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The National Supplementary Health Agency (ANS) announced today (20) a new calculation method for defining the annual adjustment index of individual and family health plans. The new IRPI is based on the variation of medical costs of operators in individual schemes and in the general inflation of the economy, reflecting, according to the ANS, the "reality" of the segment.
"It also brings others reduce the time between the calculation period and the adjustment application period and transfer the average efficiency of the operators to the beneficiaries, resulting in a reduction readjustment rate, "said the regulator.
approved by the board of directors of the organ last Tuesday (18) and published today in the Official Journal of the Union. The new calculation method comes into force from next year and the annual adjustment can only be applied by the operators.
"This methodology is the result of studies conducted by the agency's technical staff over the last eight years and has been discussed in detail with the sector and society, who collaborated through the through contributions at public hearings, meetings and suggestions sent through an electronic form provided by the agency, "says the ANS.
The readjustment index allowed by the ANS is applicable to health care plans contracted after January 1, 1999 or adapted to Law No. 9,656 / 98. According to October data , 8 million beneficiaries are currently in these conditions – about 17% of the total number of clients of health care plans in Brazil.
Understanding
The new model combines the index of the value of care expenditures. (IVDA) with the general index of consumer prices (IPCA). The first index reflects the change in expenditures with the beneficiaries of the health care plan, while the second is related to other types of costs, such as administrative expenses. In the formula, the IVDA will have a weight of 80% and the IPCA of 20%.
The IVDA formula consists of three components: Variation of Assistance Expense (ARV), Variation of Income by Age Group. Efficiency Gains Factor (FGE)
The VFE deducts the portion of the incomes of the operators, which is already recovered by the changes due to the change in age. On the other hand, the EGF is an index of efficiency calculated from the variation of health expenditures, transferring to consumers the average efficiency of the sector and avoiding a model of automatic repercussion of the variation of costs.
Readjustment of Health Plans – Press Release / ANS
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