QRS conducted an exploratory study to learn more about the trend of hospitals to self‑insure and their use of different models for medical malpractice coverage. The findings synthesize available information and provided recommendations regarding a potential compliance program and future studies. Information for the report was drawn from three sources: 1) an extensive literature search, 2) analysis of selected data sets, and 3) the assembly and interrogation of an expert panel (EP). The EP included diverse representation; experts from 1) hospitals insured commercially, 2) hospitals self‑insured, 3) malpractice insurers, 4) reinsurance firms, 5) insurance brokers and consultants, 6) legal community, and 7) physician association representatives. Members of the EP were selected for their relevant expertise; not as spokespersons for their organization. The panelists engaged in an iterative process to explore relevant questions pertaining to the study’s purpose.