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El Tolima fortalece articulación con ADRES para optimizar recursos hospitalarios en crisis de fiebre amarilla
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La Secretaría de Salud del Tolima y la Administradora de los Recursos del Sistema General de Seguridad Social en Salud (ADRES) acordaron acciones inmediatas para mitigar glosas y agilizar el flujo de recursos hospitalarios, en medio de un creciente brote de fiebre amarilla que ha dejado 98 casos y 35 fallecimientos en el departamento.
Articulación estratégica para agilizar pagos y mitigar glosas
El encuentro fue liderado por Katherine Rengifo Hernández, secretaria de Salud del Tolima, y contó con la participación de Félix León Martínez Martín, director de ADRES. Durante la jornada, ambos mandatarios ratificaron su compromiso de “trabajar de la mano” para fortalecer la gestión de las cuentas por cobrar de los hospitales y clínicas del departamento. ADRES, ente encargado de gestionar los giros de la Unidad de Pago por Capitación (UPC) y los recursos transferidos por el Sistema Único de Información de la Protección Social (SUIP), ofreció calendarizar visitas a terreno en agosto para capacitar al personal administrativo en protocolos de facturación y manejo de glosas.
Estas formaciones técnicas buscarán reducir rechazos de facturas por errores de codificación, documentos incompletos o falta de anexos, que representan un porcentaje significativo de las glosas que afectan la liquidez de los recursos hospitalarios.
Impacto de glosas en la sostenibilidad de la red hospitalaria
Las glosas por gastos asociados a accidentes de tránsito y eventos catastróficos suelen acumular demoras de hasta 180 días en su reconocimiento, generando presiones en el flujo de caja de los prestadores de servicios.
Estas demoras comprometen la capacidad de los hospitales para adquirir insumos críticos, pagar personal y mantener niveles óptimos de atención. Según datos de la Asociación Colombiana de Empresas de Medicina Integral (ACEMI), el valor de las glosas a nivel nacional supera los 1,5 billones de pesos anuales, cifra que podría haberse reducido en un 15% con mejores prácticas de articulación entre territorios y el nivel central.
Capacitación técnica como herramienta de mejora continua
El personal de las secretarías de salud municipales y de las IPS recibirán talleres sobre verificación de requisitos, uso del Manual Único de Facturación (MUF) y la herramienta FEV-RIPS, desarrollada por el Ministerio de Salud y Protección Social para estandarizar la presentación de facturas y eventos de salud.
Estas capacitaciones, programadas para la primera semana de agosto en Ibagué, Chaparral, Ataco y Prado, serán facilitadas por expertos de ADRES y consultores certificados, garantizando la adopción de mejores prácticas internacionales en facturación hospitalaria.
Contexto del brote de fiebre amarilla y su repercusión
El Tolima enfrenta un brote de fiebre amarilla activo desde finales de 2024, con 98 casos confirmados y 35 fallecimientos registrados hasta el 17 de julio de 2025, de acuerdo con el informe de la Organización Panamericana de la Salud (OPS) y el Instituto Nacional de Salud (INS). Los municipios más afectados Ataco, Villarrica y Prado han visto un colapso parcial de sus servicios de urgencias, lo que aumenta la presión sobre la red hospitalaria del departamento.
Este escenario epidemiológico ha elevado los costos operativos de los hospitales, incluyendo implementos de bioseguridad y contratación de personal adicional para labores de vigilancia epidemiológica. La combinación de glosas atrasadas y mayor demanda de servicios de urgencia crea un cuello de botella que puede comprometer la atención primaria y los programas de vacunación.
Fortalecimiento de la atención primaria y la vacunación
En paralelo a la articulación financiera, el Gobierno departamental ha reforzado las campañas de vacunación contra la fiebre amarilla, con el objetivo de alcanzar coberturas superiores al 95% en zonas rurales y urbanas de riesgo.
En Dolores, por ejemplo, se implementó un monitoreo riguroso para garantizar que más del 95% de la población reciba la dosis de refuerzo, acción que ha logrado mantener el control del brote a nivel local.
Además, la OPS y la Secretaría de Salud del Tolima organizaron un programa de formación para 526 trabajadores de la salud en estrategias de comunicación de riesgo, con el fin de mejorar la percepción ciudadana sobre la vacuna y reducir la resistencia individual.
Experiencia y perspectiva de los voceros oficiales
“Nos complace llevar estas buenas noticias al Tolima. ADRES estará en el territorio en agosto para impulsar una jornada de formación técnica clave que permitirá mejorar la gestión y articulación del sistema”, afirmó la secretaria Rengifo Hernández durante el evento. Por su parte, el director Felix León Martínez insistió: “Nuestra meta es apoyar a toda la red de hospitales y clínicas para optimizar el flujo oportuno de recursos y reforzar la atención primaria, especialmente en los municipios de primer nivel”.
Perspectivas de corto y mediano plazo
Tras la mesa técnica, ambas instituciones acordaron establecer un comité de seguimiento quincenal, que permitirá monitorear avances en la reducción de glosas, tiempos de giro y cobertura de vacunación. Se prevé que, dentro de tres meses, el Tolima pueda registrar una disminución de al menos el 20% en glosas pendientes y un incremento de 10 puntos porcentuales en la cobertura de vacunación interrumpida por la contingencia.
Este comité estará integrado por delegados de la Gobernación del Tolima, ADRES, la Superintendencia Nacional de Salud y representantes de la Asociación Colombiana de Hospitales y Clínicas (ACHC), garantizando una mirada multisectorial y la resolución ágil de obstáculos.
Recomendaciones y buenas prácticas
El Ministerio de Salud recomienda documentar cada glosa y su causa raíz, realizar auditorías internas de manera trimestral, mantener actualizado el sistema de codificación en las IPS, estandarizar los procesos administrativos y adoptar soluciones digitales que faciliten la trazabilidad de cada factura hasta su pago definitivo. Asimismo, resalta la continuidad de los “diálogos de saberes” con las comunidades afectadas para reforzar la confianza en las campañas de vacunación y garantizar un abordaje culturalmente pertinente en poblaciones indígenas y afrodescendientes.
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