Cost of UTI for covid increases 187% and must increase health plan

The cost of each patient with covid-19 hospitalized in ICUs (Intensive Care Units) of hospitals that provide medical insurance has almost tripled, with an increase of 187% since the beginning of the pandemic, according to a survey by FenaSaúde (National Health Federation Supplementary), which brings together the 15 largest operators in Brazil.

The organization argues that the increase in these costs should increase the monthly fees for medical plans next year, which is criticized by professor and researcher at USP (University of São Paulo) Mario Scheffer, for whom the threat of an increase ignores the Brazilian economic stagnation in full pandemic.

THE FenaHealth attributes the increase in the cost of hospitalization to “increased demand [mais pacientes doentes], from the few suppliers, increased logistical costs, uncertainties in the Brazilian economy and, above all, an increase in the dollar.” Scheffer says that the individual cost increased because “the inpatient treatment with covid evolved”.

“Protocols in the ICU have changed, medications and procedures have been incorporated. When recommended, the time on dialysis, for example, has increased”, he says.

According to the survey, a patient infected with the coronavirus who had to be admitted to the ICU in March of last year cost R$ 34,200 on average.

This value grew over the months until it reached a peak of R$ 98,300 in August this year, with a small drop in September. Now a patient hospitalized in the ICU costs the plans R$ 97,300.

During this period, according to the entity, the average length of stay also increased. In March 2020, patients remained in the ICU for five days compared to eight in September 2021.

“The greatest number of days of hospitalization was found in February and May 2021, with an average of 14 days,” he told the UOL Vera Valente, executive director of FenaSaúde.

As a result, each patient in September cost R$ 12 thousand per day to the health insurance.

President of the AMIB (Brazilian Intensive Care Medicine Association), Suzana Lobo says that the increase in length of stay can also be justified “by the greater availability of beds in hospitals, which, with greater peace of mind, would not have such urgency to free up ICU beds for new ones patients”.

In fact, the volume of admissions to the private network has been falling. The peak was in March this year, when 336 people were treated in the ICU for every 100,000 plan beneficiaries. Today this ratio is 122, a continuous reduction since May.

health insurance will be more expensive

“Unfortunately, the beneficiaries will feel the consequences of the high costs in the readjustment next year”, says Valente. “This stability of costs at such expressive levels, the highest in the historical series, which can have consequences for the sustainability of the system, is very worrying.”

There is a very common Brazilian commercial characteristic: after prices increase due to an economic necessity of the moment, after that, they will hardly fall again.”
Vera Valente, executive director of FenaSaúde

“There is no room for readjustments”

For Scheffer, however, “there is no room for readjustments now”.

“At a time of economic recession like this, companies are having great difficulty paying employee plans, while individuals and families are making sacrifices to continue paying monthly fees,” he says.

The professor argues that “the plans spent far less on covid than before” because “severe cases and covid admissions have dropped dramatically in the private sector with the highest vaccination coverage.”

He says that “this threat of passing on costs to monthly fees will expel a lot of people from ‘false collectives'”, plans that cover up to 30 people that are created by operators to overturn the adhesion to individual and family models, whose monthly fees are decided by ANS. “Who should define readjustment criteria is the ANS, not the operators”, says the professor.

to Valente, of the FenaHealth, are the accident rates disclosed by the ANS which support the defense of an increase in the monthly fee.

“The loss ratio grew ten percentage points since the first quarter of the year, which indicates a strong increase in assistance expenses”, he defends.

Patients go back to using plans

A study shows that the value of plans called "false collectives" had an increase of 12.94%, on average, between 2019 and 2020 - Pablo Jacob - Pablo Jacob

Spending on medical plans increased in 2021, says federation

Image: Pablo Jacob

In addition to the increase in hospitalization costs, beneficiaries have been activating more agreements in 2021. These are patients who stopped seeking medical help in 2020 due to the pandemic and who are now rescheduling appointments, exams and surgeries.

According to the ANS (National Supplementary Health Agency), the rate of “accidents” —when the patient uses the plan— already surpasses the pre-pandemic period: it was 79% in 2019, fell to 76% in 2020 and is now 85%.

Thanks to this, says FenaSaúde, operators’ expenses rose from R$77.5 billion, in the first six months of 2020, to R$96.9 billion in the same period this year, an increase of 25%.

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