Loss ratio of the capitation payment unit of the health-promoting entities in Colombia between 2017 and 2021: a financial–actuarial approach

Espinosa, Oscar; Rodríguez, Jhonathan; Urdinola, B. Piedad; Do Nascimento Silva, Pedro Luis; Sánchez, Alejandra; Arias, Martha-Liliana; Valdez, Emiliano A.; Cheng, Terence; Fisher, Sara-Ellison

doi:10.1186/s12962-023-00481-5

Cost Effectiveness and Resource Allocation

Table 2 Financial sub-accounts of CPU costs for the contributory scheme according to IFRS or PAR group

From: Loss ratio of the capitation payment unit of the health-promoting entities in Colombia between 2017 and 2021: a financial–actuarial approach

IFRS 1 and 2
Financial sub-accounts	Cost of technical reserves^a—Settled pending payment—Health services	Cost of technical reserves—Known unliquidated—Health services	Cost of technical reserves—Pending unknown—Health services	Contracts for promotion and prevention activities	Catastrophic illnesses and high-cost illnesses	Other reserves	Cost of provision of services from own providers
Financial catalog AT FT001	61020101 61020301	61020401 61020601	61021001 61021201	61021301	61021401	61021501	61050101

PAR 6, 7 and 8
Public entities before resolution 427 of 2019 of the general accounting of the nation (years 2017 to 2019)		Public entities after resolution 427 of 2019 of the general accounting of the nation (the year 2020)		Public entities after resolution 223 of 2020 of the general accounting of the nation (the year 2021)
Capitation contracts—Contributory	561301	Capitation contracts—Contributory	561301	Promotion and prevention—Contributory	561303
Contracts by event and other modalities—Contributory	561302	Contracts by event and other modalities—Contributory	561302	Guarantee and quality system—Contributory	561304
Promotion and prevention—Contributory	561303	Promotion and prevention—Contributory	561303	High-cost disease reinsurance—Contributory	561305
Guarantee and quality system—Contributory	561304	Guarantee and quality system—Contributory	561304	Technical reserve for known unpaid health services and technologies, financed with the CPU	537201
High-cost disease reinsurance—Contributory	561305	High-cost disease reinsurance—Contributory	561305	Technical reserve for health services and technologies that have occurred and are not known	537202
Technical reserves for authorized health services	561320	Technical reserves for authorized health services	537201	Other provisions for health services and technologies	537290
Technical reserves for unknown health services occurred	561321	Technical reserves for unknown health services occurred	537202
Other technical reserves	561323	Other provisions for health services	537290

^aThe technical reserves can be understood as a provision that will guarantee the payment for the HST provided to the affiliates of the HPE, which is a legal requirement defined by the National Health Superintendency

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ISSN: 1478-7547

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