Renegotiations and Disallowances by Health Board for Medical-Hospital Care and High-Cost Procedures from Brazilian Army Health System in 2021

Abstract

This article describes the worth of renegotiations and disallowances by the Health Board of the Brazilian Army for high-cost procedures in 2021 from all military regions. Its principal objective is to describe the economy resulting from the values renegotiated and/or disallowanced by the Board. The specific purposes are to describe the renegotiated and/or disallowanced values distinguished from each military region, to mention the primary medical specialties, and list the main reasons for renegotiations or disallowances, suggesting measures to outcome the Brazilian Army’s health audit services. It is a retrospective, descriptive, qualitative, and quantitative study. In the results, the 11th, 7th, and 2nd Regions stand out with the highest total values in the authorizations, renegotiations, and denials of 2021. Cardiointervention and Neurosurgery/Neurointervention were the areas with the most significant prominence in values, followed by Orthopedics, Oncology, Urology, and home care. We suggested measures to improve the performance of the Brazilian Army’s health audits teams, such as training and continuous education; elaboration and regular updating of the Standard Operating Procedures in audit processes; the exclusive dedication of audit team members, avoiding functional deviations; construction and updating of local market value indicators for orthoses, prostheses, and special materials; use and regular updating of the Brazilian Army’s assistance protocols; closer communication between the Board of Health, Military Regions and Military Health Organizations. This article explored the theme; however, further research must deepen and corroborate our study.