Perfomance Evaluation

Private Health Insurance and Plans Performance Evaluation Policy

Set of principles and guidelines which promotes a new perspective on regulation of private healthcare with emphasis on the qualification of all stakeholders - insurers, health service providers, beneficiaries and the regulator itself - in order to improve the functioning of this sector.

The proposal is to practice an inducer regulation, based on the strengthening of new management practices and changes in the healthcare model. This regulation´s goal is to build an industry whose main interest is the production of health, with actions on health promotion and disease prevention based in the principles of quality, completeness and resolution.


Private Health Insurance and Plans Performance Evaluation Program

The private health insurers are assessed through a Supplementary Healthcare Performance Index (IDSS), which is calculated through indicators defined by ANS. These indicators are clustered into four dimensions: Healthcare, Economic & Financial Aspects, Structure & Operations, and Beneficiary Satisfaction. Once the assessment is completed, the private health insurers is assigned a score in rating brackets indicating their performances. Only insurers with active ANS licences are rated.


Private Health Insurance and Plans Performance Evaluation Program

Program established by the ANS for private health insurers to disclose in all their communications attributes of healthcare providers on their networks, including programs, certificates and work process or institutional affiliations associated with recognized quality improvement in healthcare.

The main goal of the program is to increase the users´ ability to evaluate and therefore choose both a health insurance or plan according to the network of healthcare providers offered, and specific healthcare providers on a network.


Quality information program of private insurance healthcare providers

Program established by the ANS for private health insurers to disclose in all their communications attributes of healthcare providers on their networks, including programs, certificates and work process or institutional affiliations associated with recognized quality improvement in healthcare.

The main goal of the program is to increase the users´ ability to evaluate and therefore choose both a health insurance or plan according to the network of healthcare providers offered, and specific healthcare providers on a network.


Quality monitoring program of private sector healthcare providers (QUALISS)

Program established by the ANS to monitor the quality of service providers in the health insurance and plans sector and to spread this information to society, especially to beneficiaries. Since the quality of care can not be measured directly, several indicators are used to characterize it and meet the requirement of transparency and information needs of users of the health system.


Complaints Rate

ANS discloses a ranking of health plan companies with most complaints from consumers.


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ANS - Agência Nacional de Saúde Suplementar - Av. Augusto Severo, 84 - Glória Rio de Janeiro/RJ - Brasil - CEP: 20021-040