CARe stands for Communication, Apology and Resolution. Using this approach, patients who are harmed during medical care are given a full explanation about what happened, an apology for avoidable injuries, and fair compensation when appropriate. A key part of the CARe process is an investigation into what led to the event and a commitment from the health care organization to implement policies to prevent it from happening again when possible.

This model was developed as an alternative to litigation. It helps alleviate distrust of the health care system experienced by many patients and families pursuing malpractice claims, as well as loss of confidence in the justice system by clinicians and staff.

Frequently asked questions

  • Is there evidence that CARe is an effective alternative to malpractice lawsuits?

    Though lawsuits can help patients and families receive compensation in some cases, the reality is that it rewards very few people and is not equitable. In many cases, patients and families go through a long, arduous process without getting what they need or want. CARe helps make this process less time-consuming and difficult for patients. By including all parties involved, it allows for a quick and fair resolution. Research in Michigan and here in Massachusetts find evidence of reduced malpractice claims, decreased cost, and time to resolution with CARe.

  • What is my role as an attorney representing a patient who opts for the CARe approach?

    Patients going through the CARe process are strongly encouraged to be represented by a lawyer. The attorney's role is to help the patient process the information shared by the health care providers and insurers, and ensure their needs and interests are addressed. If compensation is warranted, attorneys make sure that the compensation is fair and that their clients understand the settlement terms.

  • Does participating in CARe deny patients the right to bring legal action?

    No, a patient does not need to sign away the right to sue in order to participate in CARe. If, however, the patient accepts compensation for injuries offered through a CARe program, they must forego litigation.

  • What current laws support the CARe approach?

    In 2012, the governor signed the Chapter 224 Payment Reform which made significant changes to the medical liability system in Massachusetts. This law provides strong apology protection, sharing of medical records, and expectations of full disclosure after medical harm occurs to a patient during care. These changes paved the way for the CARe model and were endorsed by the Massachusetts Bar Association (MBA), Massachusetts Academy for Trial Attorneys (MATA), and Massachusetts Medical Society. Full text of the key provisions of the legislation is available here.

  • As an attorney, what should I expect in CARe meetings?

    Health care organizations implementing CARe commit to open and honest communication with patients. Information shared in these meetings should be truthful and transparent. The benefit of CARe is that legal and medical concerns from all parties will be shared together in a collaborative environment. The patient receives an apology and appropriate compensation, and efforts are made to improve patient safety to prevent recurrences.

  • How are attorneys compensated for work on CARe cases?

    The CARe approach is less expensive than litigation because the process requires less time and works toward a resolution. The statutory contingent fee structure may not be appropriate. Ideally, the objective is to evaluate an already existing offer from the hospital and insurer, not to engage in the same level of extensive discovery and expert review associated with traditional litigation. Therefore, having a flexible and fair billing arrangement such as hourly pay or a reduced contingent fee should be considered when representing patients.

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Representing health care providers

Best practices for representing health care providers (one-pager)

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The role of lawyers in CARe

Jeffrey Catalano is a CARe Advisory Board member. He spoke to the Massachusetts Bar Association about the importance of attorneys to CARe.

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