Fact Sheet: Protect Pennsylvanians’ Health Care, Stop Venue Shopping

HAP Resource Center

Fact Sheet: Protect Pennsylvanians’ Health Care, Stop Venue Shopping

Pennsylvanians’ health care is being threatened.

Physician with suitcase leaving hospital

During August 2022, the Pennsylvania Supreme Court abruptly eliminated a rule that had stabilized the state’s medical liability system and protected Pennsylvanians’ health care for nearly two decades.

The decision reverts to a pre-2003 legal framework that allows personal injury lawyers to move medical liability claims from the counties in which the event occurred to counties that have histories of higher payouts. This practice is called “venue shopping.”

The change took effect January 1, 2023 and venue shopping has already returned. HAP is urging the General Assembly to take action to protect Pennsylvania health care by again stopping venue shopping.

Venue shopping has already returned to Pennsylvania.

In only the first 20 days of 2023, there were 57 medical malpractice cases filed in Philadelphia, 148 percent higher than the average filed monthly during 2022.¹

Venue shopping will make Pennsylvania one of the least attractive places for health care providers to practice.

We’ve been here before, with bad outcomes—particularly for obstetrics and specialty care.

The last time venue shopping was allowed in Pennsylvania:

It was difficult for the commonwealth to attract and keep health care providers
Hospitals were forced to cut services
Health care providers couldn’t afford skyrocketing premiums
Insurers left the market

Pennsylvania has stopped venue shopping before.

In 2002, Pennsylvania’s governor, General Assembly, and Supreme Court commissioned a study that concluded venue shopping was the leading cause of a medical liability crisis. Together, they agreed to end the practice. Through law and judicial rule, they required that claims be considered in the county where the alleged medical liability occurred.

Venue shopping distorts liability trials.

Certain specialties, such as obstetrics and gynecology, were hit particularly hard. From 1999–2000—just one year—median medical liability awards increased nearly 43 percent²
In 2001, Philadelphia’s 117 medical liability trials totaled a higher number than any other county in the nation, even higher than New York, which had 72 trials³
In 2002, medical liability jury verdicts in Philadelphia were more than twice the national average, nearly a quarter were for $1 million or more⁴
From 1999–2001, Philadelphia had 87 medical liability cases of $1 million or more, only slightly fewer than the entire state of California during those same years⁵
In 2020, Philadelphia’s medical liability cases accounted for only 24 percent of the medical malpractice filings statewide, a 71 percent drop in Philadelphia filings from when venue shopping ended in 2002⁶

There is no evidence that verdicts have been unfair, but plenty to suggest venue shopping will worsen Pennsylvania’s health care workforce crisis.

There is no evidence—and, for 20 years, has been no public outcry—that counties in which liability actions are being litigated are not rendering fair results⁷
The reduction in court filings cited by the Civil Procedural Rules Committee reflects an increase in less-costly and faster resolution strategies to settle claims, such as arbitration and mediation
There have been many positive advancements for patients since venue shopping was eliminated in 2002, including creating the Patient Safety Authority, passing an apology law, expanding disclosure requirements, and evolving health care quality improvements
A 2022 actuarial study commissioned by the state Senate Judiciary Committee forecasted the devastating effect should venue shopping return for medical liability cases. The report predicted alarming premium increases in some parts of the state that could result in another medical liability crisis⁸
Pennsylvania cannot afford policies that create additional challenges for obstetric units or that cause physicians to leave the state. From 1999–2020, the number of obstetric units in Pennsylvania hospitals fell 40 percent⁹ and current estimates suggest that, by 2025, Pennsylvania will need at least 1,000 more primary care physicians to care for its aging population¹⁰
Since 2000, the number of hospitals affiliated with health systems has grown by 146 percent.¹¹ Reinstating venue shopping will encourage lawyers to pull even more cases to Philadelphia and Allegheny counties in search of higher payouts

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¹The Legal Intelligencer. "20 Days Into New Venue Rule, Phila. Sees Surge of Medical Malpractice Filings." 1/23/2023.
²Prepared statement of Shelby L. Wilbourn, MD, representing the American College of Obstetricians and Gynecologists, on “Patient Access Crisis: The Role of Medical Litigation,” a joint hearing before the Committee on the Judiciary and the Committee on Health, Education, Labor, and Pensions (Senate Hearing 108-253) on “Examining the Status of Patient Access to Quality Health Care, Focusing on the Role of Medical Litigation and Malpractice Reform.” 2/11/2003. Last accessed 03/01/2022.
³Courtstatistics.org. Medical Malpractice on Appeal. Deecember 2009. Accessed: 03/01/2022.
⁴Bovbjerg RR and Bartow A. Understanding Pennsylvania’s Medical Malpractice Crisis: Facts about Liability Insurance, the Legal System, and Health Care in Pennsylvania. Pew Charitable Trusts Project on Medical Liability in Pennsylvania. 2003. Accessed: 03/01/2022.
⁵Ibid
⁶The Unified Judicial System of Pennsylvania. Pennsylvania Medical Malpractice Filings. Accessed: 03/01/2022.
⁷HAP analysis of U.S. Department of Health and Human Services, National Practicioner Data Bank's medical malpractice payment report data, 2003 through 2022.
⁸OliverWyman. ACTUARIAL REVIEW OF THE PROPOSED AMENDMENT TO THE MEDICAL PROFESSIONAL LIABILITY VENUE RULE. Accessed: 08/26/2022.
⁹HAP analysis of Pennsylvania Department of Health, Division of Health Informatics Annual Hospital Survey data, 1999 through 2020.
¹⁰U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Workforce, “State-Level Projections of Supply and Demand for Primary Care Practitioners: 2013-2025,” (Nov. 2016), p. 11.
¹¹HAP’s March 2022 analysis of Pennsylvania Department of Health, Division of Health Informatics’ Annual Hospital Survey data, 2000 through 2020.