By Carlos Moura*
In the supplementary health segment in Brazil, in the last 20 years, due to the difficulty for managers to understand the risks and impacts of commercial negotiations with health operators, they have taken advantage of this scenario. In addition to not replacing inflation in procedure values, they manage to reduce values with negotiation techniques.
Many Radiology and Diagnostic Imaging services do not have dedicated people, with an adequate profile and qualified to effectively conduct commercial negotiations with health operators. Historically, clinics have focused on negotiations, mainly the CH value (AMBs) or UCO and Porte value (CBHPMs), but there are 20 more negotiation points that need to be observed in each negotiation, which can have great financial impacts, many of which times greater than the readjustment value itself!
We always hear about the fear of providers of a possible disqualification if a readjustment is requested or even the claim that it is not worth asking for a readjustment, due to the few results that could be achieved, by the strength of the health operators in the negotiations! Both statements are not true. I've been negotiating with health operators throughout Brazil for over 15 years in this segment and I've never received retaliation for negotiating with health operators! The main issue is how to approach and conduct the negotiation.
First, we need to understand that negotiations can take months. Resilience is vital to achieving goals, but we also need good rhetoric. Our negotiator needs to be well-prepared, have all the information about what is being negotiated and know how to use the most appropriate approach for each situation. Remember that we do not negotiate with health insurance companies just once a year, but the whole year, because there are several points of negotiation in addition to the annual readjustment according to Law 13.003/14.
In the segment of radiology and diagnostic imaging, small changes in values in high-turnover exams, even in small clinics, can generate a great gain or a great annual financial loss! For example, a variation in the Digital Mammography exam of R$ 10.00 can mean, at the end of the year, an impact of R$ 10,000.00 in net profit! A change in negotiation of the reference value of Materials and Medicines from Brasindice PF (factory price) to Brasindice PMC (Maximum Price to the Consumer) for generating an annual variation of R$ 250,000.00 in net profit!
Our focus should no longer be just the volume of exams, because the volume of exams with an exam value below cost only brings harm to the clinic! If the fixed cost is high and the value of the exam is below the cost, however much the clinic does volume, the result will continue to be a loss! We need to be very attentive and trained in the clinics' negotiations, because once the negotiation is accepted, it is difficult to reverse it!
Understanding this strategic importance, the Brazilian Association of Diagnostic Imaging Clinics (ABCDI) brings a module of its Clinic Management course focused only on commercial negotiation with everything we need to know to improve the outcome of these negotiations. The module will take place on August 4th and 5th, at the headquarters of ABCDI, in São Paulo (SP).
* Carlos Moura is an economic advisor at CBR, a business administrator with an MBA in IT from USP, with an International Course on Human Talent Development from the University of Central Florida. Professor of the Clinical Management course at ABCDI
Read too: ABCDI Clinic Management Course has a record of enrollments focusing on specific issues in the sector