Avaliação da percepção do cenário competitivo local em mercado de uma cooperativa médica após entrada de uma grande operadora verticalizada nacional: visão dos cooperados

• Ano de defesa: 2021
• Autor(a) principal: Silveira, Tiago Bueno da
• Orientador(a): Alberto, Fernando Lopes
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Saúde suplementar; Administração de serviços de saúde; Gastos em saúde atenção primária em saúde; Sistemas de pagamento em saúde
• Palavras-chave em Inglês: Supplemental health; Health services administration; Health expenditures; Primary health care; Health payment systems
• Link de acesso: https://hdl.handle.net/10438/31369

The concentration in the supplementary health market, which serves 24% of the Brazilian population, has been consolidating large vertical operators, such as Grupo NotreDame Intermédica. With the escalation of fiercer competition over the years, the Unimed system has been reinventing itself in an environment of more accessible health insurance offers. The objective in this Applied Work was to describe and analyze the understanding of member phisicians of a single local Unimed by the cooperating physicians about the new competitive scenario caused by the start local entering of a large operator, and to evaluate their vision in relation to concepts and trends, medium and long term, in the supplementary health market. This qualitative approach applied research using content analysis for codifying and organizing information collected from 30 online interviews. According to data obtained: 66.6% of respondents believe they will be at risk of losing customers to these new competitors. Despite that, interviewees trust the potential of the local Unimed, pointing out the following strengths are mentioned: a united, motivated, and qualified clinical staff, in addition to an excellent physical structure. The cost control and survival strategies mentioned are: investment in Primary Health Care practices (PHC), cited by 12 respondents (40%), local expansion with construction of new patient facilities (9 citations, 30%), especially the new hospital and verticalization (7 citations, 23.3%). Even so, doctors believe that investment in PHC (9 citations, 30%) and verticalization (8 citations, 26.6%) may reduce costs. While the excess of exam requests is still a problem, and that, perhaps, investment in internal auditing may help. Nevertheless, there is yagueness from the cooperative physician members in pointing out solutions, with no mention of any by more than 50% of physicians. When it comes to compensation, models other than fee-for-service were scarcely mentioned, and few doctors pointed out the usual limitations of this form of payment. Value-based care, which takes outcomes, experience and cost of care into account, was mentioned only once, and superficially. Thus, we can conclude that future challenges for the Unimed system are inevitable, and competitive strategies will involve its partner-collaborators who today presente with an early-stage maturity in relation to management, administration and entrepreneurship.