La Administradora de los Recursos del Sistema General de Seguridad Social en Salud -ADRES- giró $19,4 billones en los doce meses del año para costear Unidad de Pago por Capitación (UPC) con la que se financian los servicios médicos de los usuarios Sisbén, comunidades indígenas, desplazadas, desmovilizadas y demás personas en condición de vulnerabilidad, afiliados al Régimen Subsidiado de Salud.
En comparación con la vigencia 2017, el monto total de la cápita que el Estado reconoció a las distintas EPS por sus afiliados creció 11%.
Fuente de financiamiento para la salud 2018
La financiación de las del régimen subsidiado para este año se logró por el esfuerzo de las entidades territoriales y del Gobierno Nacional, distribuido de la siguiente manera: el 44,64% lo aportó el Presupuesto General de la Nación o ADRES, el 36,37% del gasto fue financiado con los recursos del Sistema General de Participaciones, el 10,44% con los recursos del FONPET, el 5,67% con esfuerzo propio territorial, el 1.69% con los recursos transferidos por Coljuegos y el 0,14% por las Cajas de Compensación Familiar.
Para esta vigencia, el esfuerzo propio territorial aplicado en la financiación del subsidio de salud de la población vulnerable creció un 14%, pasando de aproximadamente $1.4 billones a $1.6 billones (incluido Coljuegos).
Giro directo a prestadores de servicios de salud
En materia de giro directo, el 70,1% del monto total girado en esta vigencia se realizó de manera directa a 3.043 prestadores y proveedores de servicios de salud, beneficiando a aquellas instituciones que se encargaron de atender a los usuarios del régimen subsidiado de salud. El giro directo a prestadores en el régimen subsidiado aumentó en un 21%, pasando de $11,2 billones en 2017 a $13.6 billones para 2018.
Este incremento se logró gracias a la labor desempeñada por la Superintendencia Nacional de Salud, y a la verificación estricta de la ADRES sobre los porcentajes que deben cumplir las EPS que se encuentran en medida de vigilancia especial, intervención o liquidación por parte del organismo de control y vigilancia competente y por la Resolución 3310 de 2018 expedida por el Ministerio de Salud y Protección Social que exige aplicar giro directo a los recursos de movilidad.
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