Communication, Apology, and Resolution (CARe) following medical injury. Prompt recognition of, and response to, medical injury, along with appropriate compensation to the patient or family, has demonstrated potential to improve patient safety, reduce medical costs, and enhance fairness and transparency in health care. It is, simply, the right thing to do.
Through its activities and this web site, MACRMI seeks to:
- Assist the Massachusetts pilot hospitals in implementing the Communication, Apology, and Resolution (CARe) approach and continuously improving upon the model.
- Share lessons learned from the pilot sites with other sites to enable a broad implementation of CARe in Massachusetts and, eventually, in other states.
- Inform other interested stakeholders (patients, attorneys, hospital leadership, health insurers) of this approach, its benefits, and the status of its implementation, and involve these stakeholders in the ongoing CARe initiative.
A Summer 2012 Vital Signs article provides a further overview of the initiative and the CARe model.
MACRMI was formed as the result of a research initiative led by Beth Israel Deaconess Medical Center and the Massachusetts Medical Society, and funded by the Federal Agency for Health Care Research and Quality in 2010. Its purpose was to uncover the barriers to implementation of a CARe program (often also referred to as Disclosure, Apology, and Offer or DA&O) in Massachusetts, and to propose a roadmap for overcoming these barriers. This roadmap was developed in 2010, vetted in 2011, and made public in 2012. It has garnered significant attention at the state and national levels.
MACRMI has already helped pass enabling legislation in Massachusetts. The 2012 Payment Reform legislation included a comprehensive adoption of the so-called Michigan model of “disclosure, apology and offer” to resolve patients’ claims of medical malpractice. This includes the establishment of a 182-day waiting period to permit the disclosure, apology and offer process. It it provides strong apology protections, sharing of pertinent medical records, and expectations of full disclosure.