From 1994 to 1997, staff at two organizations worked to develop administrative no-fault malpractice compensation systems in Colorado and Utah and to collect and analyze medical-injury data for the two states. Project staff also examined financial, policy and legal issues critical to the design of a no-fault system.

The organizations were:

• Copic Insurance Co., a physician-owned professional liability carrier in Colorado.
• Utah Alliance for Health Care, a nonprofit coalition of Utah health care provider organizations and other interests.

Both of these organizations also worked with a Harvard University academic team—headed by Troyen A. Brennan, MD, JD, MPH, a physician and lawyer on the Harvard Medical School and Harvard School of Public Health faculties as well as on the staff of Brigham and Women's Hospital, a Harvard teaching affiliate—to oversee the research.

The project was part of the Robert Wood Johnson Foundation's (RWJF) Improving Malpractice Prevention and Compensation Systems national program.

Key Results:

• In both Colorado and Utah, the preparation of an administrative system was not completed, and a no-fault system was never implemented.

Key Findings: Among the findings of the medical-injury study, the Harvard team reported that:

• The adverse event rate among hospitalized patients in each state in 1992 was an estimated 2.9 percent. (An adverse event was defined as an injury caused by medical management and resulting in either a prolonged hospital stay or disability at time of discharge.)
• The cost of all adverse events in the two states in 1992 totaled $661.9 million, substantially exceeding the money spent on the current medical malpractice system.
• The estimated annual cost of a no-fault model could be significantly reduced by restricting compensation to certain "avoidability" and disability criteria.