Nueva EPS Valle del Cauca Mortality Increase

A study led by experts Dr. Víctor Muñoz and Dr. María Cristina Lesmes, current health secretary of Valle del Cauca, which aimed to evaluate whether there is a differential increase in the mortality of members of Nueva EPS in Valle del Cauca during the institutional crisis reported since July 2025, describes a consistent temporal association between the worsening of the institutional crisis of Nueva EPS and a significant increase in the mortality of its members in Valle del Cauca.

While the average of the departmental health system limited the increase in deaths to 9.6%, Nueva EPS registered an increase of 14.1% in the same period. This differential, observed in the temporal comparison of the analysis, coincides with reports of access barriers and suggests the need to evaluate the continuity of care, especially in patients with chronic diseases through clinical and operational audits.

Hypothesis and data source

The main hypothesis of the study was: to establish whether systematic failures in Nueva EPS (denial of authorizations, shortages of medications, interruption of treatments, barriers to access to specialists) could be associated with an increase in avoidable mortality; while the source of the information was the RUAF-ND, Departmental Health Secretariat of Valle del Cauca: 97,095 non-fetal deaths of residents of the department.

Context: When administrative management defines the clinical outcome

Continuity in service delivery draws the fine line between successful management of chronic disease and a premature fatal outcome. The RUAF-ND technical report (Births and Deaths Module) processed by the Departmental Secretariat of Health of Valle del Cauca, has put definitive figures on a problem that has become a public health problem.

The study covers a wide observation window to avoid seasonal biases. The researchers contrasted a “Baseline” period of 30 months (starting in January 2023) against the 7 months defined as the institutional “Crisis Period”, between July 2025 and January 2026. The central hypothesis of the analysis suggests that systematic failures such as the denial of authorizations, the shortage of essential medicines, the interruption of treatments and the barriers to access the network of specialists do not operate as simple administrative procedures, but could be associated with an increase in avoidable mortality.

It is essential to clarify that the data exclude external causes due to the absence of EPS registration (traffic accidents, homicides or injuries), focusing the analysis exclusively on medical causes sensitive to the quality of care, those where the timely intervention of the insurer makes a difference.

Photo caption: Figure 1. Historical trend in deaths. The shaded area marks the beginning of the operational crisis and the consequent peak of mortality in Nueva EPS.

The Differential Gap: A pattern of systemic divergence

The most compelling finding of the study lies in the comparison of the mortality behavior between Nueva EPS and the rest of the Health Promotion Entities (EPS) that operate in the department and districts. We are not facing a general phenomenon of deterioration in public health in Valle del Cauca, but rather a focused event.

During the crisis period analyzed, the average monthly mortality in Nueva EPS experienced an increase of 14.1%. This figure contrasts with the 9.6% increase observed in the average of other insurers during the same period.

The critical data is the relative difference since there is a gap of 4.5 percentage points between both indicators. This implies that, in comparative terms, the increase in mortality in Nueva EPS was a 47% areperior to the rest of the insurance in the region. This statistical difference is the consistent signal that suggests a break in risk management within the entity, distancing itself from the standard behavior of the sector.

Caption: Figure 2. Differential mortality gap: While the system grew at 9.6%, the New EPS skyrocketed to 14.1% during the crisis.

Clinical Analysis: The pathophysiology of shortages

By disaggregating the information by basic causes of death, the report shows how administrative interruption translates into lethal clinical complications. The deterioration is not uniform; It focuses on pathologies that depend on strict therapeutic adherence and the uninterrupted supply of health technologies.

Photo caption: Table 1. Impact by pathology. Metabolic and respiratory diseases show the greatest deviations from the baseline.

1. Metabolic Alert (Diabetes):

The group of metabolic diseases, dominated by diabetes mellitus, presents the most alarming behavior in the study. This segment recorded the greatest relative increase, shooting up 50,1% compared to its baseline.

From a medical perspective, this peak is compatible with failures in the dispensing of insulins, GLP-1 analogues or oral hypoglycemics. Without these inputs, chronic patients are susceptible to debuting in emergency departments with diabetic ketoacidosis or hyperosmolar states, acute conditions of high lethality that are entirely preventable with correct outpatient management.

2. Operational asphyxiation: The breathing pattern

Chronic respiratory diseases (COPD, asthma) showed an increase in 12,8% on the monthly average. The technical document is explicit in linking this excess with a probable “interruption in the supply of inhalers and home oxygen, or access to nebulizations and hospitalizations.”

3. Communicable and Neurological Diseases:

In absolute terms, the greatest numerical impact is found in communicable diseases (HIV, Tuberculosis and pneumonia), where 48 additional cases (+10.0%) during the analyzed period. Likewise, neurological pathologies (epilepsy, Parkinson’s) increased by 17,5%.

Risk Georeferencing: Municipal mortality map

The impact of the crisis is not homogeneous throughout the territory. The municipal and district analysis reveals areas where excess mortality is disproportionate, suggesting specific ruptures in the local and pharmaceutical delivery networks of certain municipalities.

Photo caption: Table 2. Territorial sources of excess mortality. Cartago and Seville present the most critical alerts in respiratory health.

• Cali (Critical Volume Zone): As a capital, it concentrates the largest absolute volume with an excess of +71 deaths, which represents an increase of 10.5% compared to its baseline. It is notable that the respiratory cause contributed to an increase of 22% in this city.
• Cartago (Respiratory Red Alert): This municipality presents the most serious indicator in relative terms. Although its population is smaller, general mortality increased by 29.0%. Even more serious, mortality from respiratory causes shot up by 140%. This indicates an evident contraction in the care of pulmonary patients in the north of the Valley.
• Palmyra: It recorded 36 excess deaths (+16.7%), with a 60% increase in respiratory causes.
• Seville and Tuluá: Seville, an intermediate municipality, saw a 20.2% increase in general mortality and a 97% increase in respiratory causes. Tuluá, for its part, reported an excess of 17 deaths (+11.7%), with a 71% increase in respiratory pathology.

The analysis consistently suggests that the respiratory cause is the common denominator in the municipalities with the highest excess mortality.

Oncology: Critical divergence and statistical significance

One of the most sensitive points for the medical community and patients in the Cauca Valley is the decline in outcomes due to cancer, a group of pathologies where time is crucial. The report highlights six types of cancer where Nueva EPS worsened its indicators while the rest of the system managed to improve them.

Photo caption: Figure 3. Oncological disparity. While New EPS (red) presents increases in mortality in 6 types of cancer, the rest of the system (green) shows reductions, especially in ovarian cancer (-32%).

The case of ovarian cancer is paradigmatic of inequity in access: during the period of analysis, mortality from this cause increased by 37% in Nueva EPS, while in the other insurers mortality from this same pathology was reduced by 32% during the same period.

Regarding breast cancer, the mortality of these patients increased by 21% in the period, while in the other EPS it decreased by 7%.

The human cost of administrative barriers

The analysis confirms that the operational and financial crisis of the New EPS It has immediate and measurable repercussions, an excess of mortality during the 7 months of measurement, exclusively in the sensitive causes analyzed.

The evidence from Valle del Cauca shows that, in the current model, the interruption of care continuity, whether due to lack of contract, lack of payments or authorization barriers, has an irreversible and very painful lethal cost for the entire community.

Thank you Dr. María Cristina Lesmes for turning the feeling of lack of protection that is advancing around insurance, and especially Nueva EPS, into clear and objective statistics, to continue looking for immediate solutions in high government.

Find the full report here