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09/07/2021 | Fonte: SONHO SEGURO

Negative adjustment defined by the ANS for individual health plans follows the variation in health system costs, says FenaSaúde

Very expressive effects on assistance costs over the coming months and, therefore, with effects on the prices of tuition to be practiced in the next adjustment cycle in 2022, adds the federation

Individual health plans were readjusted with a negative index by the National Supplementary Health Agency (ANS). Operators associated with FenaSaúde – which represent 15 companies responsible for 40% of the private health and dental care plans and insurance market in the country – agree with the negative adjustment of 8.19% for individual and family health plans. According to the federation, the index tracks the cost variation of the supplementary health system in the first year of covid-19 in Brazil.

Agency data show a 20% drop in expenses for operators in 2020. This year, the use of health services has not yet reached pre-pandemic levels. The service numbers, says the ANS, are on the same level for exams and elective therapies. Or at a lower level, in the case of hospitalizations and emergency room visits. On the other hand, in 2021 the attendances resumed with force and will be felt in next year’s readjustment.

“At the beginning of the pandemic, several procedures were suspended or postponed, which explains the lower use of the system by beneficiaries, the drop in assistance expenses and, consequently, the reduction today”, comments FenaSaúde in a statement. The reduction announced by ANS reinforces the contractual nature of a sector subject to regulation. Health plan operators associated with FenaSaúde have always complied and will continue to comply with the rules established by the legislation regarding supplementary health in the country. “FenaSaúde considers that respect for contracts is a value to be strictly obeyed in an economy that intends to be strong, healthy and inclusive.”

The statement emphasizes that it is important to emphasize that the scenario that led to the unprecedented application of negative readjustments in the monthly fees of individual health plans this year has already been changing since the end of 2020 and, with more intensity, at the beginning of this year. In addition to the second wave of Covid, which filled hospitals, care for other diseases reached very high levels.

The loss ratio, that is, the percentage of revenue spent on payment of care expenses for patients, is already at the same level as before the pandemic, according to official data from the ANS  (chart below). In April and May, operators’ expenses reached the highest level in two and a half years, also according to official data from ANS.

Within the mutualist model that regulates relationships in supplementary health, the significant increase in the procedures we are now observing – whether due to new waves of the coronavirus, whether due to the resumption of electives or the significant increase in the costs of inputs and raw materials – tends to continue to have very significant effects on assistance costs over the coming months and, therefore, with effects on the prices of tuition to be practiced in the next adjustment cycle in 2022.

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