Regularly conducting performance evaluations of institutions is of utmost importance to ensure the quality of services provided. In the healthcare sector, the indicator that measures the performance of operators is the IDSS – Supplemental Health Performance Index, which is part of the Operator Qualification Program established by the ANS - National Health Agency, through RN 139/2006. It is an index of Operator Evaluation, comprising 29 indicators divided into 4 dimensions:
• Quality Dimension in Healthcare – IDQS – Assesses the provision of healthcare services to beneficiaries, emphasizing preventive actions.
• Access Guarantee Dimension - IDGA Assesses the accessibility of the provider's care network.
• Sustainability Dimension in the Market – IDSM – Assesses economic and financial balance and aspects related to beneficiary satisfaction.
• Process Management and Regulation Dimension – IDGR – Assesses compliance with regulatory requirements and adherence to ANS standards.
The indicators are calculated based on data sent by the operators to the ANS. This data is sent through strict protocols, in established formats and frequencies (SIB, SIP, RPS, SCPA, and DIOPS).
Annually, the ANS publishes the consolidated index for each health insurance provider on its portal, the IDSS, along with the indices for each of the evaluated dimensions.
The importance of IDSS for health plans
ANS does not foresee any direct regulatory consequences for operators that do not perform adequately in terms of their IDSS.
However, the adoption by the operators of concrete policies and actions aimed at the continuous improvement of their indicators seems extremely appropriate to us. In our opinion, the IDSS provides operators with quality benchmarks that, if perceived as goals to be pursued, should inspire and promote management practices that will undoubtedly improve overall business results.
Another relevant aspect of the IDSS is related to how the operators themselves have used their classification in the program in their market actions. Obviously, those that have succeeded in making efforts to obtain a classification in the ranking of operators indicating superior quality of services provided to consumers are ahead of the competition.
Increasingly, health insurance providers are using their IDSS classification as a sales pitch and for institutional advertising, and increasingly, consumers and the media are recognizing the importance of the IDSS as a way to distinguish health insurance providers that offer quality services from those that do not.
How is the IDSS calculated
Each indicator that makes up the 4 dimensions of the IDSS has weights ranging from 1 to 3, in addition to bonus indicators that can contribute a loading of up to 15% on the dimension's index. A deeper analysis indicates the total impact of each indicator on the IDSS, which we call Relative Weights:
Another analysis classifies the actions that impact each indicator based on the relative weights of each one to which it is related. We conclude that 31% of the IDSS can be impacted by low or medium-cost actions, always depending on the cost structure of the provider in question.
IDSS Management
MBO Business Consulting has developed a management process aimed at improving the IDSS (Integrated Healthcare Performance Index) of Health Insurance Operators, based on the PDCA management model. To have greater control and systematize the monitoring of goals and indicators, the company relies on the technology developed by Stratec.
To learn more, contact us!
This article was developed by Agnus Oliveira, a partner at MBO Consult.
