EPS Famisanar has presented its new action plan after receiving a one-year extension for the forced administrative intervention. This plan focuses on three fundamental axes: reducing health care costs per member, improving financial stability and ensuring the continuity of its services.
(See: ‘Financial stability has not yet been achieved’: Famisanar’s intervening agent)
Among the main initiatives is the implementation of preventive strategies in various regions, which will include health teams dedicated to providing outpatient care. This approach seeks not only to improve the health of members, but also to reduce future costs.
Besides, The EPS will develop an Institutional Reorganization Plan (PRI) that will be presented to the National Health Superintendencefollowing its approval by the Shareholders’ Meeting.
This plan is designed to ensure medium-term financial viability, focusing on the clean-up of liabilities and strengthening of assets.
(See more: What is the status of the EPS that is in the process of withdrawing from the health system)
Sandra Milena Jaramillo Ayala, special agent intervener of the EPS
Courtesy
During the first year of intervention, Famisanar managed to reduce the cost of health care, which went from 116.6% in 2022 to 103.6% in 2023. However, a slight increase in costs has been recorded in August 2024, reaching 105.8%. Given this scenario, the EPS will intensify new strategies to balance costs without affecting members’ access to services.
(Read also: The New EPS suspended payments to 144 IPS due to inconsistencies in invoices)
The actions to assess the relevance and rationality of the care of hospitalized patients have generated significant savings for the EPS, reaching $74,762 million in 2024, an increase of 15% compared to the previous year. Likewise, Savings of $47.486 million have been generated through risk management in patient cohorts.
Famisanar.
THE TIME file
In the new period, the network of service providers will be monitored through audits and quality assessments, in order to optimize available resources. Famisanar will also continue the process of liquidating contracts and purging unprovided services.
(Read: Adres has turned over $49.46 billion from January to July for UPC)
The EPS, in collaboration with its service delivery network, will implement Resolutions 2335, 2284 and 2275 of 2023, adjusting referral and counter-referral processes to facilitate access to health services and reduce costs.
Finally, Sandra Milena Jaramillo Ayala, special intervention agent of the EPS, called on all actors in the health system, ensuring that “Achieving financial balance for the EPS is key to its continuity and benefits members and collaborators. I invite everyone to work together with commitment in this process.”.
(See more: Analysis: Is Colombia’s health system in ‘intensive care’?)
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