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Summary

In this video, Jamon Ferreira discusses the new financing model for primary healthcare teams in Brazil, effective from May 2025. He explains how population size determines the expected number of individuals each team should manage, with specific parameters for different team types (Saúde da Família and EAP). The video covers the financial implications of falling below these parameters, how the Ministry of Health evaluates and allocates funds, and the credentialing process for health teams. Ferreira also emphasizes the importance of understanding the rules to avoid financial losses and manage resources effectively in healthcare management.

Takeaways

• 😀 The new financing system, effective from May 2025, introduces a set of rules for evaluating services and distributing resources to primary health care.
• 😀 Unlike the previous Previne Brasil model, the new financing prioritizes the parameter (average expected population per team) over simply increasing the individual registration base.
• 😀 Parameters for teams, like Saúde da Família (SF) and equipes de atenção primária (EAP), are based on the population size of the municipality and vary according to different ranges of population (e.g., 20,000, 50,000, 100,000 inhabitants).
• 😀 In the case of SF teams, the expected parameter is a specific number of people per team depending on the municipality's population size, with a maximum 'teto' (ceiling) of 50% more than the parameter.
• 😀 For EAP teams, the parameters are smaller than for SF teams, considering they work with fewer hours and do not require community health agents as part of the minimum team composition.
• 😀 Municipalities with teams below the expected parameter may experience financial consequences, such as lower funding, as part of the new financing model.
• 😀 The Ministry of Health has not provided a detailed calculation method for the new financing system, leading to uncertainty in how it will specifically handle municipalities with teams below the expected population threshold.
• 😀 The Ministry of Health uses the total population of the municipality as a reference in determining funding distribution, and this reference is applied across teams that fall below the base registration target.
• 😀 Teams below the expected parameter can still receive funding during the transition period (until May 2025), but after that, those with insufficient registration or poor results may face reduced repasses and lower funding categories.
• 😀 The new financing model does not directly affect team accreditation, as it is separate from rules on service habilitation. Teams will lose accreditation only if they fail to submit production reports for extended periods or if they are removed from the system.

Q & A

What is the primary focus of the new financing model introduced in May 2025?

The new financing model focuses on evaluating primary health services and distributing resources based on specific parameters, not merely the quantity of registered individuals. The model introduces a new approach with parameters and limits for teams, impacting the credentialing of new teams and the continuation of existing ones.

What are the main differences between the previous financing model (Previne Brasil) and the new one?

Previne Brasil emphasized increasing the individual registration base, where more registrations equaled more funding. In contrast, the new financing model introduces parameters and limits, shifting the focus to maintaining quality over quantity in the registration base.

How does the new financing model determine the 'parameter' and 'ceiling' for each team?

The 'parameter' is a standard that represents the expected average number of people per team based on the population size of the municipality. The 'ceiling' is the maximum allowable number, set at 50% above the parameter. These are determined by the population brackets (up to 20,000, 20,000-50,000, 50,000-100,000, and over 100,000).

What is the significance of the population estimates used by the Ministry of Health in this new model?

The Ministry of Health now uses the IBGE population estimate from 2024 rather than the 2022 census to determine the expected population size for each municipality, which impacts the calculation of the parameters for health teams.

What does the term 'parameter' mean in the context of this financing model?

'Parameter' refers to a benchmark or expected standard for team performance, such as the ideal number of people a health team should serve based on the municipality's population size.

How does the parameter for a Family Health Team (ESF) differ from that of a 20-hour or 30-hour Primary Care Team (EAP)?

The parameter for an ESF is higher because it has a larger composition and a longer workweek (40 hours), allowing for a larger service area. In contrast, EAP teams have smaller parameters due to their reduced work hours and smaller team size.

How are municipalities with populations below the set parameters handled in the new financing model?

If a municipality has teams with fewer people registered than the parameter, the Ministry of Health may adjust the funding based on the population size divided by the number of active teams, but the exact methodology has not been fully clarified.

Can a health team lose its credentialing due to a reduced registration base?

No, teams cannot lose their credentialing solely based on a reduced registration base. Credentialing is linked to resource availability and whether teams meet the funding requirements. If a team is inactive or its production is not reported, only then could it lose its credentialing.

What role does budget availability play in the credentialing of new health teams?

Before granting a new team credentialing, the Ministry of Health checks if there is sufficient budget for continued funding. It evaluates whether it can finance the new team based on the availability of resources.

What happens if a team is below the expected parameter for registrations but still receives funding?

The Ministry of Health may continue to fund teams that are below the expected parameter, but there could be a reduction in funding or a shift in the team's classification depending on performance, especially after the transition period ends in May 2025.