There are two EPS that hold the undisputed first place in a key indicator for the battered Colombian health system: risk management of high-cost diseases. It is a work front in which Sura EPS, in the contributory system, and Mutual Ser in the subsidized system, have been repeating first place for five years as the best. And in its most recent ranking of 2022, the High Cost Account of the Ministry of Health and Social Protection ratifies the leadership of both entities on the subject.
The list also rewarded the IPS, provider institutions, for their management of high-cost diseases. The report establishes categories according to the disease, but among all the winners among the IPS, Clínica Universitaria Colombia keeps the highest number of recognitions, being the winner in nine areas, including management in: adult population with cancer, gastric cancer, cervical cancer, cervix and acute lymphocytic leukemia, among others.
In the categories for the EPS, Sura sweeps. She was nominated in all of them and in nine areas she won first place, in addition to receiving the award for the best comprehensive management in the tax regime.
The report highlights the entities that best manage the most expensive diseases in their treatment. It is a list that is made in light of diseases such as hemophilia, high blood pressure, diabetes mellitus, hepatitis C, rheumatoid arthritis, HIV and chronic kidney diseases, among others, as well as the 11 types of cancer prioritized in the country.
“We got nine awards and were nominated in all categories. This is thanks to the focus we have on risk management, on delivering well-being to people. Through objective indicators, a third party audits, and the facts and data allow us to be awarded today”, says Pablo Otero, manager of EPS Sura.
Sura is first in rheumatoid arthritis, cancer of the cervix, breast, prostate, lung, colon and Hodgkin’s lymphoma, among others.
In second place is EPS Sanitas, recognized as the first in five categories of diseases. New EPS obtains three first places, followed by Total Health, with one category.
Sanitas stands out for its management of pathologies such as hepatitis C. In the case of New EPS, it stands out with the best results in managing cardiovascular risk in people with high blood pressure or diabetes mellitus, and also those on dialysis. And Salud Total is noted for efficiently treating patients with HIV/AIDS.
“During these 13 years at Nueva EPS we have worked on a risk management model that has guaranteed comprehensive care for patients with chronic pathologies, which has been achieved by having a national network of providers and the active participation of our users. . Thanks to this hard work, today we managed to obtain this recognition,” says José Fernando Cardona, president of Nueva EPS.
The ranking recognizes the management on this sensitive front of IPS classified as “small”, such as the General Clinic of the North, a care center in Puerto Colombia, or the Rheumatology and Dermatology Study Center in Cali. “Important things can be achieved in this health system,” says Lizbeth Acuña, director of the High Cost Account.
By 2019, there were about 44 EPSs. Today, with the intervened and liquidated, the system was left with around 30.