Concentração de mercado das operadoras de plano de saúde e seus efeitos sobre os preços, custos e qualidade

Abstract

The study focuses on the evolution of concentration in the supplementary health market and the analysis of its effects on prices, costs, and quality of services, comparing Brazilian Health Plan Operators (HPOs) grouped into Medical Cooperative, Group Medicine, and Specialized Health Insurer categories, from 2013 to 2022. To this end, the supplementary health system, its concept, evolution, and regulatory body are presented, along with the theoretical basis of concentration indices and types of competition, and the behavior of market concentration over time. Additionally, there is a presentation and analysis of the data collected from large health operators in the aforementioned modalities, as well as the Supplementary Health Performance Index (IDSS), the avarage unit cost and ticket of these operators. The series of actions taken by the regulatory agency to ensure financial solvency and establish minimum quality criteria for users appear to have resulted in greater market concentration. It was found that, on one hand, the more concentrated market did not result in lower healthcare costs; on the other hand, it seems to have positively affected the overall quality management of this market.