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Supersalud levanta medida de recuperación a Capital Salud EPS
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Este 3 de agosto, la Superintendencia Nacional de Salud (Supersalud) levantó la medida de recuperación que regía sobre Capital Salud – EPS, tras evidenciarse la recuperación financiera de la entidad promotora de salud y el cumplimiento de los indicadores de gestión establecidos. La determinación quedó oficializada en la Resolución 50236 de 2022.
Tras analizar varios informes, la Supersalud evidenció que Capital Salud registra capitalizaciones por $437.000 millones desde 2018 y que la EPS cumple con el régimen de inversiones para reservas técnicas, pues en mayo de este año ya acreditaba la suma de $404.219 millones.
También le puede interesar: Supersalud mantiene medida de programa de recuperación a la EPS Capital salud hasta 2022
En materia financiera, entre junio de 2020 y febrero de 2022, la EPS capitalizó $287.000 millones. Con ello, Capital Salud ha realizado pagos por $261.909 millones, lo cual beneficia a la red prestadora y proveedora de servicios y tecnologías en salud. Cabe señalar que, para ejecutar el pago de las acreencias, la EPS ha dado prioridad a la cartera superior a 180 días.
Y en lo que respecta a las acciones de mejoramiento para la atención de los usuarios, Capital Salud ha diseñado estrategias para optimizar el costo médico y alcanzar eficiencia en su operación, implementando un modelo de atención integral actualizado y alineado con la organización de la prestación de servicios de salud.
Como resultado, la EPS ha llevado a cabo la caracterización epidemiológica de sus afiliados y ha realizado con éxito el cálculo de la demanda potencial de servicios del plan de beneficios para proyectar los estudios previos y organizar los procesos de contratación de la red de servicios primaria y complementaria. Adicionalmente, la Supersalud evidenció un avance en el cierre efectivo de quejas con un 99,86% y un descenso en el número de días promedio para el cierre de las reclamaciones.
Le puede interesar: Se levanta medida de vigilancia especial a Capital Salud EPS
Acciones de mejoramiento de Capital Salud EPS no deben detenerse
Pese a que la Supersalud levantó la medida de programa de recuperación, se ordenó también a la EPS que implemente y ejecute planes de trabajo en un término de 12 meses, orientados al cumplimiento de las condiciones financieras y de solvencia, indicadores trazadores de efectividad, gestión del riesgo y experiencia en la atención en salud.
Asimismo, debe asegurar la conciliación y el pago oportuno a la red prestadora y proveedora de servicios y tecnologías en salud, así como adelantar gestiones de radicación, conciliación y recuperación de cartera todavía pendiente.
No olvide leer: Viruela del mono: así deberán manejar los casos las EPS e IPS
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