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Reajustes de planos coletivos na saúde suplementar do Brasil : uma aplicação do modelo de regressão descontínua
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O objetivo deste trabalho é avaliar o impacto, nos reajustes dos planos (seguros) de saúde
coletivos no Brasil, da política implementada por um normativo (RN 309) da Agência Nacional
de Saúde Suplementar (ANS), que é o órgão que regulamenta os planos de saúde no Brasil.
Esta política baseia-se em agrupar os contratos de planos de saúde coletivos com menos de 30
beneficiários para que estes tenham um percentual único de reajuste e que isto minimize a
vulnerabilidade destes contratos. O percentual de reajuste visa a atualização da mensalidade
paga pelo beneficiário frente à variação de custos, de forma a preservar a continuidade do
serviço em proporcionalidade às condições iniciais de contratação. Para avaliar o impacto da
aplicação deste normativo considera-se a Regressão Descontínua (RDD), que é uma técnica
estatística comummente usada para medir o efeito da aplicação de um tratamento binário com
ponto de corte definido. O estudo consiste em comparar os reajustes aplicados um pouco acima
e um pouco abaixo do ponto de corte de 30 beneficiários usado para o agrupamento. A base de
dados utilizada é a base dos comunicados de Reajustes dos Planos Coletivos (RPC) que está
disponível no Portal Brasileiro de Dados Abertos (PDA), sendo o período de análise de 2016 a
2020 e o período de comparação dos resultados de 2008 a 2012. Como principal resultado
observou-se que os contratos abaixo do ponto de corte possuem reajustes maiores que aqueles
acima deste ponto. Isto significa dizer que, estando em contratos com características exatamente
iguais um beneficiário receberá um reajuste anual maior em sua mensalidade simplesmente por
ter seu contrato agrupado, enquanto outro beneficiário terá um reajuste menor quando seu
contrato não está agrupado. Observou-se também um aumento desta diferença após a
implementação da Resolução Normativa 309/2012. Uma vez que analisamos apenas um dos
aspectos que compunham objeto do regulamento, não podemos afirmar sobre a efetividade
integral do normativo.
This research aims to evaluate the impact of the Brazilian National Health Agency’s (ANS) policy on group insurance plans, implemented by the regulatory framework RN 309. The ANS is the government body that regulates insurance plans in Brazil. The policy is meant to group insurance contracts with less than 30 beneficiaries so that they have a single plan readjustment percentage and that this is to minimize the vulnerability of these contracts. This adjustment percentage aims to update the monthly insurance fee paid by the beneficiary, to cover cost variations, and thus allows the insurance company to maintain the conditions agreed upon on the initial insurance contract. To evaluate of the application of this regulatory, the Regression Discontinuity Design (RDD) is considered, which is a statistical method commonly used to measure the effect of applying a binary treatment with a selected cut-off point. This study consists in comparing the readjustments applied slightly above and slightly below the cut-off point of 30 beneficiaries used in the insurance plan grouping. The database used for this thesis is the database for announcements of Readjustments of Group Plans (RPC), available on the Brazilian Open Data Portal (PDA), the analysis period from 2016 to 2020 and the period of comparison of the results from 2008 to 2012. As the main result, it was observed that contracts below the cut-off point have higher readjustments than those above this point. This means that, being in contracts with exactly the same characteristics, a beneficiary will receive a higher annual adjustment in his monthly fee simply for having his contract grouped, while another beneficiary will have a smaller adjustment when his contract is not grouped. And it was also observed an increase in this difference after the implementation of the Normative Resolution 309/2012. Despite the results presented, we cannot say about the effectiveness of the regulation, since we analyzed just one of the aspects that made up the object of the regulatory.
This research aims to evaluate the impact of the Brazilian National Health Agency’s (ANS) policy on group insurance plans, implemented by the regulatory framework RN 309. The ANS is the government body that regulates insurance plans in Brazil. The policy is meant to group insurance contracts with less than 30 beneficiaries so that they have a single plan readjustment percentage and that this is to minimize the vulnerability of these contracts. This adjustment percentage aims to update the monthly insurance fee paid by the beneficiary, to cover cost variations, and thus allows the insurance company to maintain the conditions agreed upon on the initial insurance contract. To evaluate of the application of this regulatory, the Regression Discontinuity Design (RDD) is considered, which is a statistical method commonly used to measure the effect of applying a binary treatment with a selected cut-off point. This study consists in comparing the readjustments applied slightly above and slightly below the cut-off point of 30 beneficiaries used in the insurance plan grouping. The database used for this thesis is the database for announcements of Readjustments of Group Plans (RPC), available on the Brazilian Open Data Portal (PDA), the analysis period from 2016 to 2020 and the period of comparison of the results from 2008 to 2012. As the main result, it was observed that contracts below the cut-off point have higher readjustments than those above this point. This means that, being in contracts with exactly the same characteristics, a beneficiary will receive a higher annual adjustment in his monthly fee simply for having his contract grouped, while another beneficiary will have a smaller adjustment when his contract is not grouped. And it was also observed an increase in this difference after the implementation of the Normative Resolution 309/2012. Despite the results presented, we cannot say about the effectiveness of the regulation, since we analyzed just one of the aspects that made up the object of the regulatory.
Descrição
Mestrado Bolonha em Métodos Quantitativos para a Decisão Económica e Empresarial
Palavras-chave
Planos Coletivos de Saúde Suplementar Índice de Reajuste RN 309 Análise de Impacto Regressão Descontínua Group Private Health Insurance Readjustment Index RN309 Impact Analysis Discontinuous Regression
Contexto Educativo
Citação
Souza, Fernanda de Castro (2022). “Reajustes de planos coletivos na saúde suplementar do Brasil : uma aplicação do modelo de regressão descontínua”. Dissertação de Mestrado. Universidade de Lisboa. Instituto Superior de Economia e Gestão
Editora
Instituto Superior de Economia e Gestão