Clipping of news on Brazilian Culture, Law and Citizenship
07/09/2013
This article was translated by an automatic translation system, and was therefore not reviewed by people.
The health plan operators are proposing an average increase of 20% for companies that offer this type of benefit to their employees. This is the highest average of the past five years, according to data from eight major health insurance providers (see table), and Fenasaúde Aon Consulting, the association that brings together operators.
The percentage increase varies according to the accident rate of the company that hires the plan. Ie, the more the health insurance is used, the greater the adjustment and vice versa. In cases where the use of the agreement was well controlled, there are usually only a replacement of the variation in medical and hospital costs (medical inflation or, in industry parlance). Bradesco is negotiating adjustments between 13.29% (replacing medical inflation) and 20% with its customers, according to the president's health insurer, Marcio Coriolanus. In Intermédica, this percentage is 26.75% and SulAmérica rotates at around 16%. SulAmérica reports that it is possible to define an average adjustment due to the different characteristics of each contract.
What pulled up the adjustment of health plans were the costs of hospitalization, doctors fees, examinations and other procedures of the genre. The variation of these expenses this year reached 15.45%. Last year was 13%. "The medical inflation is more than two times higher than general inflation. The main factors are the introduction of new drugs and technologies and longer life of the people," explains Humberto Torloni, vice president of Aon Consulting which manages a portfolio of 1 6 million users of business plans.
The hospital is identified as the "villain" of medical inflation, since it is this type of procedure that are commonly used new drugs and technologies, and orthotics and prosthetics imported. Hospitalization represents half of all medical and hospital expenses of an operator. "In the operators linked to Fenasaúde accumulated in the last five years, only hospitalization expenses increased 223.3%. Was a much higher percentage to total medical expenditures, which increased 133.8%," said José Cechin, CEO Fenasaúde, which represents approximately 30 operators.
"What contributes to increasing health care costs is that we live in a system of addition and not replacement. For example, it is still common to ask the doctor resonance and plate at the same time," said Ricardo Lobao, CEO of UIB benefits, consulting specializing in health.
Given these rates because it expects an arm fierce among operators and contractors of health plans. In recent years, we have seen that companies are able to negotiate. In 2012, the carrier revenue totaled R $ 97.2 billion, up 13.9%. Medical expenses already hit the U.S. $ 79.9 billion, an adjustment higher than 15.9%. The result was a negative operating margin of 1.3%.
Among the operators linked to Fenasaúde, performance was better. Last year, the operating margin was positive at 2.8%, but still represented a decrease of 1.2 percentage point compared to 2011. The reason is that groups linked to the entity are large and can dilute the claims of high value in its customer base.
With this scenario, companies, especially multinationals and large, are adopting programs that closely follow the habits of life of its employees and how they use the covenant, and seek new tools to try to hold the claims as " stop loss "- a kind of reinsurance for extraordinary medical expenses for high cost (see below).
In order to control the cost of health insurance - which represents the second largest expenditure of human resources - companies are also adopting some measures: the employee pays part of the consultation or medical procedure (to inhibit overuse); chronically ill have regular monitoring (to avoid admissions), payment of health club; medical treatment "medallions" in cases of high complexity; hiring own doctors to guide the employee (to avoid unnecessary queries). According to data from consulting SantéCorp, a person who schedules more than 17 visits per year, probably goes through a problem that must be managed.
"Monitoring programs do not reduce costs up because every year new technologies are introduced. But it is possible to control the excessive increase," said Lobao Benefits of UIB, which tracks 20 companies - Heineken, Petrobras, and Casting PROSEGUR Tupy, including . (Beth Koike)
Source: Economic Value
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This article was translated by an automatic translation system, and was therefore not reviewed by people.