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 3 Financial sub-accounts of CPU costs for the subsidized 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 subaccounts	Cost of technical reserves—Settled pending payment—Health services	Cost of technical reserves—Known unliquidated—Health services	Technical reserve cost—Unknown pending—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	61020102 61020302	61020402 61020602	61021002 61021202	61021302	61021402	61021502	61050102

PAR 6, 7 and 8^a
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—Subsidized	561307	Capitation contracts—Subsidized	561307	Promotion and prevention—Subsidized	561309
Contracts by event and other modalities—Subsidized	561308	Contracts by event and other modalities–Subsidized	561308	Guarantee and quality system—Subsidized	561310
Promotion and prevention—Subsidized	561309	Promotion and prevention—Subsidized	561309	High-cost disease reinsurance—Subsidized	561311
Guarantee and quality system—Subsidized	561310	Guarantee and quality system—Subsidized	561310	Technical reserve for known unpaid health services and technologies, financed with the CPU	537201
High-cost disease reinsurance—Subsidized	561311	High-cost disease reinsurance—Subsidized	561311	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 expenses for the administration of social security in health	561390
Other technical reserves	561323	Other provisions for health services	537290
Other expenses for the administration of social security in health	561390	Other expenses for the administration of social security in health	561390

^aIn public catalogs (AT-FT001-06, AT-FT001-07, AT-FT001-08) it is not possible to determine, in the sub-accounts related to technical reserves, whether those are from the SS or the CS, and therefore this should be considered in accordance with the authorized/enabled regime of the study HPE

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ISSN: 1478-7547

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