In the second installment of our exclusive financial analysis, led by Germán Chaparro of Proyekta Data Solutions, we dive deep into the critical liquidity crisis facing Health Service Providing Institutions (IPS, by its Spanish acronym). After analyzing a sample of 53 private IPSs, the data reveals a harsh reality for medical device manufacturers and technology providers: the rapid deterioration of hospital cash flows is drastically halting the sector’s modernization.
Today, IPSs are operating at their absolute limit, becoming involuntary financiers of a system that is stifling their capacity to invest.
1. The Illusion of a Surplus: A Strangled Cash Flow
Although income statements might show a degree of profitability, the actual cash on hand tells a very different story.
- Limited Cash: The analyzed sample showed that at the close of 2025, the sector generated a mere $53.98 million USD in Free Cash Flow. This is the money left over after paying taxes, replenishing working capital, and covering essential investments.
- The Burden of Debt: This figure reflects the outstanding obligations from financial commitments secured through debt, leasing, and similar arrangements. Once these obligations and their corresponding interest are deducted, the economic surplus drops drastically. This leaves almost no margin for dividend distribution or capital reinvestment to justify a sustainable long-term growth rate.
2. Trapped in Receivables: Involuntary Financiers
The hospital sector isn’t losing cash to irresponsible spending or inventory hoarding; rather, its cash is getting trapped in accounts receivable.
- During 2025, operating working capital requirements surged by 34.6% (equivalent to an additional $407.89 million USD). This growth vastly outpaced the healthcare system’s operating revenue, which grew by only 9.4%.
- For every additional dollar generated by an IPS, a large portion does not convert to cash, but instead ends up financing the outstanding balances owed by EPS (Health Promotion Entities, by its Spanish acronym) insurers.
| Working Capital Items | End of 2024 (USD) | End of 2025 (USD) | Change |
| Accounts Receivable (Clients/System) | $1,764.19 million | $2,188.64 million | ↑ 24% |
| Inventories | $129.26 million | $143.29 million | ↑ 10% |
| Accounts Payable (Suppliers) | $718.31 million | $749.65 million | ↑ 4% |
3. The Technological Sacrifice (A Warning for Manufacturers)
For manufacturers of medical devices and equipment, this next finding is the ultimate red flag: the severe lack of liquidity has destroyed clinics’ capacity to invest.
- While private IPSs have $2,184.21 million USD immobilized in accounts receivable, the funds allocated to infrastructure and technology (CAPEX) represent just 3.97% of their sales.
- The ratio of Property, Plant, and Equipment to sales dropped dramatically from 67.17% in 2020 to 46.86% in 2025.
What does this mean? Hospital technology investment decisions are no longer driven by strategic goals or clinical growth, but strictly by cash availability. IPSs aren’t investing in what they need; they are investing in whatever they can afford to finance. This points to severe, impending delays in the modernization of medical equipment.
4. Credit Risk Unmasked
The 2025 figures reveal stress indicators that should never be ignored in any B2B negotiation within the sector:
| IPS Credit Risk Indicators | 2025 Result | What Does This Mean? |
| Probability of Default | 10% | Solvency exists, but liquidity is lacking |
| Average DSO (Days Sales Outstanding) + Estimated Grace Period | 140 + 30 days | Critical delays in collecting receivables |
| Total Debt Level | 45% | Debt is in the “watch zone” |
| Growth Leverage | 0.40 | Growing requires more cash than is generated |
The Challenge of Official Debt Reconciliation
To mitigate this crisis, the National Government has convened EPSs, IPSs, administrators, and pharmaceutical companies to reconcile the system’s debts. However, the state has declared it will legally assume only the funds associated with the UPC (Capitation Payment Unit), leaving all other obligations as the responsibility of private actors. This makes having verifiable financial information more urgent than ever before.
Methodological Note: All amounts stated in this article were converted from Colombian pesos (COP) to U.S. dollars (USD) at an exchange rate of 1 USD = 3,800 COP.
Next Steps
Contact GHI to dive deeper into these financial challenges, presented in collaboration with Proyekta Data Solutions. Discover how you can adjust your market access strategy, structure secure financing models, and manage credit risk to effectively connect with healthcare providers in Latin America. Our research team is ready to equip your organization with the strategic regional intelligence and supply chain analysis you need to gain invaluable insights and support confident corporate decision-making.
