The financial situation of the Health Promotion Companies (EPS) in Colombia continues to deteriorate worryingly, according to data published by the National Health Superintendency as of the third quarter of 2024.
(See: Financial crisis in Colombian health: EPS debt reaches $18.9 billion)
For this reason, the Así Vamos en Salud think tank presented its analysis showing a worsening of financial indicators compared to the same period in 2023. highlighting the structural challenges facing the health system in the country.
At the end of the third quarter of 2024, The system’s net worth stood at -$7.1 trillion, which represents an increase of 41% compared to the -$5 trillion recorded at the end of 2023. This negative equity is distributed between the subsidized regime with around -$4.9 trillion and the contributory regime with around -$2.4 trillion, marking a trend of accelerated decapitalization.
(See more: Appointment assignment, main barrier for patients to access health services)
According to the think tank, a historical comparison reveals that the deterioration is not new, but its magnitude is alarming. In 2023, negative equity was -$2.7 trillion in the third quarter, a figure that closed at -$5 trillion at the end of the year. In 2024, however, negative levels reached an all-time high, driven by higher medical and operating costs.
On the other hand, this year, the EPS accumulated operational losses of $3.1 trillion, representing a significant increase compared to the $2.6 trillion lost in the same period of 2023. Of the total, the contributory regime accounts for 64%, with $2 trillions, while the subsidized regime recorded losses of one trillion pesos, with an increase of 85.3% compared to the previous quarter.
(Read also: Supersalud intervenes EPS Coosalud due to administrative and healthcare deficiencies)
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Among the entities with positive equity, Coosalud and Mutualser stand out, which registered $264,000 million in the third quarter, although this figure shows a decrease compared to the second quarter of 2024, when they reached $307,000 million.
(Read also: In October, Adres allocated $7.13 billion for health insurance)
EPSs that operate in both regimes, such as Compensar, present operational losses amounting to $144,000 millionshowing that the impact is transversal to all actors in the system.
“Así Vamos en Salud calls on authorities and actors in the sector to prioritize structural solutions that ensure financial sustainability and access to quality services for all Colombians.” they indicated.
(See: Lawsuit against the Minsalud and Invima for shortages of medicines)
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The situation of those intervened
One of the most critical points of the analysis is the situation of the EPS under special surveillance or intervention measures, which account for 55.9% of the system’s operational lossesequivalent to $1.7 billion.
The result for the year for these entities was -$1.4 trillion, which translates into a significant deterioration compared to the -$879,000 million recorded in 2023.
(Read: They denounce shortages of medicines and deterioration in health services)
Of the total EPS with negative equity as of the third quarter of 2024, eight are under intervention or special surveillance, being Sanitas is the one that registers the greatest deterioration in assets, with an increase of 440% between 2023 and 2024. Other entities such as Capresoca (807%), Asmetsalud (96%) and Comfenalco Valle (171%) also show a strong deterioration.
Another point addressed in the analysis is the accident rate indicator, which measures medical costs and administrative expenses as a percentage of operating income. In that sense, in 2024, This figure reached 106.1%, which means that the income is not enough to cover the costs and expenses. Medical costs represented 99.6% of income, while the remaining 6.5% corresponded to administrative expenses.
(See also: Health reform: accounts that Andi makes about the impacts that the project would have)
“Exceeding 100% in all EPS groups reflects unsustainable structural pressure that threatens the financial viability of the system”the document states.
New EPS
Luis Lizarazo García. EL TIEMPO Archive
Absence of New EPS
The analysis presented by Así Vamos en Salud, excludes the financial data of Nueva EPS, which in 2024 represents 22.8% of the total number of members of the system. This was attributed to the lack of information reported in the financial catalogs of the National Health Superintendency, which introduces a limitation in the global interpretation of the results.
(See more: Andi’s warning: health reform would generate a deficit of $163 billion)
However, even without including this entity, the deteriorating trend is evident, say the report’s authors. “According to the data from this stated period, a health system is in crisis, with significant operational and property losses, especially in the EPS under intervention or special surveillance.“, they say.
Additionally, highlight the importance of having complete and timely information to evaluate the health of the system as a whole. In a context of crisis, every piece of information counts to design effective public policies that ensure equitable access to health for all Colombians.
In fact, the representative to the Chamber, Andrés Forero, highlighted that through a guardianship he managed to get the New EPS to send information on the entity’s portfolio statements. Faced with this, The congressman revealed that the portfolio for more than 180 days went from $89,000 million just before the intervention to $935,000 million at the end of October and the 180-day portfolio grew from $139,000 million to $813,000 million.
(See also: These are the articles that were added to the health reform that was approved)
Furthermore, he noted that “As of July, the accumulated losses of Nueva EPS in 2024 are $2.75 billion. The final loss of the year may be worse than that of 2023, which including the hidden liability reported by Rincón was $4.45 billion. Is the entity in trouble the one that will play a key role in the reform?”, he concluded.
