A growing crisis within Colombia’s Nueva EPS, the country’s largest health insurer with 11.5 million members, is being linked to a significant increase in mortality rates among its beneficiaries. A recent study conducted by the Valle del Cauca Governor’s Office, led by Víctor Muñoz and Health Secretary María Cristina Lesmes, investigated the impact of the insurer’s difficulties on patient outcomes.
Researchers analyzed whether a differential increase in mortality had occurred among Nueva EPS members beginning in July 2025, compared to the rest of the healthcare system in the Valle del Cauca department. The findings suggest a concerning correlation between the worsening administrative crisis at Nueva EPS and a notable rise in deaths among its enrollees.
According to the report, while the overall healthcare system in the region experienced a 9.6% increase in mortality during the period analyzed, Nueva EPS saw a 14.1% increase. This 4.5 percentage point difference represents a substantial gap, with the mortality rate among Nueva EPS affiliates being 47% higher than that of other insurers operating in Valle del Cauca. This suggests an unusual pattern compared to the broader regional healthcare landscape.
The analysis utilized data from the Single Registry of Affiliates – Births and Deaths (RUAF-ND), processed by the Departmental Health Secretariat. The study included 97,095 non-fetal deaths of residents in the area, excluding external causes such as traffic accidents, homicides, or injuries due to a lack of EPS registration in those cases.
The study, published by Consultor en Salud, hypothesized that systemic failures – including denials of authorizations, medication shortages, treatment interruptions, and barriers to specialist access – could be associated with an increase in preventable deaths. Researchers aimed to determine whether these administrative issues directly impacted clinical outcomes.
The observation period included a 30-month baseline starting in January 2023, contrasted with a seven-month “crisis period” between July 2025 and January 2026. This timeframe was designed to minimize seasonal biases and compare trends before and after the reported institutional deterioration.
Comparative analysis revealed that the observed pattern was specific to Nueva EPS and not a widespread public health trend in Valle del Cauca. While other insurers maintained performance close to historical averages, Nueva EPS demonstrated a marked deviation during the critical period.
Further analysis of leading causes of death indicated a greater impact on conditions requiring continuous monitoring and consistent medication or health technology provision. Chronic diseases and conditions dependent on strict therapeutic adherence were particularly sensitive to disruptions in care.
Víctor Muñoz and María Cristina Lesmes stated that the evidence suggests continuity of care is a key factor in patient outcomes. When interrupted due to contractual, financial, or administrative reasons, clinical risk increases and can lead to preventable fatalities.
The study concluded that the operational and financial crisis at Nueva EPS had measurable effects during the seven months evaluated, reflected in excess mortality from causes sensitive to the quality of care. The study’s authors emphasize the need for clinical and operational audits to assess risk management and implement immediate corrective measures to protect the health and lives of its members. This situation highlights the critical importance of stable healthcare access for vulnerable populations.
