Managed care and innovation in healthcare management: a Brazilian experience

Abstract

ABSTRACT This work analyses how Brazilian health insurance operators and hospitals apply Managed Care (MC) and innovation-related criteria upon managing healthcare operations. Four health plan operators and two internationally accredited hospitals in Southern Brazil were analysed. Semi-structured interviews were performed with managers appointed by the selected organisations. A framework based on MC and innovation management criteria was used as a reference for data collection. The surveyed hospitals have shown to be more compliant with the MC criteria whereas the surveyed health plan operators are less compliant to these criteria. The highest compliance rate for both types of organisations was on the management of medical services criterion. No evidence was found about adoption of the selected concepts of innovation in healthcare management. MC and Innovation criteria may produce an integrated focus on the client (patient), considering a systemic view of the value chain and of innovation in healthcare management as ways of increasing the quality of services provided while reducing costs. Managers would have benefited from taking this approach.