The American Society for Health Care Risk Management (ASHRM), a professional membership group of the American Hospital Association with nearly 6,000 members, is the preeminent authority on healthcare risk management. Each year, ASHRM surveys* experienced risk professionals nationwide to identify the top enterprise risks facing the industry.
Here, we take ASHRM’s top risks and add a critical dimension: the role insurance plays in mitigating each risk. While operational strategies and governance are essential, insurance serves as the financial backstop that protects organizations when prevention falls short. A well-structured insurance program is not a substitute for risk management—it is an indispensable complement to it.
ASHRM’s Top 10 Risks & Insurance Solutions
# | Risk | ASHRM-Identified Threat | Insurance Response |
|---|---|---|---|
1 | Business Continuity Operations | Staff shortages and supply chain disruptions leave critical tasks undone, affecting patient care and operations. | Business interruption insurance reimburses lost revenue during covered events. Contingent BI coverage extends to supplier/vendor failures. Supply chain risk insurance covers increased procurement costs from sourcing alternatives. |
2 | Clinical/Patient Safety | Hospital-acquired infections, medication errors, and falls are resurging, driving patient harm and legal claims. | Professional liability (malpractice) insurance covers indemnity and defense costs from adverse clinical events. Excess/umbrella layers provide additional protection as claim severity rises. Captive programs can optimize retention levels. |
3 | Consolidation & Mergers | M&A activity creates integration risk and inherited legacy liabilities from acquired entities. | Representations & warranties (R&W) insurance protects buyers from undisclosed liabilities. Tail coverage ensures pre-transaction malpractice claims remain covered. D&O and transaction liability insurance protect leadership and address deal-specific risks. |
4 | Reimbursement Financial | Shifting payment models and rising denials create revenue volatility and financial instability. | Accounts receivable insurance protects against payer insolvency. Captive insurance programs improve cash flow predictability. E&O coverage for billing operations addresses regulatory risk from coding errors or false claims allegations. |
5 | Skills & Credentialing Human Capital | High turnover reduces time to evaluate credentials, creating gaps that lead to patient harm and regulatory exposure. | Credentialing practices directly affect underwriting and premium pricing. EPLI covers claims from corrective actions against staff. Regulatory liability coverage addresses penalties from credentialing non-compliance. |
6 | Nuclear Verdicts Legal/Regulatory | Jury awards exceeding $10M pose existential financial threats, amplified by social inflation and litigation funding. | Adequate liability towers—primary plus excess layers—are the most direct response. Organizations must reassess limits regularly. Policy terms for consent-to-settle, punitive damages coverage, and experienced defense counsel are critical for large-loss outcomes. |
7 | Cybersecurity Technology | Data breaches, ransomware, and system outages threaten patient data, operations, and organizational reputation. | Cyber liability insurance covers incident response, business interruption, ransomware costs, and data restoration (first-party) plus privacy litigation, regulatory fines, and PCI assessments (third-party). Underwriters increasingly require MFA, EDR, and incident response plans as coverage conditions. |
8 | Workplace Violence | Healthcare workers face elevated violence risk from patients and visitors, causing injury, trauma, and care disruption. | Workers’ compensation covers physical injuries and wage replacement. General liability responds to negligent security claims from third parties. EPLI addresses related harassment or retaliation claims. Active assailant endorsements cover crisis response and counseling costs. |
9 | AI – Expectations vs. Reality | Over-reliance on AI tools can lead to clinical errors when the technology does not match expectations. | Professional liability responds when AI-assisted decisions cause patient harm. Tech E&O covers proprietary AI tool failures. Cyber liability addresses AI-related data breaches. Emerging AI-specific endorsements and standalone products are entering the market; annual coverage gap reviews are essential. |
10 | Wellness of Professionals | Burnout and mental health crises drive turnover, errors, and compromised care across the workforce. | Workers’ comp may cover workplace-related psychological injuries (varies by state). Disability insurance provides income replacement during recovery. EAPs serve as early intervention. Burned-out providers correlate with higher malpractice claims, linking wellness investment directly to insurance costs. |
A Coordinated Approach
ASHRM’s 2025 risk landscape reveals an industry under pressure coming from several directions. No single strategy can address these risks in isolation. Insurance does not prevent data breaches, clinical errors, or workplace violence. But when properly structured, it ensures the financial consequences of these events do not compound the harm. Organizations purchase insurance to remove volatility from their balance sheets. The most effective organizations treat their insurance programs as strategic assets that are aligned with their actual risk profiles and continuously reassessed as the threat environment evolves.
*The American Society for Health Care Risk Management (ASHRM) surveys risk professionals each year to identify the industry’s top enterprise risks. Their 2025 top 10 risks list spans clinical, operational, financial and workforce domains to reflect the consensus judgments of practitioners on the front lines of healthcare risk.
