Analysis of the implementation of capitation policy based on service commitment at Social Security Agency on Health, Semarang-Indonesia
DOI: https://doi.org/10.33024/minh.v8i9.1316
BPJS Health Capitation Health Insurance National Health Insurance Performance-based Capitation
Abstract
Background: Performance-based capitation payments are an innovative approach in the health financing system implemented by Social Security Agency on Health (BPJS Health).
Purpose: To analyze of the implementation of capitation policy based on service commitment.
Method: A descriptive qualitative approach with a case study approach, which aims to analyzing the implementation of the Performance-Based Capitation policy, by taking four variables that are considered most crucial in determining the success of the implementation of the Performance-Based Capitation policy in the city of Semarang, with the policy implementation model approach from Donald Van Meter and Carl Van Horn, namely communication factors, resources, implementer disposition, and implementer characteristics.
Results: This approach aims to stimulate the provision of higher quality and more efficient health services, by providing incentives to health service providers based on optimal performance and service outcomes. The implementation of performance-based capitation payments provides several benefits, including increased accountability of health service providers, more effective cost management, and stimulation of innovation in service provision.
Conclusion: Performance-based capitation payments by BPJS Health are a step forward in creating a health insurance system that focuses on service quality. Performance-based capitation payments by BPJS Health are a step forward in creating a health insurance system that focuses on service quality.
Downloads
References
Agustina, A., Hidayat, B., & Noormanadi, P. (2022). Kajian Sistematis: Perkembangan Sistem Pembayaran Kapitasi Berbasis Penyesuaian Risiko di Berbagai Negara. Jurnal Ekonomi Kesehatan Indonesia, 6(2), 81–94.
Agustinakhoeriyah, G., Mardiah, I. M., & Hidayati, M. H. (2021). Analisis Faktor Yang Mempengaruhi Kapitasi Berbasis Komitmen (KBK) Di Puskesmas Cikancung Dinas Kabupaten Bandung. Cerdika: Jurnal Ilmiah Indonesia, 1(8), 954–959.
Anggraini, M. R., Permatasari, P., Azahra, S., & Astuti, W. D. (2024). Efektivitas penilaian kinerja dan penggajian berbasis kinerja dalam peningkatan kualitas layanan kesehatan. Indonesian Journal of Health Science, 4(6s), 883–892.
Ardhiasti, A., & Setiawan, E. R. (2021). Pembayaran Kapitasi Berbasis Kinerja Pada Fasilitas Kesehatan Tingkat Pertama (FKTP) Kota Malang. Jurnal Pendidikan Kesehatan, 10(2), 208–225.
Aryani, A. D. (2022). Factors Affecting the Achievements of Performance-Based Capitation: A Scoping Review. Jurnal Jaminan Kesehatan Nasional, 2(1), 53–65.
Darmawan, A., Kusdiyah, E., Enis, R. N., Susantara, S., Realita, E. (2020). Kajian Capaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan (KBK) BPJS Di FKTP Kota Jambi. Jambi Medical Journal, 8(1), 315-324.
Erkan, I., & Unal, M. (2022). Total quality management practices in health services. Pressacademia, 9(4), 197-205.
Fadila, R., Via, M. P., Dewiyani, A. C., & Ardhia, A. (2023). Analisis Pencapaian Indikator Kapitasi Berbasis Kinerja Pada Masa Pandemi Covid 19. Jurnal Kesehatan Qamarul Huda, 11(1), 241–249.
Hartawan, R. C., & Kosasih, F. (2023). Implementation of the Van Meter and Van Horn Zoning System Policies Model. International Journal Of Humanities Education And Social Sciences (IJHESS), 2(4), 1348–1358.
Khujaefah, K., Ratnawati, R., & Yuliyanti, S. (2020). Hubungan Tingkat Pencapaian Indikator Kapitasi Berbasis Kompetensi (KBK) Dengan Kepuasan Pasien. Buletin Penelitian Sistem Kesehatan, 23(3), 205–213.
Kurhayadi, K. (2023). Public Policy Implementation: A Theoretical Review. Ministrate: Jurnal Birokrasi Dan Pemerintahan Daerah, 5(1), 10–18. https://doi.org/10.15575/jbpd.v5i1.23742
Mubarok, S., Zauhar, S., Setyowati, E., & Suryadi, S. (2020). Policy Implementation Analysis: Exploration of George Edward III, Marilee S Grindle, and Mazmanian and Sabatier Theories in the Policy Analysis Triangle Framework. Journal of Public Administration Studies, 5(1), 33–38.
Mujiburrahman, M., & Sofyandi, A. (2021). Analisis Komunikasi dan Sumberdaya dalam Implementasi Kebijakan Kapitasi Berbasis Komitmen Pelayanan Badan Penyelenggara Jaminan Sosial (KBK-BPJS). Bima Nursing Journal, 2(2), 90-103.
Petryk, S., Andrieiev, I., Tishko, D., Kurbanov, A., & Yunger, V. (2023). The effectiveness of quality management strategies in health care organizations: an analysis of quality standards implementation and clinical performance improvement. Revista Amazonia Investiga, 12(68), 333–345.
Rahmani, A. A., & Putri, N. K. (2023). Distribusi Peserta Jaminan Kesehatan Nasional pada Fasilitas Kesehatan Tingkat Pertama di Kecamatan Gubeng, Surabaya. Media Gizi Kesmas, 12(2), 1036–1040.
Sambodo, N. P., Bonfrer, I., Sparrow, R., Pradhan, M., & van Doorslaer, E. (2023). Effects of performance-based capitation payment on the use of public primary health care services in Indonesia. Social Science and Medicine, 327, 115921.
Sukohar, A., Suryawinata, A., & Mediansyah, A. (2020). Quality of Health Services in the First Level Health Facilities and the Role of Quality and Cost Control Team in Lampung Province. Review of Primary Care Practice and Education (Kajian Praktik Dan Pendidikan Layanan Primer), 3(1), 8.
Syukran, M., & As-Shidieq, F. H. (2020). Dampak Kapitasi Khusus Terhadap Capaian Kinerja Fasilitas Kesehatan Tingkat Pertama Di Kabupaten. Jurnal Manajemen Pelayanan Kesehatan, 23(4), 114–119.
Widodextrosa, W., Muryanto, I., Rany, N., Hanafi, A., & Puspasari, A. (2021). Analisis Upaya Pencapaian Indikator Kapitasi Berbasis Pemenuhan Komitmen Pelayanan (KBPKP) di Puskesmas Rumbai Kota Pekanbaru. Jurnal Kesehatan Komunitas, 6(3), 310–327.
Witter, S., Toonen, J., Meessen, B., Kagubare, J., Fritsche, G., & Vaughan, K. (2013). Performance-based financing as a health system reform: Mapping the key dimensions for monitoring and evaluation. BMC Health Services Research, 13(367), 1–10.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Dian Ratna Arifin
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
