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Salud financiera de las IPS

The financial health of private IPS

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

In order to have a complete perspective of the financial situation of the main actors of the health system, a review of the financial statements of the private IPS was carried out, which can be found on the website of the National Superintendency of Health with a cut-off of 31 December 2019 [1], corresponding to 5,641 private IPS.

Prior to the presentation of the results, it is pertinent to specify that several EPS and companies with a different corporate purpose that provide some type of health service (gyms, pharmaceutical managers, etc.) are classified as private IPS, which were not taken into account for the tables presented, but if they are found in the summations of each item reviewed, since it is not possible to separate what corresponds to the provision of health services and other services.

 

The above with the exception of the table that corresponds to income, since these are found separately in the reviewed information, and therefore, said table corresponds only to those received for the provision of health services, regardless of the main corporate purpose of the entity .

 

Assets and accounts receivable

 Regarding assets [2], the total of these reported by private IPS was $62.7 billion. The top ten active IPSs were as follows:

IPS1

 

Of these assets, accounts receivable [3], amounted to $29,793 billion. The top ten private IPSs on these accounts are shown below:

IPS2

 

Liabilities and accounts payable

Regarding liabilities [4], these totaled $36 billion, and the following table also shows the first ten IPS:

IPS3

 

Of the liabilities, accounts payable [5] totaled $8,931 billion, and the first ten IPS in these accounts are below:

IPS4

 

Of the liabilities, the financial debts [6] that amounted to the sum of $26.6 trillion are striking. The first ten IPS with this type of debt were:

IPS5

 

Income

 The income from the provision of health services [7] of the private IPS in 2019 was $15.578 billion.

 

It is reiterated that in this case EPS and companies with different corporate purpose appear, but the information shown corresponds only to the income from the provision of health services, this being the only item of those reviewed where such separation is found.

 

The top ten IPS in revenue were:

IPS6

 

The results[8]

Reported profits totaled $13,472 billion.

 

The ten IPS with the best profits or surpluses were the following:

IPS7

 

On the contrary, the ten IPS with the highest losses were:

IPS8

 

Conclusions

The figures show that the financial situation of the private IPSs is good, however, there are special situations that cannot be ignored.

 

Although it is true that liabilities are 57% of assets, it should be noted that accounts receivable in turn represent 45% of those same assets, that is, a significant part of the financial figures of the revised IPS are monies owed to them.

 

Additionally, it is striking that accounts payable are 25% of liabilities, compared to 72% of those same liabilities that represent financial debts, which implies that private IPSs have probably turned to the financial sector to pay their suppliers and guarantee its operation, and / or the large constructions and endowment updates that we have seen in recent years have been financed with loans.

 

As was found with the ESEs [9], the debts reported by the IPS are related to those reported by the EPS [10], that is, what the state owes through the Social Security Resources Administrator in Health (ADRES) to the EPS generates a cascade effect in all the actors of the health system.

 

In any case, comparing accounts receivable with accounts payable and financial liabilities, the former are less than the latter two, which is why, even if the private IPS obtained payment of the total amount owed to them, they would not be able to cancel its liabilities, without forgetting that a part of the latter are not due immediately.

 

Once again we reiterate that the accounts receivable are not completely refined as the glosses have not been deducted, since it is mandatory for private IPS to record the total value invoiced, without this value being fully recognized by the entities responsible for payment (EPS, prepaid medicines, insurance, etc.)

 

Consequently, as commented in the blog on the financial situation of the ESEs, a part of the profits and accounts receivable are an accounting effect, which do not necessarily represent the financial reality of each private IPS.

 

Regarding the results, it is evident that profits are being generated, but once again we reiterate that they correspond to a large extent to uncertain accounts receivable.

 

It is noteworthy that in the information reviewed there are EPS or other companies that provide health services and whose figures are globalized in totals, with the exception of income as explained, that is, there is a mix of values that includes income from insurance and for other concepts, which does not allow an absolute precision of the financial situation of the provision of health services.

 

Finally, we must remember that according to what is established in Law 100 of 1993, when an EPS has its own IPS, it must have separate accounts, so that the figures found in the revised information should correspond solely and exclusively to what is related to the provision health services.

 


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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 13 in the information of the National Superintendency of Health.

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

5. Code 2106 in the information of the National Superintendency of Health.

6. Code 21 in the information of the National Superintendency of Health.

7. Code 4101 in the information of the National Superintendency of Health.

8. Code 35 in the information of the National Superintendency of Health.

9. See blog: https://www.neuroeconomix.com/la-salud-financiera-de-las-empresas-sociales-del-estado/

10. 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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