Readjustment of health plans will depend on the situation of each operator

The National Agency for Supplementary Health (ANS) released, at the beginning of last week, the financial economic data of the sector in 2022 and considered that the year ended in “zero to zero”. There was a net profit of R$ 2.5 million, a result much lower than the previous year. In 2021, the profit was R$ 3.8 billion. Already in 2020, the sector had registered a record, with the amount of R$ 18.7 billion.

The director-president of ANS, Paulo Rebello, told the Brazil Agency that the message is one of caution, but that there are already signs of recovery. According to him, there were performance differences between the various health plan operators. The biggest negative results were recorded by large operators. Rebello indicates that the specific economic reality of each one of them should have weight in the annual update of the monthly fees of their respective plans.

“The percentages of readjustments will depend on the situation of each operator”, he said. The ANS is responsible for setting the maximum rate that can be applied to individual and family health plans. Last year, the ceiling was 15.5%, the highest ever approved by the agency since its inception in 2000.

Industry data for 2022 is available at Supplementary Health Accounting Panel, maintained by ANS and fed with financial information sent by health plan operators. On Monday (24), the results for the 4th quarter of 2022 were included, thus allowing the consolidation of last year’s performance figures.

According to the ANS, effective revenue from health operations, the industry’s main business, was R$ 237.6 billion. Thus, the profit of R$ 2.5 million represented only 0.001% of revenue.

“We can see a recovery in the 4th quarter. So it is good to clarify that the term ‘zero to zero’ only seeks to show equality between revenues and expenses in the sector in 2022. There was a derisory positive result compared to total revenues for the year” , explains Rebello.

According to him, the sector has resources to go through this period. “Obviously it was a difficult year. There was an increase in inputs, growth in the frequency of use of the plans. The message is one of caution. But there are already signs of improvement”, he said.

The drop in performance was registered even with the expressive growth in the number of beneficiaries since the beginning of the covid-19 pandemic, reaching a record 50.5 million at the end of last year. A year earlier, in December 2021, supplementary health registered 48.9 million beneficiaries.

“It is important to consider the entire context of the pandemic. The sector already expected an effect on use after social isolation. During social isolation, people did not use plans. For this reason, in 2020, there was a historic profit”, evaluates the CEO of ANS.

Segments

The Supplementary Health Accounting Panel allows you to cut data by segment and by operator. In the case of medical-hospital operators, there was a loss of R$ 505.7 million. The exclusively dental operators, in an unprecedented way, also had a negative performance. The loss was R$ 47.3 million.

The only segment that registered a positive result was benefit administrators. Profit reached R$ 555.57 million. Benefit administrators are companies that act as intermediaries in contracting collective health plans, such as Qualicorp and AllCare. They manage to obtain from operators special conditions for people who have links with companies, public bodies, associations, unions or class councils with which they have signed an agreement.