The effect of the exit of an insurer, due to government liquidation, on access to health care: evidence from Colombia.

Abstract

Our study evaluates the liquidation effect of a health insurer from a subsidized scheme, with the largest number of members in Colombia, on restrictions to future access to user care. Based on the information regarding complaints and judicial claims about healthcare, the effect of this government decision is estimated using a dynamic econometric model of differences in differences. Our results suggest that the liquidation of the Health-Promoting Entity (EPS, its acronym in Spanish) CAPRECOM has a negative effect, specifically, it led to an increase of 0.32 and 0.21 in complaints rates per 1,000 members in the receiving EPSs during the first and second quarters after the intervention, respectively. However, this effect does not persist over time and becomes diluted in the following quarters. There is no evidence of a relationship between the magnitude of the effect and the EPSs performance ranking. Additionally, we do not find significant effects on judicial claims. Our results are important concerning the design and implementation of public policies for EPSs liquidation. We demonstrate the necessity of implementing actions to incorporate guidelines and strategic plans during the transition period. Such actions would enable safeguarding the right to health for the affected population in a liquidation insurer case.