Nueva EPS, the largest promotional entity in the country, with more than 10 million members and presence in 32 departments, This week, a national call will be opened for all independent professionals, clinics or hospitals (IPS) that want to provide services to the EPS to do so.
Julio Rincón, intervening agent of Nueva EPS, explained to several media outlets during the ‘Gobernar Salud’ 2024 Congress that they will carry out a non-binding market study for all IPS that want to participate.
Hospital.
Photo:Governorate of Valle
“We need to expand the network for our members and we are also preparing them for what may happen in the country. Indeed, as other EPS have requested voluntary withdrawals, the New EPS is the protagonist of the current health system,” he said.
According to Rincón, within the study they plan to review aspects such as location. This is because one of the priorities of the EPS is that its members (almost 20% of the system’s users in Colombia) can access health care points close to where they live.
“We are very interested in independent professionals who are in small Colombian municipalities. We need specialists who are located close to where our members are,” said Rincón.
And he added: “We cannot allow our members to have to travel long distances in the city to receive services, we want nearby care sites, we also want to ensure that any provider who meets the standard of being enrolled in the service can be our provider.” .
At this point, it is important to clarify that the reform proposed by the Government, which failed in early April in the Seventh Commission of the Senate, prioritized the care of patients in centers close to their homes. Although this would bring with it a series of problems, such as the patient’s free choice, what Nueva EPS would be seeking is to achieve access without geographical barriers to care for its members in remote territories.
It is no secret that access to health services for certain peripheral territories in Colombia presents great challenges. One of the most notable is the lack of professionals and medical centers capable of settling in these places, whose population is vulnerable and numerous.
The most recent SISPRO Registry of Human Talent in Health highlights that at least nine departments in the country have a rate of doctors per 10,000 inhabitants of between 0.00 and 12.50, when the highest rate ranges between 27. 00 and 51.00.
It is no coincidence that the departments located towards the geographical margin are those with the lowest rates of health personnel: Arauca, Vichada, Guainía, Vaupés, Amazonas, Caquetá, Putumayo, Chocó and (as an exception) Cundinamarca.
New EPS.
Photo:Luis Lizarazo Garcia. EL TIEMPO Archive
The situation is similar with the hospital structure. As of December 2022, in 501 of the country’s 1,104 municipalities, the public hospital is the only provider of health services.
In total, Colombia has 932 public IPS (ESE) that are responsible for the basic care of nearly 24 million people. Furthermore, the obligation to contract with public hospitals 60% of the UPC and 100% of the promotion and prevention services in the subsidized regime does not encourage private sector investment in rural areas.
To the above we must add the difficult financial situation that the health sector is going through and the increase in debts that the majority of IPS in the country have.
“There is concern on the part of the IPS because with the debts that exist at the moment they believe that they are not going to be paid, that this money is going to be lost. The New EPS is not going to ignore the accounts that have to be paid, we are going to recognize them all However, we are going to reach agreements with them because we have several ways of looking at the accounts: the invoices they presented, how the population they served fared, among others. These elements, which we have the ability to evaluate, are part of the negotiation. “This is a health system that is created to achieve the best possible health,” said Rincón.
