The Ministry of Health and Social Protection issued Resolution 2161 of 2025, with which it establishes the criteria and standards that the Health Promotion Entities (EPS) must meet. to continue operating within the General Health Social Security System.
This standard is part of the implementation of the Preventive, Predictive and Resolutive Health Model, designed by the Government through Decree 0858.
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According to the text, The purpose of the measure is to establish the criteria and standards for compliance with the conditions of authorization, qualification and permanence of the Health Promotion Entities. or whoever takes their place, adopt provisions for its operation in the functional subregions for the Comprehensive Territorial Management of Public Health, and establish the rules for the assignment of members.
One of the main changes introduced is the territorialization of insurance. From now on, the EPS will operate according to the functional subregions created to articulate the provision of health services with the characteristics of each territory. “The National Health Superintendence will update the administrative acts through which the operation of the EPS is authorized in order to incorporate the new territorial scope”says the resolution.
These subregions are classified into metropolitan, nodal, rural and special categories.. In metropolitan areas all authorized entities will be able to operate, while in smaller integrated rural areas only the presence of up to three EPS will be allowed. “In special category functional subregions, such as those with high dispersion, ethnocultural or insular regions, only an EPS with a greater number of authorized members in the functional subregion may operate,” the document details.
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EPSs with more than 20% of members at the national level will be able to operate in all subregions of the country.
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Entities that concentrate more than 20% of affiliates at the national level will receive a national operating authorization, which will allow them to operate in all subregions. In turn, The Ministry and the Administrator of System Resources (Adres) will be in charge of carrying out the reassignment of affiliates according to the territorial scope of the receiving EPS. “No entity may refuse to receive the members assigned to it,” the rule indicates.
The assignment process will be carried out independently of the affiliation regime and must guarantee continuity of care. Family groups will remain integrated and patients with high-cost diseases or pregnant women will be distributed proportionally and randomly.
The receiving EPS must guarantee care from the first day of the month following the official delivery of the affiliates. After sixty days, users will be able to exercise the right to free choice within the same functional subregion.
The resolution also defines restrictions to maintain operating authorization. EPSs with less than five million members and a participation of less than 10% in a region will not be able to operate in that territory. Those with less than one million members will only be able to do so in the subregion where they are already located, as long as they represent at least 1% of the members. As for the indigenous EPSs, they will retain their authorization without the need for new administrative acts.
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Entities with less than five million members and a participation of less than 10% will not be able to maintain their authorization in a region.
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Entities that decide to withdraw from any subregion must submit the request to the National Health Superintendence within the year following the update of their authorization. demonstrating operational continuity for at least twelve months and attaching payment plans for its obligations with providers and notification to affiliates and territorial authorities.
The new regulatory framework also introduces standards for qualification and permanence based on technical, scientific, technological, operational and territorial capacity. The criteria are grouped into components of organizational governance, risk management, comprehensive care, human talent, territorial operation and information technologies. According to the Ministry, the purpose is “guarantee effective, integrated, continuous, timely and quality access to health services”.
The updated operating authorization will be valid for three years, renewable after verification of compliance with the established conditions. If the standards are not met, the Superintendency may suspend or revoke the authorization.
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The EPS of the subsidized regime and the public of the contributory regime must contract at least 60% of health spending with State Social Enterprises (ESE).
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In financial matters, the resolution reinforces the limits of vertical integration and contracting. The EPS of the subsidized regime and the public of the contributory regime must contract at least 60% of health spending with State Social Enterprises of the municipalities where the affiliates reside. “They may not allocate more than 30% of health spending to contracting with their own IPS or with those in which they have direct or indirect participation.“, indicates the text.
Finally, the EPS will have a period of one year to adjust their operational capacity to the new conditions. During this period, the National Health Superintendency will carry out monitoring with a territorial approach, prioritizing the entities with the highest risk of non-compliance. With this resolution, The Government repeals Resolution 497 of 2021 and redefines the operational structure of the EPS based on the territoryconsolidating the new preventive, predictive and resolution model of the Colombian health system.
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DIANA K. RODRÍGUEZ T.
Portfolio Journalist
