Impacto financeiro de 2010 a 2030 do envelhecimento dos beneficiários em operadoras de plano de saúde de Minas Gerais:: um estudo de caso

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

31/08/2011

RESUMO

The portfolio aging of individual health plans, combined with epidemiological changes and the regulatory legislation of the National Health Insurance, is a challenge to be faced by the health insurance market. The aim of this dissertation is to analyze what the financial impact over the next 20 years for health insurance carriers would be, if prices do not change. Data used came from a sample of operators of the type of Medical Cooperative in Minas Gerais, from 2003 to 2009. The method adopted was the cohort-component projections, with two methodological approaches: 1) fixed rate method, with constant spending per beneficiary, calculating a pure demographic effect, isolated from other factors affecting spending on health, 2) method of variable rate variation over the years of spending per beneficiary due to the change in the price of procedures, combined with the changes of service utilization by the beneficiaries. For each approach, a number of scenarios were created. The results indicate that the proportion of elderly grows up and reaches 26% at the end of 2030; also, losses increase exponentially over from 2010 to 2030, according to two methods. There is an increasing association between the average spending per beneficiary for 59 years or more and up to 18 years, exceeding the limit set by six times the monthly SLA between these age groups. In the scenarios of having an estimated initial monthly fee, only to cover health care expenses, and no real increases over the period, the results are worrisome, independent of the method used, due to the reduced timeline (two years) for operators to keep portfolios solvents. In the scenery of initial inclusion of monthly profit and losses are the carriers survive longer, more comfortable with the method of fixed rate. In alternative scenarios, if the plans were no longer marketed, findings indicate similarities with other scenarios obtained, but the method of fixed rate gains imply some years of relevant financial survival. The contribution of this dissertation, finally, is to underscore and disentangle the impact yielded by the aging process in the private sector, and to highlight that solutions are urgent to the future solvency of the portfolios.

ASSUNTO(S)

idosos cuidados médicos teses. previsão demografica teses. minas gerais. demografia teses.

ACESSO AO ARTIGO

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