health
Supersalud reveals increase in claims and exposes widespread failures in service provision
General claims rate in EPS reached 423.35 per 10,000 affiliates in the last year. Photo: Photo: iStock/Private Archive
TL;DR
- The Superintendency of Health is facing new pressure due to the top EPS claims report.
- Superintendent Daniel Quintero ordered investigations into EPS denying medications.
- The general claims rate is 423.35 per 10,000 affiliates, showing high dissatisfaction.
- Comfenalco Valle leads with 653.04 claims per 10,000 affiliates.
- SOS, Famisanar, Capital Salud, and Compensar also show high claim rates.
- Nueva EPS is not the worst performer but needs a plan of action.
- More than half of the analyzed EPS are at or above the average claim rate.
- The focus is on medication denial as a critical issue in service quality.