Traslados entre eps en Colombia: ¿Qué dicen las historias laborales de cotizantes en cinco ciudades del país?

Insurers (hmos) argue that there is no incentive to invest in prevention activities because members can easily move to another insurance company. At the same time freedom to choose hmos is a key accountability mechanism of the Colombian Health System because citizens can leave low-quality insurers and enroll in high-quality insurers. This paper quantifies the size of the rate of transfers between hmos in the country to shed light on this debate. This study used publicly available information on affiliation histories to the health system for the last 14 years (2001-2014) for a random sample of adults between 40 and 50 in five different capital cities. The rate of enrollee transfers within a continuous enrollment period between hmo was estimated. Results showed that 56 % of enrollees had four or more enrollment periods; within the same enrollment period at least 54 % of enrollees did not transfer between hmo; in a year less than 6 % decided to transfer; there was a weak correlation between transfers and hmo service quality indicators.