{"id":2314,"date":"2017-10-31T08:00:29","date_gmt":"2017-10-31T10:00:29","guid":{"rendered":"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/?p=2314"},"modified":"2021-06-22T16:34:42","modified_gmt":"2021-06-22T19:34:42","slug":"ans-debate-compartilhamento-de-riscos-na-saude","status":"publish","type":"post","link":"https:\/\/segurosinteligentes.com.br\/oldrh\/ans-debate-compartilhamento-de-riscos-na-saude\/","title":{"rendered":"ANS debate compartilhamento de riscos na sa\u00fade"},"content":{"rendered":"

[et_pb_section admin_label=”section” transparent_background=”on” background_color=”#ffffff” allow_player_pause=”off” inner_shadow=”off” parallax=”off” parallax_method=”off” padding_mobile=”on” make_fullwidth=”off” use_custom_width=”off” width_unit=”on” make_equal=”off” use_custom_gutter=”off” custom_padding=”0px||50px|”][et_pb_row admin_label=”row” make_fullwidth=”off” use_custom_width=”on” width_unit=”off” use_custom_gutter=”off” padding_mobile=”on” allow_player_pause=”off” parallax=”off” parallax_method=”off” make_equal=”off” parallax_1=”off” parallax_method_1=”off” parallax_2=”off” parallax_method_2=”off” column_padding_mobile=”on” custom_padding=”50px|35px|50px|35px” background_color=”#ffffff”][et_pb_column type=”2_3″][et_pb_text admin_label=”tag e data” background_layout=”light” text_orientation=”left” text_font=”|on|||” text_font_size=”16″ text_text_color=”#9ec31e” text_line_height=”1.5em” use_border_color=”off” border_color=”#ffffff” border_style=”solid” custom_margin=”||0px|”]<\/p>\n

MAIS TRANSPAR\u00caNCIA | 31.NOVEMBRO.2017<\/p>\n

[\/et_pb_text][et_pb_text admin_label=”t\u00edtulo” background_layout=”light” text_orientation=”left” text_font=”|on|||” text_font_size=”32″ text_text_color=”#495358″ text_line_height=”1em” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n

ANS debate compartilhamento de riscos na sa\u00fade<\/p>\n

[\/et_pb_text][et_pb_text admin_label=”conte\u00fado” background_layout=”light” text_orientation=”left” text_font=”Open Sans||||” text_font_size=”16″ text_text_color=”#748690″ text_line_height=”1.5em” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n

Em outubro, a ANS realizou uma audi\u00eancia p\u00fablica para discutir a responsabilidade das operadoras de sa\u00fade e o impacto para os benefici\u00e1rios quando o assunto \u00e9 compartilhamento de riscos. Com o objetivo de trazer mais transpar\u00eancia sobre o processo de utiliza\u00e7\u00e3o dos benefici\u00e1rios, os participantes – 60 representantes de planos de sa\u00fade – apresentaram sugest\u00f5es para a elabora\u00e7\u00e3o da nova norma.<\/p>\n

No evento, a ag\u00eancia apresentou sua proposta de resolu\u00e7\u00e3o normativa e as operadoras trouxeram tr\u00eas modelos de compartilhamento de risco: corresponsabilidade entre as operadoras para atendimento aos benefici\u00e1rios, para oferta conjunta de planos e possibilidade de cria\u00e7\u00e3o de fundos m\u00fatuos para despesas assistenciais.<\/p>\n

\n

Hoje, como funciona o compartilhamento de risco?<\/p>\n

A corresponsabilidade para atendimento e a constitui\u00e7\u00e3o de fundos j\u00e1 s\u00e3o praticadas, principalmente pelas cooperativas de sa\u00fade. Nesses casos, a ANS solicitou mais detalhes sobre a opera\u00e7\u00e3o, para considerar os resultados na formula\u00e7\u00e3o da nova norma.
\nPara o terceiro modelo, oferta conjunta de planos e fundos m\u00fatuos, a ANS usou como base as opera\u00e7\u00f5es j\u00e1 existentes de cosseguros.<\/p>\n

\n

Por que compartilhar riscos pode ser positivo?<\/p>\n

Uma das principais motiva\u00e7\u00f5es para implantar o compartilhamento de risco \u00e9 a viabiliza\u00e7\u00e3o de atendimento de benefici\u00e1rios em locais que operadora contratada n\u00e3o possuir rede<\/a> e estrat\u00e9gia comercial. Isso seria fundamental para mitiga\u00e7\u00e3o de riscos operacionais e financeiros, al\u00e9m de gerar ganhos de escala e expertise com a opera\u00e7\u00e3o de planos.<\/p>\n

A partir dessa reuni\u00e3o, a norma e sugest\u00f5es ser\u00e3o avaliadas pela Diretoria Colegiada da ANS considerando a viabilidade de cada modelo. A aprova\u00e7\u00e3o est\u00e1 prevista para ocorrer at\u00e9 o final deste ano. Se todo o processo ocorrer dentro do cronograma, a nova norma deve entrar em vigor no in\u00edcio de 2018.<\/p>\n

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Nova resolu\u00e7\u00e3o normativa sobre compartilhamento de riscos pretende trazer mais transpar\u00eancia ao processo.<\/p>\n","protected":false},"author":1,"featured_media":2319,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_links_to":"","_links_to_target":""},"categories":[13],"tags":[168],"_links":{"self":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2314"}],"collection":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/comments?post=2314"}],"version-history":[{"count":5,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2314\/revisions"}],"predecessor-version":[{"id":8205,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2314\/revisions\/8205"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media\/2319"}],"wp:attachment":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media?parent=2314"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/categories?post=2314"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/tags?post=2314"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}