Given this scenario, it is very clear how important it is to adopt a more preventive approach in health management models. And in the context of supplementary health, this also gains a new perception of value regarding the health plan, even becoming a factor favorable to customer loyalty.

Prevention campaigns – check out the advantages for healthcare providers

Health care providers must be increasingly concerned about the well-being and quality of life of their beneficiaries through actions aimed at health promotion, risk reduction and prevention. And this is not only to improve your brand's reputation, but also because investing in prevention campaigns provides operators with a series of benefits, in addition to a significant cost reduction in the medium and long term. Come and understand the main advantages:

1. Reduction in the monthly Solvency Margin requirement

The total expenses of operators with programs to promote health and prevent risks and diseases (which are approved and recorded in the accounts in the previous year) can be converted into a reduction of up to 10% of the monthly solvency margin requirement for the current year, as per establishes Art 6 of the INC 07/12. To do this, the program must not only be registered, but registered and approved by the ANS. 

Since solvency is the operator's ability to honor all benefits and financial commitments assumed, avoiding future claims to beneficiaries, the Solvency Margin is the extra capital to face unforeseen circumstances. It allows ANS to monitor companies' performance and receive an alert when the operator is below the minimum requirement level.

2. Bonus for Care Monitoring

Another specific advantage is the bonus in the form of points granted by the ANS in Assistance Monitoring, which measures operators' risk every quarter, that is, it periodically monitors products that may be indicative of risk to the quality or continuity of assistance to beneficiaries of health insurance.

A methodology of Assistance Monitoring used by ANS takes into account 5 aspects: Actuarial, Structure and Operation, Information, Complaints Index and Assistance. In this last dimension, the bonus occurs for operators that have prevention and health promotion programs approved by the ANS. It has a weight of 15.25% in the composition of the note. With greater weight, the Complaints Index (49%) and Information (15.58%) are ahead.

The classification of operators can characterize them as having low, pre-moderate, moderate or active care risk, each with different monitoring procedures defined by the agency.

3. IDSS bonus score

ANS uses the Supplementary Health Performance Index (IDSS) to assess the quality of operators. It is calculated based on four indicators: health care; economic-financial assessment; structure and operation; and beneficiary satisfaction. The biggest weight is health care, so having preventive medicine programs helps to increase the company's IDSS. Registered programs, not just those registered with the agency, earn bonus IDSS scores and program and operator data are published by ANS on its website.

More than promoting health and quality of life for plan beneficiaries, it is proven that preventive medicine programs also contribute to the financial health of operators.

4. Positive brand reputation

By promoting awareness campaigns, the health plan operator builds a humanized and positive image. This adds value to your service and increases the chances of customers relating even more to the brand.

5. Significant cost reduction

These actions generate a feeling of welcome for patients, in addition to generating financial advantages, as many diseases can be prevented. This makes customers value the chosen health plan even more, ensuring greater satisfaction and loyalty.

How does technology make all the difference?

Using a medical bill audit system In your healthcare provider you will have a strategic vision of your business. Use the data acquired in the system and study your cost flow to understand where to start your prevention campaigns. There are campaigns for every month of the year, each one aimed at a specific situation.

Our golden tip is: start the prevention campaign for the disease that generates the most expenses for your healthcare provider! And if you don't already have a medical audit system in place, contact us! ; )

To learn about the origins of colors and their respective causes, check out another post about the importance of implementing prevention campaigns.