BRAZILIAN SUPPLEMENTARY HEALTHCARE IS ON THE FALL: REGULATION, AUDIT AND THE SEARCH FOR MARKET SUSTAINABILITY

Abstract

Currently, there is talk about a crisis experienced by the supplementary health sector in Brazil, which is characterized, among other issues, by fraud and waste, and by the lack of internal and external control strategies on the part of operators. The present study seeks to analyze the challenging scenario of Brazilian supplementary healthcare and investigate alternatives based on health regulation and audit mechanisms to promote the reversal of this situation, aiming at the sustainability of the market as a whole. To this end, a bibliographical research was carried out, which included the analysis of publications on the topic. The results achieved confirm that strategies such as auditing and strengthening regulation can contribute to facing the crisis in the supplementary health sector in Brazil: while health auditing can optimize the control of operators, ensuring beneficiaries the most appropriate treatments and impact on the quality of service, and greater regulation generates price control, inspection, increased transparency, among other issues, generating more market sustainability and preventing the Unified Health System from being affected or harmed by the collapse of health plans. health at a national level. It is concluded that there is a need for urgent action to face the supplementary health crisis in Brazil, which fundamentally involves the adoption of audits and regulatory and regulatory strengthening.