In the last decade, we have seen significant growth in supplementary healthcare in Brazil — the ANS shows us that, from 2009 to 2019, coverage of the area covered almost 5 million more Brazilians. Although this means success in the segment, however, the challenges for the health operator manager also increase.

With the responsibility of covering a growing number of users, this professional must be concerned with multiple areas of service. The attractiveness of supplementary healthcare also increases the number of healthcare plans, intensifying competition; and, finally, the rising cost of healthcare makes financial management increasingly delicate.

Thinking about the new challenges that influence the career of a healthcare operator manager, we have brought together 5 practices of excellence in the sector. With them, you will have more tools to stand out in the market and take your plan to a new level. Keep reading to find out more.

1. Professionalize your management

Specialties in medicine are becoming increasingly diverse. Today, we find postgraduate degrees Lato sensu in areas specifically focused on private health management: courses in auditing, financial management and life management are some examples.

There are several reasons for this overspecialization. The first of these is related to competition between health plans, which forces increasingly higher goals. A few years ago, such specific knowledge might not have been necessary; today is. Without highly trained professionals by your side, your management metrics may start to fall and your goals may become further away.

Another reason is the complexity of healthcare, which is growing more and more. With more effective treatment techniques, many patients survive with diseases that were not so common before. A very common example is myocardial infarction — with a higher survival rate, the number of patients with sequelae, such as heart failure, increases. The accumulation of health problems makes the role of the health operator manager more challenging, because he needs to adjust various specialties and levels of care.

There is a growing introduction of new health technologies, which are not always effective and which substantially increase the cost of care and, consequently, the accident rate for operators.

2. Pay attention to regulatory standards

Supplementary healthcare is regulated by the National Supplementary Health Agency (ANS). It dictates some standards valid throughout the national territory, valuing the quality of service and the transparency. Operators that do not comply with this regulation may suffer sanctions, ranging from fines to interruption of operations.

To ensure that its service complies with ANS quality standards, it has its own mechanism: the Certification of Good Practices in Health Care. This is an easy and objective way to identify points of inadequacy in the service and improve its management. Furthermore, certification also favors the operator marketing, bringing an image of confidence and excellence.

In addition to the ANS, national legislation also impacts health management. One of the recent examples is the General Personal Data Protection Law, 2018. It aims to increase data security for all companies, in light of recent controversies regarding the sale and leakage of data. In the health area, it evokes the need to value medical confidentiality and information under the operator's responsibility. Paying attention to these recent changes can avoid legal complications for your management.

3. Invest in technology

Those who work in the medical field know how essential technology has become for care: from modern exams to electronic medical records, we are surrounded by digital innovations. The novelty — which will become a trend in the coming years — is the arrival of this technology in healthcare management.

Some of the operator's administrative and bureaucratic processes can consume excessive time and resources. The flow of procedure requests, appointment scheduling and individual audits are some of the main examples. Technology helps to optimize these processes, reducing costs and avoiding rework.

If you choose management software, for example, all administrative processes will be centered in a single virtual environment. Requests, budgeting and organization of schedules will be carried out by computer, and no longer by hand. Have you ever imagined how your management could be easier with these tools?

4. Adopt quality KPIs

The acronym KPI refers to “Key Performance Indicator”, which, in literal translation, means “main performance indicator”. KPIs are known in various areas of business, and in the healthcare area it is no different; after all, supplementary healthcare is part of the private market and is governed by objectives common to any business.

KPIs are important because, without them, the manager can become disoriented and not know when interventions work or not. Suppose you establish a new protocol for the treatment of lung cancer, for example. How will you measure the effectiveness of this protocol? By the number of deaths from the disease? For the years of life gained with a new medicine? For the amount invested in each patient?

All of these variables impact the effectiveness of health care and, consequently, the success of its management. Therefore, before making any changes to the operator, it is important to list a representative and powerful KPI. It needs to directly measure the variable that matters most, have low variability and be easily obtained. With these characteristics, you will be sure that you are achieving the proposed objectives.

5. Simplify your management with SWOT analysis

SWOT analysis is another method used in the entrepreneurship environment, which can be taken to health plans. The acronym stands for “strengths, weaknesses, opportunities and threats”, which, translated, becomes “strengths, weaknesses, opportunities and threats”. This analysis consists of creating a table with these 4 characteristics.

Strengths and weaknesses are considered to be of internal origin, intrinsic to the functioning of the business; Opportunities and threats, on the other hand, are related to the external, more variable environment. Another analysis that can be done is related to what is useful or harmful to the company: strengths and opportunities are favorable to its growth, while weaknesses and threats are unfavorable.

Building an analysis of your management with this framework makes it easier to easily identify the factors that influence your management. The SWOT analysis also recommends specific interventions in each area: elements of internal origin, for example, are easier to change than those of external origin.

Note that, although challenging, the supplementary health management can be optimized with few adjustments. By following these practical tips, you will be better able to make your health plan stand out in the market and stand out from the competition.

In addition to these steps, there are also bad habits that can be avoided by a good healthcare provider manager. Among them, we can mention the lack of transparency in contracts and manual audits, which can increase, for example, the number of healthcare fraud.

If you are interested in being a more effective healthcare provider manager, how about going a little deeper? Find out how to make strategic cost management in health plan management!