bachelorThesis
Operadoras de plano de saúde e os impactos financeiros em um cenário de pandemia, Brasil, 2020
Fecha
2021-09-09Registro en:
LIMA, Roanna Figueiredo Mendonça de. Operadoras de plano de saúde e os impactos financeiros em um
cenário de pandemia. 2021. 49f. Trabalho de Conclusão de Curso (Graduação em Ciências Atuariais) – Departamento de Demografia e Ciências Atuariais, Universidade Federal do Rio Grande do Norte, Natal, 2021.
Autor
Lima, Roanna Figueiredo Mendonça de
Resumen
The Covid-19 pandemic has become a challenging event in human recent history to address a public health emergency of international importance. In addition to attacking life, it also impacts finances in several areas. Thus, this monograph aims to identify whether as health care providers in the group medicine modality they were financially impacted by the expenses generated by the Covid-19 pandemic. This work is justified by the fact that there are still few studies on the impacts of the pandemic on the finances of health plans. Therefore, the specific objectives include the comparison of revenue and expenditure flows in 2020 with the years 2015 to 2019, prior to the pandemic, as well as comparisons of possible differences between revenue and expenditure in 2019 and 2020 through a t-test of differences between population averages. There were two hypotheses: 1) The expenses of healthcare operators in the Covid-19 pandemic did not affect the financial balance in 2020 of operators in the group medicine modality; 2) The VCMH index was negative in 2020, which justifies a negative readjustment for the monthly fees of individual health plan operators. In order to change the per capita hospital medical cost variation of health plan operators between two consecutive 12-month periods, the temporal trend of the Hospital Medical Cost Variation Index (VCMH / IESS) was analyzed. The source of the information used by the National Agency for Supplementary Health (ANS) and the Institute for Supplementary Health Studies (IESS). In general, the results indicated that the revenues observed in 2020 were higher when compared to the pre-pandemic years, and the expenses prior to the last 5 years: in 2020 there was an increase of more than 3% in the number of beneficiaries in the private network. These results confirmed hypothesis 1. Regarding the variations in hospital medical costs in 2020, it was negative that hypothesis 2 was confirmed. The data show that even in a pandemic scenario in which new procedures had to be adopted by the ANS to face a health emergency, such as health operators of the group medicine modality financial balance in 2020, that is, the revenues of the first year of pandemic were sufficient to cover the expenses of that period. And about the variation in VCMH, not all of them remained negative during a pandemic, which was the case with hospitalizations, which is justified by the severity of Covid-19, and therapies, which are procedures more adjustable to Telehealth than consultation and exams, for example. Among the limitations of this study, there is the fact that the ANS does not have data on payments by large regions, which may have presented different profiles in relation to revenues and expenses.