The accident rate in the 3rd Quarter of 2021 closed at 83% due to the increase in health plan beneficiaries who resumed procedures previously left aside.
In a recent publication on the FenaSaúde website, the economic scenario faced by operators was presented in detail. Read until the end to understand the entire context and find out what the solution adopted by the largest health plan operators in Brazil to medical audit, cost control and accident reduction.
The mass resumption of beneficiaries impacted the operation of health plans, which in the 3rd Quarter of 2021 paid suppliers and care providers R$ 43 billion, the highest amount since the first quarter of 2019, according to data from the National Supplementary Health Agency ( ANS).
This record cost is a consequence of health inflation, Brazilian economic uncertainty, but, above all, the high demand for non-urgent procedures.
Also according to ANS, the accident rate in the 3rd Quarter of 2021 was 83%, eight percentage points higher than in the first quarter of the year, which was 75%. Considering the projection made by the regulatory agency, the fourth quarter is even more worrying!
This data is still being calculated, but the forecast is that the operators ended 2021 with 85% of accidents, ten percentage points higher than that presented at the beginning of 2021.
“The numbers recently released by ANS corroborate warnings that we have been making since the first half of the year: the accident rate is on the rise, which indicates a strong increase in assistance expenses. Just as the reduction in usage in 2021 resulted in a drop in monthly fees this year, for 2022 the movement, unfortunately, goes in the opposite direction, with enormous cost pressure that will have repercussions on the readjustments of plans”, warns the executive director of FenaSaúde, Vera Brave.
Covid cost also on the rise
Hospitalizations for Covid-19 have plummeted since the start of the vaccination campaign, but the cost per patient with the disease in an ICU stay is at peak levels during the pandemic.
This is what a study by FenaSaúde (National Supplementary Health Federation) points out based on data collected from six operators associated with the entity, which represent 25% of the total number of supplementary health beneficiaries.
The costs per Covid-19 hospitalization (ICU), in September/20, were R$ 63,966 on average, per patient. After one year, this number jumped to R$ 97,328, 52.2% more. In relation to August/21, the values for September/21 are stable, however, stability occurs at very high levels.
Source: FenaSaúde (projection based on data from six associates, representing 25% of medical and hospital plan beneficiaries)
FenaSaúde understands that the data is a reflection of exchange rate variations, increased logistics costs and uncertainties in the Brazilian economy, which are reflected in escalating prices.
Discover a solution adopted by the largest healthcare providers in Brazil
Given this scenario, it is essential to keep costs under control and audit medical bills up to date. To achieve this, large Brazilian healthcare providers use the SAUDI System, which offers a set of modules with specific easy-to-use routines, with a simple and intuitive interface, which result in a reduction in disallowances, greater control over expenses and a consequent reduction in accident rates in the first 3 months of use!
SAUDI was designed and developed to improve the financial health of healthcare providers. Directors and managers of the largest health plans use the System to obtain strategic information, carry out all medical authoring in an automated way, monitor the relationship with service providers with total transparency, and also analyze the stored data to study the behavior of beneficiaries, routines between operators and service providers, etc.
To learn even better about this solution adopted by hundreds of operators throughout Brazil, contact contact a specialist from the SAUDI team and schedule an objective, no-obligation presentation!
SOURCE news and images: FenaSaúde website.
