O papel da tecnologia da informação em um modelo de remuneração baseado em valor em operadoras de saúde

Resumo

The increase in global health costs is due to several factors, among them the traditional payment-for-use model, the fee-for-service. The literature shows that value-based remuneration models contribute to the sustainability of the sector. In the literature, although value-based models are an old theme, there are still difficulties in both their implementation and management. The objective of this applied work is to identify the role of Information Technology in the implementation and use of a value-based remuneration model in healthcare insurance providers. For this, the methodology was a qualitative approach, a case study, two health insurance providers, with a Value-Based Payment Models recognized by ANS, participated in the study. In the result, the macroprocesses of the traditional model, the valuebased and the respective uses of IT were evidenced, in addition to the final conceptual structure, of the two confirmed propositions and, in addition, the role of IT in the value-based model is integration, automation and data sharing, in addition to the need for a new technology architecture. The present study made it possible to align the views, since there is difficulty in this conversation between the business area and IT. The entire structure was designed to help a non-IT CEO of health insurance provider to rationalize the relevant points in this implementation, and to assess the need for IT for a strategic movement. And for the CIO, this study helps to base their technology strategy compatible with the value-based payments models, in support of the business strategy, according to the needs of each IT dimension that the remuneration models need.

Ficha do documento

Tipo

Dissertação

Ano

2021

Instituição

Fundação Getulio Vargas

Fonte

Repositório da FGV

Idioma

Português

Acesso

Acesso aberto

Identificador

oai:repositorio.fgv.br:10438/30535

Temas

TecnologiaSaúdeMeio Ambiente

Palavras-chave

Value-based performanceInformation technologyHealthHealth pay modelsHealth sustainabilityValue-based health paymentTecnologia da informaçãoSaúdeModelos de remuneraçãoSustentabilidade na saúdePagamento baseado em valorAdministração de empresasOperadoras de planos de saúdeServiços de saúde - CustosGarantia de qualidade dos cuidados de saúde