Mobilidade do consumidor entre os contratos de plano de saúde: análise para uma operadora de saúde da região sudeste do Brasil

Abstract

This dissertation analyzes consumer mobility between individual health plan contracts. Two empirical exercises are presented using data from a health care provider in the Southeast region of Brazil from 2010 to 2018. The first article analyzes the probability of leaving the portfolio or changing the health plan, especially at moments of the life cycle such as entering the labor market and retiring. More specifically, exits and switches from broader contracts to less broad contracts and vice versa are explored, controlling for individual characteristics, plan characteristics, and health status. The main results show that, compared to adults aged 25 to 59 years, the elderly are less likely to change plans or leave the health care provider, with a relative risk ratio of exit up to 39% lower among those aged 60 to 69 years. The second article verifies if the price adjustment due to the change in the age group determined by the National Agency for Supplementary Health (ANS) increases the chances of canceling the contract with the health care provider or switching to a cheaper plan. The intention is to measure the causal effect of the price adjustment on the decision of the beneficiary to maintain the health plan using the Regression Discontinuity (RD) method. Beneficiaries who had the price adjustment are compared with those who had no changes in the premium value and are close in ages, as they have similar characteristics as they are in the same stage of the life cycle. The main results indicate that changing the age group increases the chances of the beneficiary leaving the health care provider when they complete 19, 54, and 59 years old.