The debt of hospitals and clinics with a cut to June 2025 reached $ 24 billion According to the most recent portfolio study prepared by the Colombian Association of Hospitals and Clinics (ACHC).
The figure means an increase of $ 3.7 billion compared to $ 20.3 billion reported to December 2024, which represents a variation of 18.4% in the absolute amount of the portfolio in just six months.
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The study also evidenced an increase in the portfolio in default and its concentration. While in December 2024 the default was 55.3%, in the most recent cut it reached 56.0%. This is equivalent to an increase greater than $ 2.2 billion in the portfolio in default between the two periods.
When disaggregated by regimes, The EPS of the contributory regime concentrate 50.5% of the total debt, that is, more than $ 12.1 billion. They are followed by the EPS of the subsidized regime, which represent 26.3% of the total with more than $ 6.3 billion.
The debtors grouped in the State category concentrate 7.9% of the debt, about $ 1.9 billion, including territorial entities, the administrator of the resources of the General Social Security System in Health (ADRES) and the extinct Solidarity and Guarantee Fund (FOSYGA). Insurers, including the mandatory traffic accident insurance branch (SOAT), They total 2.7% of the total, while companies of complementary plans and prepaid medicine represent 1.9% and 0.5% Occupational Risk Insurers.
The ACHC analysis details that More than 90% of the debt reported in the contributory regime corresponds to 12 EPS in operation, with a value exceeding $ 10.9 billion. In contrast, about $ 1.2 billion, equivalent to 9.7% of the total debt, belong to 17 EPS that were liquidated or requested voluntary withdrawal.
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In just six months, the wallet increased by 3.7 billion pesos, an increase of 18.4%.
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Among the three main debtors of this regime are new EPS, Sanitas and Famisanar, which together owe about $ 7.8 billion, which is equivalent to 71.3% of the total debt of the EPS of the contributory regime in operation. The portfolio in default of these three entities amounts to $ 4.4 billion, representing 77.2% of the total default of the active EPS in this regime.
In the subsidized regime, The total debt of $ 6.3 billion is concentrated in 81.1% in 17 active EPS, while 18.9%, about $ 1.2 billion, corresponds to 32 entities liquidated or fused. The three main debtor in this regime are new EPS, Savia Salud and Emsasar, with a joint portfolio of more than $ 2.8 billion, representing 45.2% of the total. The default of these entities amounts to more than $ 1.6 billion, which is equivalent to 55.3% of the total portfolio of the subsidized regime.
The ACHC said that in recent years the liquidated EPS have left debts greater than $ 2.3 billion. In the contributory regime, Medimás, Coomeva, Cafesalud, Cruz Blanca, Saludcoop and Health Vida stand out. In the subsidized regime, the debts correspond to a conviction, Medimás, Ecoopopsos, Comfamiliar Huila, Emdisalud and Share.
In the case of intervened EPS and under special surveillance measures, The study indicates that the 11 entities of this group owe more than $ 12.8 billionwhich represents 79.8% of the total debt of the EPS in operation. Its portfolio in Mora amounts to $ 7.3 billion, equivalent to 85.6% of the total portfolio of the active EPS.
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The default in payments went from 55.3% in December 2024 to 56.0% in June 2025.
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Faced with December 2024, these entities increased their portfolio by 27.6%, which represents more than $ 2.7 billion, and raised the concentration of their delinquent portfolio in 2.1 percentage points, from 54.9%to 57%.
The entity with the greatest absolute increase in its portfolio was new EPS, which added about $ 1.7 billion, equivalent to a 33.7%rise. Sanitas registered an increase of more than $ 290,000 million, representing 22%, and Coosalud increased by more than $ 265,000 million, with a variation of 31.3%. These three entities concentrate 81% of the portfolio growth of the 11 EPS under special measures, which together added more than $ 2.2 billion increasing against the previous period.
In the state category, Territorial entities concentrate 36.8% of the debt, equivalent to about $ 696,000 million; lA Adres owes more than $ 569,000 million, 30.1% of the total, and the extinct FOSYGA about $ 82,000 million, which represents 4.3%. In the case of insurers, whose debt exceeds $ 639,000 million, 62.1% corresponds to the SOAT branch, with more than $ 396,000 million, whose portfolio in Mora is concentrated in 62%.
By ordering for greater absolute portfolio value in Mora, The main EPS Deudora continues to be new EPS, followed by Coosalud, Sanitas, Medimás, Savia Salud, Adres and El Fospyga, Emsssanar, Famisanar, Coomeva and Cafesalud. These entities total a total debt exceeding $ 13.5 billion, with a portfolio in blackberry close to $ 8.3 billion, which is equivalent to a 60.7% concentration, a figure that increased 1.7 percentage points compared to 59.0% recorded as of December 2024.
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The 11 EPS intervened and under special surveillance concentrate 12.8 billion pesos, almost 80% of the active EPS debt.
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The considerations of the association
Given the results of the study, the ACHC reiterated the call to the government to adopt measures that allow the situation of portfolio and the illiquidity of the sector. The entity indicated the need to issue modifications in the direct turn mechanism, with an increase in the minimum percentage of 90% and the strict application of circular 015 that establishes the priority of payments to independent health institutions.
He also insisted on advancing the disinversion of technical reservations to pay old portfolios, in regulating the function of ADRES as a guarantor of access to the IPS financial system and managing A new Fondeo of the Findeter line for credits to EPS that allow to cover obligations with the lending network.
“It is not necessary to remember the importance of the concretion of the capitalization required by some insurers. We consider that the system must have a guarantee fund that is functional and can operate in times of an eventual liquidation of EPS, protecting the lending sector from the already known harmful impact of those decisions”, Said Juan Carlos Giraldo Valencia, general director of the ACHC.
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In the contributory regime, three EPS (New EPS, Sanitas and Famisanar) must about 7.8 billion pesos, equivalent to 71.3% of the debt of that regime.
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The guild asked the authorities to verify the capacity of the EPS to respond for the affiliated population and collate the population size of each entity with the networks that have made available. “Maintaining a sufficient, functional, will”The director warned.
The ACHC also expressed concern about the irregularity in rotation and paying applications, a practice that has resulted in temporary and even definitive closures of services in different regions. That is why he asked the National Superintendence of Health Protection measures for service providers. Faced with the discussion in the Congress of an eventual health reform, the guild reiterated the need to include solutions that improve the cash flow of IPS.
“Our institutional objective will always be able to serve all patients who require it, doing so successfully needs the total compliance with the commitments and obligations of all system agents. The provider sector strives to preserve their operation and care for patients and human talent in health, but requires the help of the authorities and the responsibility of the actors in the sector. Today we need a financial rescue for those who maintain the operation of our health system”, He concluded.
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Diana K. Rodríguez T.
Portfolio journalist
