What was the state of EPS Sanitas before, and what was its situation after the Supersalud intervention? The data show that the situation has worsened.

Sanitas, a health insurance company that until 2023 stood out as one of the health insurers with the highest levels of customer satisfaction, now faces a critical outlook after seventeen months under the intervention of the National Health Superintendency. Although the government justified the measure due to financial difficulties, official figures show that the situation not only has not improved, but has actually worsened dramatically.

The intervention, initiated on April 2, 2024, was based on non-compliance with financial and solvency indicators. This was the reason that led the Executive Branch to take administrative control of the EPS with the promise of stabilizing it. However, both in financial results and in those of customer service, the deterioration is evident.

Prior to the intervention, Sanitas was experiencing difficulties in meeting asset and solvency requirements, although it remained one of the EPSs with the lowest complaint rates compared to other contributory systems. This combination—financial problems combined with strong performance in terms of user satisfaction—was what led the government to order the administrative intervention measure.

However, the Supersalud's financial statements reveal that during the 17 months of intervention, the EPS's finances plummeted. Equity fell from 21 billion pesos to -1.7 trillion, while liabilities grew from 1.6 trillion to 3.9 trillion pesos.

This was compounded by a drop in the technical reserves balance, which fell from 32% to 14%, reflecting a greater imbalance between available resources and obligations to members. The accident rate—an indicator that measures how much the EPS spends on care compared to what it receives—also deteriorated, dropping from 102% to 111%. In other words, the EPS went from spending $102 pesos for every $100 received before the intervention to spending $111.

The trend in complaints clearly reflects the deterioration and its impact on users. Between January and April 2024, before the intervention, Sanitas received 63,936 complaints (PQRD), with a monthly average of between 14,000 and 18,000 cases. With a population of 5.7 million, the cumulative rate over those four months was 110.41 complaints per 10,000 users, below the average for the contributory system, which registered 116.46.

A year later, under the intervention, the trend changed dramatically. From January to April 2025, Sanitas accumulated more than 84,000 complaints, with peaks of up to 22,206 in March. The complaint rate soared to 145.88 per 10,000 members, a jump of more than 35 points compared to the previous year. Although it was still below the regime's average (167.26), the difference compared to its own records demonstrates an unprecedented deterioration in its service.

Sanitas insists that, beyond the complaint figures, the exact extent of the damage is still unknown. "The impact on the care network, professional teams, and user confidence goes far beyond the numbers. The worst part is yet to be fully understood," company spokespersons warned.

Sanitas has emphatically warned that the full extent of the damage is still unknown. Keralty President Joseba Grajales stated that "the damage caused by the illegal intervention and the government's irresponsible actions is devastating. Repairing this disaster will take time and a colossal effort."

The company insists that the impact is not limited to its financial statements, but also affected the healthcare network, the availability of medications, and the trust of millions of users.

The Sanitas case reveals a paradox: the intervention was justified as a way to correct financial problems, but it ended up deepening both the financial deficit and user dissatisfaction. The measure, which sought stability, resulted in greater fragility.

Environment and Health Journalist