{"id":21187,"date":"2026-07-08T14:05:53","date_gmt":"2026-07-08T17:05:53","guid":{"rendered":"https:\/\/acrisure.com.br\/insights\/?p=21187"},"modified":"2026-07-08T17:26:46","modified_gmt":"2026-07-08T20:26:46","slug":"mapa-assistencial-ans-2025","status":"publish","type":"post","link":"https:\/\/acrisure.com.br\/insights\/mapa-assistencial-ans-2025\/","title":{"rendered":"Mapa Assistencial 2025: uso dos planos sobe e interna\u00e7\u00f5es concentram maior custo"},"content":{"rendered":"

[et_pb_section fb_built=”1″ admin_label=”Post” _builder_version=”4.19.4″ custom_padding=”0px||0px||false|false” global_colors_info=”{}”][et_pb_row admin_label=”Post” _builder_version=”4.19.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” width=”100%” custom_padding=”0px||0px||false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text admin_label=”Conte\u00fado” _builder_version=”4.27.6″ _module_preset=”default” text_letter_spacing=”1px” custom_margin=”||||false|false” global_colors_info=”{}”]<\/p>\n

A utiliza\u00e7\u00e3o dos planos de sa\u00fade continuou em alta no Brasil em 2025. \u00c9 o que mostra a edi\u00e7\u00e3o mais recente do<\/span>\u00a0<\/span>Mapa Assistencial da Sa\u00fade Suplementar<\/span><\/a>, da<\/span>\u00a0Ag\u00eancia Nacional de Sa\u00fade Suplementar (ANS), que registrou\u00a0<\/span>2 bilh\u00f5es de procedimentos<\/span><\/b>\u00a0realizados por benefici\u00e1rios no per\u00edodo.<\/span>\u00a0<\/span><\/p>\n

Na compara\u00e7\u00e3o com 2024, o volume total cresceu\u00a0<\/span>3,7%<\/span><\/b>, movimento que ajuda a dimensionar a press\u00e3o sobre a opera\u00e7\u00e3o das operadoras e, principalmente, sobre a gest\u00e3o de custos assistenciais.<\/span>\u00a0<\/span><\/p>\n

Mas os dados do Mapa tamb\u00e9m refor\u00e7am um ponto importante para as empresas:\u00a0<\/span>o impacto financeiro da sa\u00fade suplementar n\u00e3o depende apenas da quantidade de atendimentos, e sim do perfil de utiliza\u00e7\u00e3o e da participa\u00e7\u00e3o de eventos de maior complexidade nas despesas<\/span><\/b>.<\/span>\u00a0<\/span><\/p>\n

Mapa Assistencial 2025: quais foram os principais volumes de utiliza\u00e7\u00e3o<\/span>\u00a0<\/span><\/h2>\n

O levantamento da ANS re\u00fane indicadores de produ\u00e7\u00e3o assistencial da sa\u00fade suplementar e permite acompanhar a evolu\u00e7\u00e3o do uso de servi\u00e7os m\u00e9dico-hospitalares e odontol\u00f3gicos. Em 2025, os principais volumes registrados foram:<\/span>\u00a0<\/span><\/p>\n

    \n
  1. Exames ambulatoriais:<\/span><\/b>\u00a01,23 bilh\u00e3o de procedimentos;<\/span>\u00a0<\/span><\/li>\n
  2. Consultas m\u00e9dicas:<\/span><\/b>\u00a0288,7 milh\u00f5es de atendimentos;<\/span>\u00a0<\/span><\/li>\n
  3. Procedimentos odontol\u00f3gicos:<\/span><\/b>\u00a0193,8 milh\u00f5es;<\/span>\u00a0<\/span><\/li>\n
  4. Terapias ambulatoriais:<\/span><\/b>\u00a071,8 milh\u00f5es de procedimentos;<\/span>\u00a0<\/span><\/li>\n
  5. Interna\u00e7\u00f5es:<\/span><\/b>\u00a09,9 milh\u00f5es de registros.<\/span>\u00a0<\/span><\/li>\n<\/ol>\n

    Os\u00a0<\/span>exames ambulatoriais<\/span><\/b>\u00a0seguiram como o grupo mais representativo da sa\u00fade suplementar, respondendo por mais de\u00a0<\/span>60% do total de procedimentos realizados<\/span><\/b>. A m\u00e9dia chegou a\u00a0<\/span>23,5 exames por benefici\u00e1rio<\/span><\/b>, o maior patamar da s\u00e9rie hist\u00f3rica iniciada em 2019.<\/span>\u00a0<\/span><\/p>\n

    Na sequ\u00eancia aparecem as\u00a0<\/span>consultas m\u00e9dicas<\/span><\/b>, com 288,7 milh\u00f5es de atendimentos, e os\u00a0<\/span>procedimentos odontol\u00f3gicos<\/span><\/b>, que continuam entre os eventos de maior volume no setor.\u00a0<\/span>\u00a0<\/span><\/p>\n

    O comportamento desses grupos ajuda a mostrar que a\u00a0<\/span>utiliza\u00e7\u00e3o dos planos segue elevada, mas distribu\u00edda de forma desigual<\/span><\/b>\u00a0entre atendimentos de rotina, preven\u00e7\u00e3o, diagn\u00f3stico e eventos de maior complexidade.<\/span>\u00a0<\/span><\/p>\n

    Interna\u00e7\u00f5es seguem com o maior peso sobre as despesas assistenciais<\/span>\u00a0<\/span><\/h2>\n

    Embora representem apenas\u00a0<\/span>0,49% do total de procedimentos realizados<\/span><\/b>\u00a0em 2025, as\u00a0<\/span>interna\u00e7\u00f5es<\/span><\/b>\u00a0concentraram\u00a0<\/span>41,9% das despesas assistenciais<\/span><\/b>\u00a0da sa\u00fade suplementar.<\/span>\u00a0<\/span><\/p>\n

    O dado \u00e9 um dos mais relevantes do Mapa Assistencial porque mostra que a press\u00e3o sobre os custos n\u00e3o est\u00e1 necessariamente ligada ao volume absoluto de utiliza\u00e7\u00e3o. Em outras palavras,\u00a0<\/span>nem todo procedimento pesa da mesma forma sobre a despesa assistencial<\/span><\/b>. Eventos de maior complexidade, maior perman\u00eancia hospitalar e maior custo unit\u00e1rio – como as interna\u00e7\u00f5es – tendem a concentrar uma parcela muito mais significativa do gasto total.<\/span>\u00a0<\/span><\/p>\n

    Al\u00e9m disso, as interna\u00e7\u00f5es registraram\u00a0<\/span>crescimento de 8,9% em rela\u00e7\u00e3o a 2024<\/span><\/b>, o maior avan\u00e7o proporcional entre os principais grupos monitorados pela ANS.\u00a0<\/span>\u00a0<\/span><\/p>\n

    Para empresas que oferecem plano de sa\u00fade aos funcion\u00e1rios, esse movimento merece aten\u00e7\u00e3o porque pode sinalizar maior uso de atendimentos hospitalares e procedimentos de alto custo, com\u00a0<\/span>impacto direto sobre a\u00a0<\/span><\/b>sinistralidade<\/span><\/b><\/a>\u00a0e os reajustes futuros.<\/span><\/b>\u00a0<\/span><\/p>\n

    Crescem os atendimentos de maior complexidade<\/span>\u00a0<\/span><\/h3>\n

    Os dados do Mapa Assistencial tamb\u00e9m indicam avan\u00e7o de procedimentos associados a quadros de maior complexidade cl\u00ednica. As\u00a0<\/span>interna\u00e7\u00f5es por neoplasias<\/span><\/b>\u00a0cresceram\u00a0<\/span>15,7%<\/span><\/b>\u00a0em 2025, com destaque para casos relacionados a\u00a0<\/span>c\u00e2ncer de pr\u00f3stata, mama e colo do \u00fatero<\/span><\/b>.<\/span>\u00a0<\/span><\/p>\n

    As\u00a0<\/span>interna\u00e7\u00f5es cir\u00fargicas<\/span><\/b>\u00a0tamb\u00e9m aumentaram, com alta de\u00a0<\/span>11,8%<\/span><\/b>\u00a0em rela\u00e7\u00e3o ao ano anterior, impulsionadas principalmente por procedimentos ligados a\u00a0<\/span>doen\u00e7as cardiovasculares<\/span><\/b>.<\/span>\u00a0<\/span><\/p>\n

    Esse comportamento sugere uma\u00a0<\/span>combina\u00e7\u00e3o de fatores que costuma pressionar os custos assistenciais<\/span><\/b>: envelhecimento da popula\u00e7\u00e3o benefici\u00e1ria, maior utiliza\u00e7\u00e3o de terapias e procedimentos de alta complexidade e continuidade do tratamento de doen\u00e7as cr\u00f4nicas e oncol\u00f3gicas.\u00a0<\/span>\u00a0<\/span><\/p>\n

    Embora o Mapa Assistencial n\u00e3o esgote as causas por tr\u00e1s desse movimento, ele oferece um sinal importante sobre o perfil da demanda que vem sendo absorvida pelos planos de sa\u00fade.<\/span>\u00a0<\/span><\/p>\n

    Leia tamb\u00e9m:<\/span><\/b>\u00a0<\/span>O pre\u00e7o invis\u00edvel das Doen\u00e7as Cr\u00f4nicas<\/span><\/a>\u00a0<\/span><\/p>\n

    Mudan\u00e7as no perfil de utiliza\u00e7\u00e3o ambulatorial tamb\u00e9m entram no radar<\/span>\u00a0<\/span><\/h3>\n

    Al\u00e9m do crescimento das interna\u00e7\u00f5es e dos atendimentos de maior complexidade, o Mapa Assistencial mostra mudan\u00e7as no perfil de utiliza\u00e7\u00e3o ambulatorial. As\u00a0<\/span>consultas em cl\u00ednica m\u00e9dica recuaram 20,4%<\/span><\/b>\u00a0em rela\u00e7\u00e3o a 2024, embora a especialidade tenha permanecido como a mais procurada entre os benefici\u00e1rios de planos de sa\u00fade.<\/span>\u00a0<\/span><\/p>\n

    Esse tipo de varia\u00e7\u00e3o n\u00e3o deve ser lido de forma isolada, mas como parte de um conjunto maior de transforma\u00e7\u00f5es na jornada assistencial.\u00a0<\/span><\/b>\u00a0<\/span><\/p>\n

    Mudan\u00e7as no acesso a especialidades, no perfil et\u00e1rio dos benefici\u00e1rios, na demanda por acompanhamento cont\u00ednuo e no uso de servi\u00e7os diagn\u00f3sticos e terap\u00eauticos podem alterar a distribui\u00e7\u00e3o dos atendimentos sem necessariamente reduzir a press\u00e3o sobre os custos.<\/span>\u00a0<\/span><\/b>\u00a0<\/span><\/p>\n

    O que os dados da ANS indicam para a gest\u00e3o de benef\u00edcios<\/span>\u00a0<\/span><\/h2>\n

    O Mapa Assistencial ajuda a entender\u00a0<\/span>quais tipos de atendimento est\u00e3o puxando a despesa da sa\u00fade suplementar<\/span><\/b>\u00a0e quais tend\u00eancias merecem aten\u00e7\u00e3o na gest\u00e3o do benef\u00edcio.<\/span>\u00a0<\/span><\/p>\n

    Para as empresas, a leitura dos dados refor\u00e7a alguns pontos importantes:<\/span>\u00a0<\/span><\/p>\n

      \n
    • volume n\u00e3o \u00e9 sin\u00f4nimo de custo<\/span><\/b>: exames, consultas e procedimentos odontol\u00f3gicos concentram grande parte dos atendimentos, mas n\u00e3o necessariamente representam o principal foco de press\u00e3o financeira;<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
        \n
      • interna\u00e7\u00f5es e eventos de maior complexidade t\u00eam peso desproporcional nas despesas<\/span><\/b>, o que exige aten\u00e7\u00e3o ao perfil de uso e n\u00e3o apenas ao n\u00famero total de procedimentos;<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
          \n
        • o avan\u00e7o de interna\u00e7\u00f5es por neoplasias e procedimentos cir\u00fargicos<\/span><\/b>\u00a0pode indicar maior demanda por cuidado especializado, coordena\u00e7\u00e3o assistencial e acompanhamento de condi\u00e7\u00f5es cr\u00f4nicas;<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
            \n
          • analisar a utiliza\u00e7\u00e3o de forma segmentada<\/span><\/b>\u00a0ajuda a qualificar decis\u00f5es sobre desenho do benef\u00edcio, programas de preven\u00e7\u00e3o, gest\u00e3o de sa\u00fade populacional e estrat\u00e9gias de negocia\u00e7\u00e3o com operadoras.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n

            Na pr\u00e1tica, o Mapa Assistencial refor\u00e7a que a gest\u00e3o de benef\u00edcios em sa\u00fade precisa ir al\u00e9m do acompanhamento da sinistralidade consolidada. Entender\u00a0<\/span>onde est\u00e3o os principais vetores de custo, quais eventos concentram maior complexidade e como o perfil de utiliza\u00e7\u00e3o est\u00e1 mudando ao longo do tempo<\/span><\/b>\u00a0\u00e9 parte central de uma estrat\u00e9gia mais sustent\u00e1vel para o benef\u00edcio sa\u00fade.<\/span><\/p>\n

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            Mapa Assistencial 2025 da ANS registra 2 bilh\u00f5es de procedimentos e mostra que interna\u00e7\u00f5es seguem entre os principais custos dos planos de sa\u00fade.<\/p>\n","protected":false},"author":1,"featured_media":21205,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[23],"tags":[9],"class_list":["post-21187","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gestao-da-saude","tag-rh"],"yoast_head":"\nMapa Assistencial 2025: crescem uso dos planos e interna\u00e7\u00f5es<\/title>\n<meta name=\"description\" content=\"Mapa Assistencial registra 2 bilh\u00f5es de procedimentos e mostra que interna\u00e7\u00f5es seguem entre os principais custos dos planos de sa\u00fade.\" \/>\n<meta name=\"robots\" content=\"index, follow, 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