Study of care models practiced by private operators of health plans

• Published in: Physis (Rio de Janeiro, Brazil) Vol. 21; no. 4; p. 1561
• Main Authors: de Freitas, Rosiene Maria, Mariângela Leal Cherchiglia, Félix Lana, Francisco Carlos, Deborah Carvalho Malta, Eli Iola Gurgel Andrade
• Format: Journal Article
• Language: Portuguese
• Published: Rio de Janeiro Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social 01.01.2011
• ISSN: 0103-7331; 1809-4481
• DOI: 10.1590/S0103-73312011000400020

This study aimed to identify the adoption by private health insurance companies, from the induction by the Agência Nacional de Saúde Suplementar (ANS) of models that foments integrality. The universe were companies in Minas Gerais, in the modalities self-management, philanthropy, group medicine and medical cooperative. The companies were described from ANS official registers. Also, was made a computer-assisted telephone interview - ETAC- which approached: the beneficiaries' access to services, the structuring of the network, and the introducion of care models on maternal and child health, adult/elderly, cardiovascular and cancer. There were found 182 companies in Minas Gerais; 108 were elegible; 27,1% reported the deployment of care models on maternal and child health; 22,2% on adult/elderly health and 9,25% on cancer. Inadequate internal structures and the small size of most companies may somehow explain the difficulty of implementing models of care that foments integrality. We highlight the wide scope for innovations that still exists for the introduction of these practices by the companies.