Jurnal Manajemen Pelayanan Kesehatan
Vol 13, No 01 (2010)

ANALISIS BIAYA PER KAPITA SEBAGAI UPAYA ADVOKASI PENGENDALIAN BIAYA PROGRAM JAMINAN KESEHATAN JEMBRANA

Januraga, Pande Putu (Unknown)



Article Info

Publish Date
11 Dec 2013

Abstract

Introductions: Jembrana Health Insurance (JHI) program isintended to provide health insurance at first level (PPK I) forinhabitants of Jembrana District. Up till now, financing of JHIdepends on subsidy in which it is growing up and has a trendto be out of target. Therefore, it needs to manage cost byimplementing capitation payment system. Aim of this researchwas to analyze cost per capita and to identify perceptions ofJHI stakeholders towards capitation system.Methods: This research was case study through analyzingsecondary data and performing in-depth interview. Data onmember’s utilization and claim cost were collected using forms.Results: Result of cost per capita calculation based on realutilization of PPK I namely Rp5.262,- per month per member is63 % higher than cost per capita based on normal utilization ofPPK I namely Rp1.949,- per month per member. Furthermore,result of in-depth interview shows that both policy makersand providers have a bad perception towards capitationsystem and results of cost per capita calculation.Conclusions: Local government could apply principles ofmanaged care by controlling cost and quality by developingcapitation payment system for PPK I based on normal utilization.Keywords: health insurance, cost per capita, capitation

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