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This study examines whether Brazilian health insurance companies (HICs) engage in earnings management through discretionary accruals or operational decisions by refraining from reporting a low indicator of sustainability in the market (IDSM).

The study used the Jones and Modified Jones models to identify earnings management through discretionary accruals and used the model described by Roychowdhury to estimate the abnormal behaviors of operational decisions. Data covering 2012 to 2018 were collected from the ANS website.

The results show that HICs engaged in earnings management to avoid reporting a low IDSM. The findings should help health insurance clients make decisions regarding the purchase or change of health insurance. The findings should also encourage regulators to improve their evaluation of the economic and financial risks around HICs.

The National Agency of Supplementary Health (ANS) established a qualification program for HICs, monitoring them based on a set of indicators. Managers may have an incentive to use earnings management to obtain indices that meet the requirements of the ANS qualification program in order to avoid showing signs of abnormality.

本研究旨在探討巴西的醫療保險公司，透過避免報導低的市場可持續性指標，是以裁決性應計，抑或是以操作決策來進行盈餘管理。

國立輔助醫療辦事處 (註：此為直譯)(The National Agency of Supplementary Health)為醫療保險公司建立了一個資格檢定機制，基於一套指標來監管這些公司。公司主管或會有鼓勵性的誘因去使用盈餘管理來取得符合國立輔助醫療辦事處資格檢定機制所要求的指標，從而避免顯示異常的跡象。

本研究使用Jones 模型及Modified Jones模型，透過裁決性應計來辨認盈餘管理，研究亦使用羅伊喬杜里 (Roychowdhury) 描述的模型， 來估計操作決策的異常行為。數據取自國立輔助醫療辦事處的網址，並涵蓋2012年至2018年期間。

研究結果顯示，醫療保險公司進行盈餘管理，以求避免報導低的市場可持續性指標。研究結果應可幫助醫療保險客戶在購買或更改醫療保險時作適當的決定。研究結果亦可鼓勵監管者改善他們對醫療保險公司的經濟及財務風險所作的評估。