Methodology for building institutional indicators for evaluating a federal regulatory agency for health plans and insurance

According to the report on Regulatory Reform of the Organization for Economic Cooperation and Development, Brazil faces the challenge of establishing a regulatory framework to accelerate its growth and improve quality of decisions of regulatory agencies. Since 2004, the Federal Regulatory Agency for Health Plans and Insurance (ANS) employs a qualification policy that includes an institutional qualification program, which proposal is to measure its performance in the following different competency dimensions of the supplementary assistance to health: regulation, ruling, surveillance and monitoring.
Aiming to strengthen the institutional assessment and transform it into a decision-making strategic tool, a project for the construction of indicators that would permit the monitoring and review of work processes has been developed. The methodology has lead to a wide adhesion of workers and the understanding of the work processes  (Tironi, 1991) given the principle of decentralization and motivation. The stages of the process were: 1) Identification of work units, 2) Selecting the sample through the Technique of Proportional Sampling (Mattar, 1996) that responded to a questionnaire on the main activities in their area of expertise, 3) Qualitative and quantitative analysis through the Technical of Content Analysis (Bardin, 1977), outlining the major processes at work in each unit; 4) Interviews in the areas as a complement of the construction of indicators and setting standards of quality; 6) definition and presentation the indicators to the decision making bodies of ANS to award the weights and internal dissemination.
The set of indicators formulated gives the program the prospect of identifying issues that demand in depth approach, so that the proposed solutions become consistent and appropriate to the institution, transforming the managerial action and improving the institutional performance. Furthermore, the decentralized nature of the construction, brings the opportunity for workers themselves to become responsible for the improvement of work processes.