A precificação do risco e a viabilidade econômico-financeira aplicada em um instituto privado de assistência à saúde

Abstract

This dissertation aimed at presenting a study on the managerial and actuarial system adopted at a private institute for healthcare. The study proceeded from a survey on customers, segregation by age group, measurement of beneficiaries’ contribution, and the relation with the risk to which each age group is exposed, as well as identifying the existence of and the means for provision to covering such expenses, taking into account that the cost of risk is a fundamental factor for stipulating the value of monthly payments. From that point on, study scenarios were posited in order to analyse the proportion at which monthly payments would vary so as to bear a higher risk. Document analysis and data collection have been used as methodologies. Data collected were later selected and, then, calculations were performed on an electronic spreadsheet. In having organised the data and in possession of results, analysis and interpretation then followed, reaching the conclusion that, albeit there is no provisioning to risk, the institution has an appropriate managerial planning since it is able to bear costs, inherent to service delivered, from the contribution of monthly payments, thus guaranteeing a satisfactory profit margin.