Hopkins could see higher insurance costs from settlement

The $190 million settlement for former patients of Dr. Nikita Levy might be eye-popping, but it won't overwhelm the wealthy Johns Hopkins Health System.

Hopkins officials said the payout, which received preliminary court approval Monday, would be covered by insurance and wouldn't affect patient care. Officials declined to provide more information on insurance policies and finances.


Industry experts said that while Hopkins is likely to take a financial hit — through covering payments with cash reserves if self-insured and through higher insurance premiums — the institution has the means to handle it.

Hopkins settled with former patients of Levy, who authorities say secretly recorded patients during gynecologic exams. Plaintiffs' attorneys estimate more than 8,000 patients could have a claim.


In absolute terms, the settlement, if approved, represents a significant portion of the health system's balance sheet. Hopkins reported having $510 million in cash and $860 million in accounts receivable, among other liquid assets, as of June 2013, according to its most recent balance sheet. It had $6.6 billion in total assets.

But given its nearly $5 billion in annual revenue, covering even a $190 million settlement would be manageable, experts said.

"The running joke is Hopkins has more money than God," said Gregory Dolin, associate professor and co-director at the University of Baltimore School of Law. "Hopkins, I think, will be just fine. ... I don't think it's going to affect their ability to care for their patients."

Experts said large hospital systems such as Hopkins typically carry liability insurance policies and then also self-insure, meaning they set aside cash to cover the cost of claims.

It's likely that insurers will consider raising premiums in the future, and that the Levy case has prompted Hopkins risk managers to scrutinize policies for ways to limit liability, they said.

Hopkins officials said they have "redoubled" efforts to uphold patient privacy.

Tom Baker, a professor of law and health sciences at the University of Pennsylvania Law School, said insurers "are going to be asking themselves, when pricing Johns Hopkins this year, 'Does this mean Johns Hopkins is a more risky entity to insure than we thought?'"

"There's some expectation of payback," Baker said of insurers. "I'm sure they didn't price the policy taking this into account."

The settlement's impact on Hopkins could depend on how the payouts are structured, including when the payouts are due, Dolin said.

Attorneys for both sides plan to evaluate each claim to determine the damages due to each affected patient. Those criteria could include the number of visits to Levy's office or another metric, but attorneys declined to provide details.

Going forward, experts said Hopkins officials are likely focused on efforts to increase oversight. Hopkins and its affiliates — like Johns Hopkins Community Physicians, where Levy worked — employ thousands who come into contact with customers.

Hopkins officials said in a statement that they have taken steps to train staff to flag potential problems and conducted inspections of the institution's facilities.


"The financial consequence to Hopkins or its patients or its insurers are probably the least consequential part of it," Baker said. "More so, you would hope there would be changes in behavior and monitoring that would prevent this sort of thing from happening."

Baltimore Sun reporters Colin Campbell and Justin Fenton contributed to this article.


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