DETERMINANTS OF PERFORMANCE OF HEALTH INSURANCE OPERATORS IN BRAZIL AND THEIR RELASHIONSHIP WITH EARNINGS QUALITY
DOI:
https://doi.org/10.4270/ruc.2021425Keywords:
Earnings quality, Supplementary health, Health insurance, Economic-financial performanceAbstract
This paper aimed to evaluate the earnings quality (EQ) and analyze the relationship between EQ and its determinants of economic and financial performance of the health plan operators in Brazil. Private health plan operators’ financial data from 2008 to 2017 was analyzed, with the specialties of the operators being modalities, sizes (number of beneficiaries), and coverage. For each EQ analysis, we calculated four individual measures (accruals quality, persistence, predictability, and smoothing), which we used for the composition of the EQ ranking, defined as a dependent variable of the research models. We defined the independent variables as indicators of the economic-financial performance of the operators, and we selected the final set of independent variables by the Stepwise regression method. The results show that segregating the analysis of the operators by modalities and size is more important and, in this sense, determinant to explain the earnings quality, which we did not verify with the coverage segregation. Through the ranking analysis, it was possible to identify that the operators with the highest quality belong to the modalities of group medicine and specialized health insurance; to medium size and medical-hospital coverage. The operators with the lowest quality belong to the self-management modality and the non-beneficiary category. The models analyzed are significant in explaining the quality. For economic-financial performance, the models that most influence the quality are small and medium sizes, self-management and medical cooperative modalities, and medical-hospital coverage. The results show that the explanatory variables of the economic and financial performance that determine the EQ are indebtedness (END), debt composition (CE), selling expenses (DC), and fixed assets (IMOB). The final models allowed the conclusion that QIC is positively influenced by the economic-financial performance of the operators by the determinant variables END, CE, and DC.
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