Reassessing the Effects of a Communication-and-Resolution Program on Hospitals' Malpractice Claims and Costs

An article published by Health Affairs by Allen Kachalia and ten coauthors in 2018 compares the liability outcomes of medical facilities that implemented Communication and Resolution Program (CRP) practices to liability outcomes at medical facilities that did not implement CRP. Our reexamination of their results uncovered three serious flaws in their statistical analysis. The present article describes the Kachalia et al. (2018) study and explains the flaws. We also describe our interaction with Health Affairs. The present article is a revision of a critical commentary submitted to Health Affairs. Two reviewers at Health Affairs concurred with our assessment, but the executive editor informed us only that one or more of the authors of Kachalia et al. (2018) disagreed, without mentioning or describing any specific reasons. Health Affairs offered to publish our assessment and the authors’ rebuttal as brief Letters to the Editor, and we declined. Here, we remark on the state of editing at medical and health policy journals, themselves in need of “communication-and-resolution” rehabilitation.