Reversal of the profitability rates of health plans according to age
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | MedicalExpress (São Paulo. Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2358-04292014000600346 |
Resumo: | OBJECTIVE: In this study, we will analyze assistance costs and profitability rates of a private health insurance company. METHODS: A private health insurance company of an inland city of Sa˜o Paulo was analyzed. Assistance costs and profitability rates were analyzed in a time interval of seven years according to age and gender. The assistance cost (sum of medical appointments, exams, surgical intervention) was calculated by the absorption counting method, which consists of the analysis of direct and indirect, fixed and variable costs caused by the use of medical and hospital resources. The profitability rate was calculated based on the difference between the premium (monthly fee and co-insurance [20%]) and the cost assistance. RESULTS: Although the number of users decreases as age increases, costs increase disproportionally. The growth of unitary premiums from the age group of 50 to 59 years contrasts with the unitary results. There is a surplus until the age of 59 years and subsequent deficit from this age on. This deficit progresses according to the age group. In this case, while the first age groups present a balanced unitary profit, there is a growing progression of the unitary cost that causes costs to increase above the premium, especially in individuals over 60 years of age. CONCLUSION: Our results consistently support the hypothesis of inversion of profitability rates according to age, regardless of the decrease of the number of individuals at the age group of 60 years. |
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Reversal of the profitability rates of health plans according to ageAgingcostshealth insuranceprofitability OBJECTIVE: In this study, we will analyze assistance costs and profitability rates of a private health insurance company. METHODS: A private health insurance company of an inland city of Sa˜o Paulo was analyzed. Assistance costs and profitability rates were analyzed in a time interval of seven years according to age and gender. The assistance cost (sum of medical appointments, exams, surgical intervention) was calculated by the absorption counting method, which consists of the analysis of direct and indirect, fixed and variable costs caused by the use of medical and hospital resources. The profitability rate was calculated based on the difference between the premium (monthly fee and co-insurance [20%]) and the cost assistance. RESULTS: Although the number of users decreases as age increases, costs increase disproportionally. The growth of unitary premiums from the age group of 50 to 59 years contrasts with the unitary results. There is a surplus until the age of 59 years and subsequent deficit from this age on. This deficit progresses according to the age group. In this case, while the first age groups present a balanced unitary profit, there is a growing progression of the unitary cost that causes costs to increase above the premium, especially in individuals over 60 years of age. CONCLUSION: Our results consistently support the hypothesis of inversion of profitability rates according to age, regardless of the decrease of the number of individuals at the age group of 60 years.Mavera Edições Técnicas e Científicas Ltda2014-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2358-04292014000600346MedicalExpress v.1 n.6 2014reponame:MedicalExpress (São Paulo. Online)instname:Mavera Edições Científicas e Técnicas Ltda-MEinstacron:METC10.5935/MedicalExpress.2014.06.10info:eu-repo/semantics/openAccessRaso,VagnerOliva,Flávio Albertoeng2016-03-24T00:00:00Zoai:scielo:S2358-04292014000600346Revistahttp://www.medicalexpress.net.brhttps://old.scielo.br/oai/scielo-oai.php||medicalexpress@me.net.br2358-04292318-8111opendoar:2016-03-24T00:00MedicalExpress (São Paulo. Online) - Mavera Edições Científicas e Técnicas Ltda-MEfalse |
dc.title.none.fl_str_mv |
Reversal of the profitability rates of health plans according to age |
title |
Reversal of the profitability rates of health plans according to age |
spellingShingle |
Reversal of the profitability rates of health plans according to age Raso,Vagner Aging costs health insurance profitability |
title_short |
Reversal of the profitability rates of health plans according to age |
title_full |
Reversal of the profitability rates of health plans according to age |
title_fullStr |
Reversal of the profitability rates of health plans according to age |
title_full_unstemmed |
Reversal of the profitability rates of health plans according to age |
title_sort |
Reversal of the profitability rates of health plans according to age |
author |
Raso,Vagner |
author_facet |
Raso,Vagner Oliva,Flávio Alberto |
author_role |
author |
author2 |
Oliva,Flávio Alberto |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Raso,Vagner Oliva,Flávio Alberto |
dc.subject.por.fl_str_mv |
Aging costs health insurance profitability |
topic |
Aging costs health insurance profitability |
description |
OBJECTIVE: In this study, we will analyze assistance costs and profitability rates of a private health insurance company. METHODS: A private health insurance company of an inland city of Sa˜o Paulo was analyzed. Assistance costs and profitability rates were analyzed in a time interval of seven years according to age and gender. The assistance cost (sum of medical appointments, exams, surgical intervention) was calculated by the absorption counting method, which consists of the analysis of direct and indirect, fixed and variable costs caused by the use of medical and hospital resources. The profitability rate was calculated based on the difference between the premium (monthly fee and co-insurance [20%]) and the cost assistance. RESULTS: Although the number of users decreases as age increases, costs increase disproportionally. The growth of unitary premiums from the age group of 50 to 59 years contrasts with the unitary results. There is a surplus until the age of 59 years and subsequent deficit from this age on. This deficit progresses according to the age group. In this case, while the first age groups present a balanced unitary profit, there is a growing progression of the unitary cost that causes costs to increase above the premium, especially in individuals over 60 years of age. CONCLUSION: Our results consistently support the hypothesis of inversion of profitability rates according to age, regardless of the decrease of the number of individuals at the age group of 60 years. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2358-04292014000600346 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2358-04292014000600346 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/MedicalExpress.2014.06.10 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Mavera Edições Técnicas e Científicas Ltda |
publisher.none.fl_str_mv |
Mavera Edições Técnicas e Científicas Ltda |
dc.source.none.fl_str_mv |
MedicalExpress v.1 n.6 2014 reponame:MedicalExpress (São Paulo. Online) instname:Mavera Edições Científicas e Técnicas Ltda-ME instacron:METC |
instname_str |
Mavera Edições Científicas e Técnicas Ltda-ME |
instacron_str |
METC |
institution |
METC |
reponame_str |
MedicalExpress (São Paulo. Online) |
collection |
MedicalExpress (São Paulo. Online) |
repository.name.fl_str_mv |
MedicalExpress (São Paulo. Online) - Mavera Edições Científicas e Técnicas Ltda-ME |
repository.mail.fl_str_mv |
||medicalexpress@me.net.br |
_version_ |
1754734596627365888 |