Sticky costs and regulation in private healthcare providers

Authors

DOI:

https://doi.org/10.11606/issn.1982-6486.rco.2021.169260

Keywords:

Sticky cost, National Supplementary Health Agency regulation, Private healthcare providers

Abstract

This study aims to analyze the effects of the Brazilian National Supplementary Health Agency’s (NSHA) regulation on sticky costs of private healthcare providers (PHP). The research used financial and operational data from the NSHA analyzed through panel data regression and focused on PHP classified as medical cooperatives and group medicine between 2010 and 2018. The models developed employed different cost proxies (dependent variable) and explanatory variables. We verified that two cost proxies presented significant relations in all models: selling, general, and administrative expenses, and total cost. Concerning regulation variables, one was significant in the two studied modalities: PHP dependency ratio. This paper presents many contributions to different PHP’ stakeholders, such as NSHA, their managers, and Brazilian society. Among the main findings are (a) the importance of analyzing the organizations’ legal nature when examining sticky costs; (b) the proposal of different regulation variables to understand this phenomenon while displaying its importance in regulated industries; and (c) the relevance of employing different proxies when measuring sticky cost. 

Downloads

Download data is not yet available.

References

Ação Direta de Inconstitucionalidade – 1931. (2003). Retrieved from http://portal.stf.jus.br/processos/detalhe.asp?incidente=1741189.

Agência Nacional de Saúde Suplementar – ANS. (2016) Dados e Indicadores do Setor. Retrieved from http://www.ans.gov.br/perfil-do-setor/dados-e-indicadores-do-setor.

Agência Nacional de Saúde Suplementar – ANS. Sala de Situação. 2020. Retrieved from http://www.ans.gov.br/perfil-do-setor/dados-e-indicadores-do-setor/sala-de-situacao.

Anderson, M. C.; Banker, R. D.; & Janakiraman, S. N. (2003). Are Selling, General, and Administrative Costs “Sticky”? Journal of Accounting Research, 41(1), 47-63. DOI: https://doi.org/1475-679X.00095

Avelar, E. A., Boina, T. M., Jordão, R. V. D., Santos, W. C., & Ferreira, C. O. (2019a). Análise dos Efeitos da Regulação da Agência Nacional de Saúde Suplementar (ANS) Sobre o Fenômeno dos Custos Assimétricos (Sticky Costs) em Cooperativas Médicas (Unimeds) brasileiras. Anais do Congresso Nacional de Administração e Contabilidade (Proceedings of the National Conference of Administration and Accounting), Rio de Janeiro, RJ, Brazil, 10 – Retrieved from: http://adcont.net/index.php/adcont/adcont2019/paper/viewFile/3537/1029

Avelar, E. A., Souza, A. A. Amaral, H. F., & Reyes, S. T.(2019b). Endividamento de operadoras de planos de saúde da modalidade autogestão e regulação da saúde suplementar. REAd. Revista Eletrônica de Administração, 25(3), 124-152. DOI: https://doi.org/10.1590/1413-2311.271.96907

Cook, D. O., Kieschnick, R., & Moussawi, R. (2019). Operating leases, Operating leverage, Operational Inflexibility and Sticky Costs. Finance Research Letters, 31, 369-373. DOI: https://doi.org/10.1016/j.frl.2018.12.012

Fávero, L. P. (2015). Análise de Dados: Modelos de Regressão com Excel®, Stata® e SPSS®. Rio de Janeiro: Elsevier.

Fourati, Y. M., Chakroun Ghorbel, R., & Jarboui, A. (2020). Sticky cost behavior and its implication on accounting conservatism: a cross-country study. Journal of Financial Reporting and Accounting. 18(1), 169-197. DOI: https://doi.org/10.1108/jfra-08-2018-0071

Gelbcke, E. R.; Santos, A.; Iudícibus, S. & Martins, E.(2018). Manual de contabilidade societária: aplicável a todas as sociedades de acordo com as normas internacionais e do CPC. (3a ed.). São Paulo: Atlas.

Grejo, L. M.; Abbas, K.; Camacho, R. R. & Junqueira, E.(2019). A influência do ativo imobilizado no comportamento assimétrico dos custos. Revista Contemporânea de Contabilidade, 16(38), 35-56. DOI: https://doi.org/10.5007/2175-8069.2019v16n38p35

Guimarães, A. L. de S., & Nossa, V. (2010). Working capital, profitability, liquidity and solvency of healthcare insurance companies. Brazilian Business Review, 7(2), 37-59. DOI: https://doi.org/10.15728/bbr.2010.7.2.3

Gujarati, D. & Porter, D. C.(2011). Econometria básica (5a. ed.) Porto Alegre: AMGH.

Hartlieb, S., Loy, T. R., & Eierle, B. (2019). Does community social capital affect asymmetric cost behaviour? Management Accounting Research. DOI: https://doi.org/10.1016/j.mar.2019.02.002

He, J., Tian, X., Yang, H., & Zuo, L. (2020). Asymmetric Cost Behavior and Dividend Policy. Journal of Accounting Research, 58(4) 989-1021. DOI: https://doi.org/10.1111/1475-679x.12328

Holzhacker, M., Krishnan, R., & Mahlendorf, M. D.(2015). The Impact of Changes in Regulation on Cost Behavior. Contemporary Accounting Research, 32(2), 534–566. DOI: https://doi.org/10.1111/1911-3846.12082

Kudlawicz, C.; Steiner, P. J., Neto, & Frega, J. R. (2015). Homogeneidade e rentabilidade: o caso das operadoras de planos de saúde. Revista de Informação Contábil, 9(1), 50-67.

Lei n. 9656, de 3 de junho de 1998 (Brazilian Law 9656, June 3, 1998). Provides on private health insurance plans. Retrieved from http://www.planalto.gov.br/ccivil_03/Leis/L9656.htm.

Lei n. 9.961, de 28 de janeiro de 2000 (Brazilian Law 9961, January 28, 2000). Establishes the National Agency of Supplementary Health (ANS). Retrieved from http://www.planalto.gov.br/ccivil_03/leis/l9961.htm.

Lei n. 12.527, de 18 de novembro de 2011 (Brazilian Law 12527, November 18, 2011). Regulates the access to information provided on item XXXIII of art 5; item II of paragraph 3 of art 37; and paragraph 2 of art 216 of the Federal Constitution. Modifies Law 8112, December 11, 1990. Repeals Law 11111, May 5, 2005; and provisions of Law 8159, January 8, 1991. Retrieved from http://www.planalto.gov.br/ccivil_03/_ato2011-2014/2011/lei/l12527.htm.

Li, Z., Ying, Q., Chen, Y., & Zhang, X. (2020). Managerial risk appetite and asymmetry cost behavior: evidence from China. Accounting & Finance. DOI: https://doi.org/10.1111/acfi.12692

Malik, M. (2012). A Review and Synthesis of ‘Cost Stickiness’ Literature. SSRN. DOI: https://doi.org/10.2139/ssrn.2276760.

Porporato, M., & Werbin, E.(2012). Evidence of sticky costs in banks of Argentina, Brazil and Canada. International Journal of Financial Services Management, 5(4), 303. DOI: https://doi.org/10.1504/ijfsm.2012.048834

Reis, L. S. & Borgert, A. (2019). Análise conjunta de fatores explicativos para o comportamento assimétrico dos custos. Revista Contemporânea de Contabilidade, 16(40), 91-109. DOI: https://doi.org/10.5007/2175-8069.2019v16n40p91

Resolução de Diretoria Colegiada n. 29, de 26 de junho 2000 - ANS (Resolution 29 of ANS Board of Directors, June 26, 2000). Establishes norms to adjust pecuniary benefits of private supplementary health insurance plans and products. Retrieved from http://www.ans.gov.br/component/legislacao/?view=legislacao&task=TextoLei&format=raw&id=Mzg1.

Resolução de Diretoria Colegiada n. 39, de 27 de outubro de 2000 - ANS (Resolution 39 of ANS Board of Directors, October 27, 2000). Provides on the definition, segmentation, and classification of health insurance plan operators. Retrieved from http://www.ans.gov.br/component/legislacao/?view=legislacao&task=TextoLei&format=raw&id=Mzgw.

Resolução Normativa n. 63 de, 22 de dezembro de 2003 – ANS (Resolution 63 of ANS Board of Directors, December 22, 2003). Establishes limits to adopt variation of prices according to age in private health insurance plans contracted after January 1, 2004. Retrieved from http://www.ans.gov.br/component/legislacao/?view=legislacao&task=TextoLei&format=raw&id=NzQ4.

Richartz, F. & Borgert, A. (2016). Fatores explicativos para o comportamento assimétrico dos custos das empresas listadas na BM&FBOVESPA. Anais do Congresso Brasileiro de Contabilidade (Proceedings of the Brazilian Conference of Accounting), Porto de Galinhas, PE, Brazil, 23.

Shust, E., & Weiss, D. (2014). Discussion of asymmetric cost behavior—Sticky costs: Expenses versus cash flows. Journal of Management Accounting Research, 26(2), 81-90. DOI: https://doi.org/ 10.2308/jmar-10406

Stimolo, M. I., & Porporato, M. (2019). How different cost behaviour is in emerging economies? Evidence from Argentina. Journal of Accounting in Emerging Economies. 10(1), 21-47. DOI: https://doi.org/10.1108/JAEE-05-2018-0050

Subramaniam, C. & M. L. Weidenmier (2003). Additional evidence on the sticky behavior of costs. Social Science Research Network, Retrieved from http://ssrn.com/abstract=369941

Varella, D. & Ceschin, M. (2014). A saúde dos planos de saúde: os desafios da assistência privada no Brasil. São Paulo: Paralela.

Venieris, G.; Naoum, V. C. & Vlismas, O. (2015), Organisation capital and sticky behaviour of selling, general and administrative expenses. Management Accounting Research, 26, 54–82. DOI: https://doi.org/10.1016/j.mar.2014.10.003

Zhang, J., Yin, M., Han, J., & Aroskar, R. (2019). Why is asset-light strategy necessary? An empirical analysis through the lens of cost stickiness. Tourism Management Perspectives, 32, 100571. DOI: https://doi.org/10.1016/j.tmp.2019.100571

Zonatto, V. C. S., Magro, C. B. D., Sant’ana, C. F. & Padilha, D. F. (2018). Effects of economic growth in the behavior of sticky costs of companies belonging to BRICS countries. Contaduría y Administración, 63(4), p. 1-25. DOI: https://doi.org/10.22201/fca.24488410e.2018.1110.

Published

2021-04-30

Issue

Section

Paper

How to Cite

Avelar, E. A., Santos, W. C. dos, Souza, A. A. de, & Cailleau, R. (2021). Sticky costs and regulation in private healthcare providers. Revista De Contabilidade E Organizações, 15, e169260. https://doi.org/10.11606/issn.1982-6486.rco.2021.169260