The National Superintendence of Health (Supersalud) announced the risk classification in which the Health Promotion Entities (EPS) cut to October 2022, which shed light on the best entities of this type in the country.
As Supersalud explained, this EPS classification was made after conducting an analysis of the payment capacity of these entities in the country to pay their obligations and also taking into account how they guarantee the provision of health services to its members.
“The evaluation allowed us to establish three levels of risk (high, medium and low) between what was taken into account: compliance with the conditions and financial capacity and for the payment of its obligations”, explained the National Superintendence of Health.
In the case of EPS at risk levels, something is wrong seven entities what remain under special measure from the Supersaludbecause they do not meet financial indicators and have high levels of indebtedness.
Those of medium risk are those that are measured and meet two of the three enforceable financial indicators to remain as resource managers. At this level there are also entities that are not measured and that fail to meet two of the three financial indicatorsin addition to significantly compromising its debt level. 3 EPS are located in this risk.
“In low risk level are those EPS that are not under special measure of the Superintendency, meet at least two of the three financial indicators and have a low level of indebtedness. In this category, 12 EPS are located ”, explained Supersalud.
EPS from Colombia that are at a high risk level
At the high risk level, the Supersalud classified the EPS Savia Salud, SOS, Emssanar, Capresoca, Asmet Salud, Comfachocó and Ecoopsoswhich group a population of more than 7 million affiliates and accumulate accounts payable of 3.5 trillion pesos with their providers and suppliers.
Of that total, close to 2.7 trillion pesos are concentrated in Emssanar, Asmet Health and Savia Healthwhat have a special surveillance measure or intervention, and since they are the ones with the most accounts payable with their public and private delivery networks, with its service and technology providerswith ambulance services and independent professionals.
The three EPS that are at medium risk
In the case of the medium level of risk, the Supersalud categorized three EPS: Famisanar, Capital Salud, of Bogotá, and Comfaorientewhich have a population of 4.4 million members and Debts to pay which amount to 1.2 trillion pesos.
“The first two breach financial conditions adequate patrimony and investment regime, while comfaorientewhich is under special surveillance measure, presents non-compliance only in the indicator of investment regime”, explained the Superintendency.
Regarding the amount of debts, the EPS alerted Famizan presenting accounts payable in excess of 833,000 million pesoss, the largest portfolio being the one with providers of health services and technologies ($220,516 million).
According to the Superintendence, in the health risk analysis, the three EPS were classified as high risk, because ido not meet at least two of the four indicators.
What are the EPS with the lowest risk according to Supersalud?
The National Health Superintendence classified 12 EPS as low risk: New EPS, Sanitas, SURA, Total Health, Coosalud, Mutual Ser, Compensar, Cajacopi, Comfenalco Valle, Aliansalud, Family EPS and My Health.
According to this institution, these 12 entities have an affiliated population of 35.9 million users and presents accounts payable 11.2 trillion pesos.