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empresas sociales del estado

The financial health of the state's social enterprises

Foto Francisco Garcia

Francisco Jose Garcia Lara
Surgeon and Master in Health Administration
from the Javeriana University
Columnist of the newspaper La Nación de Neiva

State Social Enterprises (ESE) is the name given in Law 100 of 1993 to public hospitals.

To review the financial situation of the ESCOs, the figures were taken from the financial statements found on the website of the National Health Superintendency as of December 31, 2019 [1], in which the information on 939 of these can be found. Business.

Here are the main results:

 

Assets and accounts receivable

Regarding assets [2], according to the aforementioned financial information, the total reported by ESCOs was $20.7 billion. The top ten in assets are as follows:

empresas sociales del estado1

 

Of these assets, accounts receivable for health services [3], that is, what is owed to them for health care, amounted to $7,944 billion. The top ten ESEs in accounts for this concept are shown below:

 

empresas sociales del estado2

 

Liabilities and accounts payable

Regarding liabilities [4], these totaled $5,117 billion, and the following table also shows the first ten:

empresas sociales del estado 3

Of the liabilities, accounts payable [5] totaled $2,588 billion, and the first ten in these accounts are below:

 

empresas sociales del estado 4

Income

ESCO revenues in 2019 were $15,578 billion. The top ten in revenue were:

empresas sociales del estado 5

 

The results[6]

Of the 839 ESEs that reported information to the national health superintendency, 810 gave profits for $1,451 billion.

 

The ten ESCOs with the highest profits are the following:

 

empresas sociales del estado 6

On the contrary, 129 ESE gave losses, for a total of $191,498,635,215.

 

The ten largest losses are in the following table:

empresas sociales del estado 7

 

What, then, is the financial situation of the ESCOs?

For several years, some detractors of Law 100 of 1993 have been assuring that said rule has led to bankruptcy of public hospitals, however, the figures of the financial situation of the aforementioned entities show a scenario contrary to that statement.

 

In fact, and as explained before, 810 ESE obtained profits in 2019, that is to say that the 86% gave profits in that year, while 129, which corresponds to 14%, reported losses, therefore most public hospitals achieved profits .

 

In turn, the 40% of its assets are represented by accounts receivable for the provision of health services, which possibly shows that the financial situation of the ESCOs is affected by illiquidity, since the debt for this concept is significant .

 

The situation thus raised is correlated with the debts reported by the EPS [7], which originate mainly for the contributory regime due to the large debt of the administrator of social security resources in health with these entities; and for the subsidized, by the lower value of the unit of payment by capitation that is recognized in comparison with the contributory one.

 

On the other hand, when comparing accounts receivable and accounts payable, the former are higher than the latter, to the point that if the ESCOs were paid all that they owe them, they would be able to pay their liabilities, understanding that a part of these are not immediately enforceable.

 

However, we must not forget that in accounting the ESCOs must record the total income once the invoice is issued, without this implying that the EPS recognize the total invoiced value, since the effect of glosses on invoicing is well known. Likewise, in the accounts receivable there must be values of the EPS in liquidation, so they will surely not receive the total amount invoiced.

 

Consequently, it is feasible that a part of the profits and accounts receivable correspond to an accounting effect, rather than to a real financial result.

 

Finally, it is evident that the majority of ESCOs obtain profits, which should require a thorough review of the companies that make losses, since these are most likely derived from inadequate administration and / or corruption, which are definitely not attributable to Law 100 of 1993 or the structure of the health system.

 


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References

1. https://www.supersalud.gov.co/esco/Paginas/DelegadaSupervisionInstitucional/Estadoestadsticas- Finanzas-IPS.aspx

2. Code 1 in the information of the National Superintendency of Health.

3. Code 1319 in the information of the National Superintendency of Health.

4. Code 2 in the information of the National Superintendency of Health.

5. Code 24 in the information of the National Superintendency of Health.

6. Code 3230 in the information of the National Superintendency of Health.

7. See blogs: https://www.neuroeconomix.com/la-salud-financiera-de-las-eps-del-regimen-subsidiado/ and https://www.neuroeconomix.com/la-salud-financiera-de-las-eps-del-regimen-contributivo/

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