The conflict with health service providers that have agreements with ADSE, within the scope of the new price lists, was motivated by the increase in payments for births in the Algarve. This is what the ADSE president says, explaining that it was necessary to prevent people from going to “Spain to give birth”.
“ADSE was faced with stop having births in the Algarve” and, therefore, decided to increase the prices to be paid for these procedures to service providers in this region, with whom it has agreements.
And it was this situation that triggered the revolt of providers in the rest of the country, namely of the CUF and Luz Saúde groups, within the scope of the new price lists.
This explanation is given by the president of ADSE, Manuela Faria, in an interview with Dinheiro Vivo.
The new price lists for the agreements with ADSE were being prepared since 2017, but they only started to be applied on the first day of this month of September, despite the conflict with CUF and Luz Saúde which announced the exclusion of several medical acts from these agreements.
Manuela Faria notes that, on the basis of the displeasure of these groups, is an addendum to the agreement made between ADSE and the Hospital Particular do Algarve, setting higher payments for births.
“Even in the final straight, there was some discomfort by providers, which had never existed before”, highlights the president of ADSE in the interview.
“We verified that the deliveries had not been stirred since 2013, 2014, and we know that there have been increased costs related to personnel and a number of things”, points out the president of ADSE, stressing that it was concluded that “the deliveries should be changed”.
“Even because they have entered ADSE workers at much younger ages” and, therefore, more likely to become mothers, a scenario that was not set before “due to the age group of the beneficiaries”, she also points out.
ADSE feared that there would no longer be births in the Algarve
In the Algarve, there is “a particular situation of lack of doctors“, he also says, stressing that it is a “chronic” problem and that “the cost of medical assistance in hospitals in the Algarve is higher than in the rest of the country, or in some areas, precisely because doctors do not settle in the Algarve and go from Lisbon to the Algarve to practice medical procedures“.
“ADSE was faced with the situation of suddenly not having births in the Algarve at all. We could not accept that ADSE beneficiaries had to go to Spain having the births”, emphasizes Manuela Faria.
“In view of the presentation of costs that this provider in the Algarve made, and ADSE verifying that the costs were higher, it made an addendum to the convention of the Hospital Particular do Algarve in which increased the price of childbirth. It was exactly when this happened that the complaints of the other providers were raised”, reveals the president of ADSE.
Manuela Faria assures that ADSE “already had similar addenda” “with some providers”, but stresses that this situation, in the Algarve, was an “exceptional case”.
“Most of the addenda that ADSE has are the opposite: providers that undertake to carry out certain acts to more advantageous prices“, note.
Now, as a result of the revolt of providers, ADSE will carry out a global analysis and prices of deliveries will “touch the rest of the country”, as highlighted by Manuela Faria.
Criticism of the providers’ “aggressive campaign”
In the interview with Dinheiro Vivo, the president of ADSE also notes that, in the context of negotiations for the new tables, it was “surprised” because, “for exactly the same procedure, there were completely different contributions regarding prices”.
“A ADSE could have done the simplest: fix the price at the lowest suggestion. No. We wanted to understand. We made our calculations very seriously. We made averages and medians of everything we had invoiced, and conscientiously posted what we believe to be a fair price”, he also points out.
As for the complaints that arose from the providers, they are motivated by the fact that the ADSE tables not being “reviewed for many years”, considers Manuela Faria.
The ADSE president also leaves a “peck” to the providers of medical services, stressing that “it was a surprise to campaign a little aggressive, or assertiveness, mainly from the large providers, and the intention to disassociate some codes in which we found no reason to do so”. “Some had even undergone a substantial increase, and others had not been altered”, he assures.
In addition, Manuela Faria also criticizes the fact that providers have announced that they intend to apply the special price list that refers to the free regime.
“We started to see a very exhaustive campaign with ADSE beneficiaries to adhere to this table, with a visibility that had not existed until now and in great loss of beneficiaries“he concludes.