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"Skripsi ini membahas terkait lessons learned dari pelaksanaan National health Insurance NHI di Taiwan bagi pelaksanaan Jaminan Kesehatan Nasional JKN Indonesia. Indonesia dengan pelaksanaan JKN yang masih berlangsung tiga tahun, masih memerlukan berbagai pembelajaran dan evaluasi sehingga dapat terus mengembangkan program ini sehingga dengan mempelajari negara dengan sistem yang mirip dapat menjadi masukan bagi pelaksanaan JKN. Metode yang digunakan adalah metode review kepustakaan secara sistematis dari berbagai sumber sekunder yang dipublikasikan dan dianalisis dengan menggunakan analisis anotasi bibliografi yang bersifat deskriptif analitik. Terdapat beberapa penerapan sistem pelaksanaan NHI di Taiwan yang juga dapat diterapkan di Indonesia seperti metode pendaftaran kepesertaan, metode perhitungan premi dengan premi dasar dan premi tambahan sesuai gaji dan kategori, serta sistem pelayanan yang terintegrasi melalui sistem informasi dengan kartu IC, serta website sehingga mempermudah proses pelayanan dan akses data kesehatan peserta.

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The purpose of this research is to get the lessons learned from the implementation of Taiwan rsquo s National Health Insurance NHI for Indonesia rsquo s Jaminan Kesehatan Nasional JKN . After three years of implementation, JKN still requires program evaluation and innovation in order to develop this program by studying other countries with similar system. This research used qualitative with systematic literature review method collected from secondary sources and analyzed by using analytic descriptive with bibliographic annotation analysis. There are several methods in Taiwan which can also be implemented in Indonesia such as membership registration method, premium calculation method with standards premium and supplementary premium according to salary and the categories, and the integrated service system through information system with IC Card and website to simplify the service process and make the access to medical record and utilization easier to track."

"Skripsi ini membahas mengenai pembelajaran dari pelaksanaan National health Insurance Program NHIP di Filipina terhadap pelaksanaan Jaminan Kesehatan Nasional JKN di Indonesia. JKN di Indonesia masih memerlukan evaluasi serta inovasi dalam pelaksanaan dan perkembangan agar menjadi program yang berkelanjutan sehingga dengan mengkaji negara tetangga yang memiliki asuransi kesehatan nasional dapat menjadi pembelajaran bagi pelaksanaan JKN. Penelitian ini menggunakan metode studi kepustakaan tersistematis bersumber dari berbagai informasi dan data sekunder yang kemudian dianalisis menggunakan teknik anotasi bibliografi bersifat deskriptif analitik. NHIP di Filipina memiliki beberapa sistem dan metode yang dapat diadaptasi dan diterapkan pada pelaksanaan JKN di Indonesia seperti metode pencakupan peserta, metode pembayaran premi dengan pilihan periode pembayaran serta metode pemberian jaminan dengan batas tertentu sehingga menekan jumlah pembayaran jaminan.

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This study discusses about lessons learned from the implementation of National health Insurance Program NHIP in Philippines for Indonesia rsquo s Jaminan Kesehatan Nasional JKN. JKN still requires evaluation and innovation in order to keep the sustainability by reviewing neighboring countries that have the scheme as well. This study uses systematic literature review method from various secondary sources of information and data which is then analyzed by using an analytic descriptive bibliographic annotation technique. NHIP in the Philippines has several systems and method that can be adapted and applied to the implementation of JKN in Indonesia such as members coverage method, payment of premium method which gives members the choices of payment period as well as the benefits limit method by giving certain limits for members to avail thereby reducing the excessive benefits payment. "

"Skripsi ini membahas tentang pelaksanaan National Health Insurance NHI di Thailand sebagai pembelajaran bagi pelaksanaan Jaminan Kesehatan Nasional JKN di Indonesia. Pelaksanaan JKN di Indonesia masih tergolong baru sehingga memerlukan berbagai evaluasi dan pembelajaran guna meningkatkan kualitas program JKN. Untuk meningkatkan kualitas program JKN, Indonesia harus belajar dari negara lain yang memiliki sistem kesehatan dan karakteristik yang hampir serupa dengan Indonesia. Metode yang digunakan dalam skripsi ini adalah metode telaah kepustakaan secara sistematis dari berbagai sumber sekunder yang dipublikasikan kemudian dianalisis dengan menggunakan analisis anotasi bibliografi yang bersifat deskriptif analitik. Terdapat beberapa penerapan sistem pelaksanaan NHI di Thailand yang dapat diterapkan di Indonesia, seperti perluasan kepesertaan, metode pembiayaan kepada penyedia pelayanan kesehatan, sistem pelayanan kesehatan, dan sistem informasi kesehatan yang terintegrasi.

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This study focuses on the implementation of National Health Insurance NHI in Thailand as a learning for the implementation of Jaminan Kesehatan Nasional JKN in Indonesia. NHI in Thailand has similar applications with JKN in Indonesia in terms of expansion of assurance membership, payment method for health service provider, health service system, and integrated health information system. JKN in Indonesia is still considered new despite its years of execution. Therefore, JKN needs some development to improve the quality of JKN it self by learning from other country who has similar health system and characteristics as Indonesia. This study is using systematic literature review as the research method and the data were collected from various published secondary sources. After collecting data, the data were analyzed using bibliography annotations analyzation."

"ABSTRAKImplementasi Program Jaminan Kesehatan Nasional (JKN) memberikankemudahan masyarakat dalam menikmati layanan kesehatan yang disediakanoleh Pemerintah dan bertujuan mewujudkan Universal Health Coverage bagiseluruh rakyat Indonesia. JKN membawa perubahan sistem pembiayaan kesehatandari Fee For Service Payment (FFS) menjadi Prospective Payment System (PPS)dengan sistem paket INA CBG?s. Ketakutan bahwa JKN merugikan Rumah Sakittidak berlaku untuk 31 Rumah Sakit Vertikal Kementerian Kesehatan. setelahimplementasi JKN terjadi kenaikan pada pendapatan khususnya pendapatanlayanan secara rata-rata pada 31 Rumah Sakit Vertikal Kementerian Kesehatan.Terjadi penurunan yang drastis juga pada masa penagihan piutang. LikuiditasRumah Sakit Vertikal Kementerian Kesehatan sangat tinggi terlebih setelah JKNdiimplementasikan. Likuiditas tinggi belum tentu baik karena dapat diartikanlemahnya manajemen kas

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ABSTRACTNational Health Insurance (NHI) programe implementation giveseasiness to people for enjoying the health service from Govermance and aimed tocomplish the Universal Health Coverage for all Indonesian citizen. NHI bringsgreat change of health finance system that is from Fee For Service (FFS)Payment become Prospective Payment System (PPS) using INA CBG?s package.There?s a fearness that NHI gives a disadvantage for the hospital and it doesn?thappen on 31 State Hospitals Under The Ministry of Health. After theimplementation of NHI, there?s an increasing on average revenue especiallycomes from service activity of 31 State Hospitals Under The Ministry of Health .Theres also a decresing of collectible receivable periode. Liquidity of statehospital is very high especially after JKN implemented. High liquidity is notnecessarily good for hospital because it can be interpreted as weakness in hospitalcash management"

"Memasuki kuartal pertama tahun 2014 sejak diimplementasikannya JKN, nilai (value) penjualan farmasi mengalami penurunan. Bahkan setelah implementasi JKN tahun 2014, pertumbuhan yang dicapai pada tri wulan pertama tahun 2014 hanya sebesar satu digit. Temuan fenomena tersebut mengindikasikan bahwa implementasi JKN berimplikasi pada terjadinya permasalahan pada corporate performance sustainability . Penelitian ini berusaha untuk menjawab permasalahan ?Bagaimana perusahaan farmasi meraih corporate performance sustainability di era JKN?. Penelitian ini bertujuan untuk menguji pengaruh variabel-variabel perubahan lingkungan bisnis, strategi politik, relasional, harga, corporate strategy sustainability dan corporate performance sustainability dengan pendekatan mixed method. Sampel yang digunakan penelitian adalah perusahaan farmasi baik PMDN maupun PMA. Expected outcome yang diharapkan dari penelitian ini adalah untuk menghasilkan sebuah model penelitian yang dapat diterima secara general. Hasil pengujian pengaruh pada variabel-variabel penelitian menunjukkan bahwa perubahan lingkungan bisnis terbukti berpengaruh positif signifikan terhadap strategi politik, relasional, dan harga; strategi politik, relasional, dan harga secara statistik juga terbukti berpengaruh secara positif signifikan terhadap corporate strategy sustainability dan corporate performance sustainability. Sinergi strategi politik, relasional, dan harga memiliki kontribusi yang lebih besar dalam membangun corporate strategy sustainability dan corporate performance sustainability dibanding apabila dilakukan secara terpisah.

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Entering the first quarter of 2014 since the implementation of NHI , the value pharmaceutical sales decreased. Even after the implementation of NHI 2014, the growth achieved in the first quarterly of 2014 only by one digit. The findings of these phenomena indicate that implementation of NHI implicated in the occurrence of problems incorporate performance sustainability. This study seeks to answer the problem"How pharmaceutical companies achieve corporate performance sustainability in NHI era?".

This study aimed to examine the effect of variables changing business environment, political strategies, relational, price, corporate strategy and performance sustainability with the mixed method approach. The sample used is a research pharmaceutical both domestic and FDI companies. Expected outcomes from this research is to produce a research model that can be accepted in general.

The test results on the influence of the variables of research shows that the business environment changing proved to give significant positive effect on political strategy, relational, and price; political strategy, relational, and prices statistically also proved to be significantly give positive effect on the corporate strategy and performance sustainability. The synergies of political strategy, relational, and prices have a greater contribution in building corporate strategy and performance sustainability than if it is done separately."

"Skripsi ini membahas tentang perbandingan peraturan perundangan skema program antara Jaminan Kesehatan Nasional (JKN) yang diselenggarakan dalam program BPJS Kesehatan oleh Badan Penyelenggara Jaminan Sosial (BPJS) di Indonesia dan National Health Insurance (NHI) di Taiwan. Dua fokus permasalahan yang diteliti adalah pengaturan hukum yang mengatur skema program jaminan kesehatan nasional kedua negara dan juga perbandingan kedua skema tersebut. Penelitian ini dilakukan dengan metode yuridis-normatif dan analisis data secara kualitatif. Hasil penelitian menunjukkan bahwa skema program JKN di Indonesia, diatur oleh Undang-Undang Nomor 40 Tahun 2004 tentang Sistem Jaminan Sosial Nasional dan Undang-Undang Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial. Sementara itu, National Health Insurance di Taiwan, yang dijalankan oleh National Health Insurance Administration, diatur oleh National Health Insurance Act Taiwan Tahun 1994. Terdapat persamaan dan perbedaan dalam aspek kepesertaan, fasilitas dan pelayanan kesehatan, serta sumber pendanaan di kedua skema tersebut. Baik program BPJS Kesehatan maupun National Health Insurance menerapkan kepesertaan wajib dan dibiayai melalui iuran peserta, hasil investasi, dan alokasi dana pemerintah. Namun, klasifikasi kepesertaan dan fleksibilitas pemilihan layanan kesehatan di kedua negara berbeda. Skripsi ini menyarankan agar program BPJS Kesehatan mengadopsi pemberlakuan premi tambahan yang besarannya ditentukan berdasarkan kondisi finansial masing-masing peserta, seperti yang dilakukan oleh NHI Taiwan, untuk menciptakan sistem premi yang lebih adil. Program BPJS Kesehatan juga disarankan untuk memberikan fleksibilitas yang lebih besar dalam pemilihan layanan kesehatan, tanpa terpaku pada sistem rujukan berjenjang. Selain itu, integrasi pengobatan alternatif ke dalam program BPJS Kesehatan, sebagaimana dilakukan NHI di Taiwan, juga disarankan.

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This thesis discusses the comparison of legal regulations for the National Health Insurance scheme between Indonesia's Jaminan Kesehatan Nasional (JKN), managed by Badan Penyelenggara Jaminan Sosial (BPJS) under the BPJS Kesehatan program, and Taiwan's National Health Insurance (NHI). The two main focuses of the research are the legal regulations governing the National Health Insurance schemes of both countries and the comparison between the two schemes. This research is conducted using a juridical-normative method and qualitative data analysis. The research results indicate that the JKN scheme in Indonesia is regulated by Law Number 40 Year 2004 concerning the National Social Security System and Law Number 24 Year 2011 concerning the Social Security Administering Body. Meanwhile, the National Health Insurance in Taiwan, managed by the National Health Insurance Administration, is regulated by the National Health Insurance Act Taiwan Year 1994. There are similarities and differences in aspects of membership, health facilities and services, and funding sources in both schemes. Both the BPJS Kesehatan program and the National Health Insurance implement mandatory membership and are funded through participant contributions, investment returns, and government fund allocations. However, there are differences in the classification of membership and the flexibility of choosing health services in both countries. This thesis suggests that the BPJS Kesehatan program should adopt the implementation of additional premiums, the amount of which is determined based on each participant's financial condition, as implemented by the Taiwan NHI, to create a fairer premium system. The BPJS Kesehatan program is also advised to provide greater flexibility in choosing health services, without being tied to a tiered referral system. Furthermore, the integration of alternative medicine into the BPJS Kesehatan program, as carried out by the Taiwan NHI, is also suggested."

"Penelitian ini mengenai Implementasi Program JKN (Jaminan Kesehatan Nasional) di RSUD Pasar Rebo. Penelitian ini menggunakan pendekatan post-positivist yang bersifat deskriptif yang bertujuan untuk mengetahui Implementasi Program JKN (Jaminan Kesehatan Nasional) di RSUD Pasar Rebo yang diukur melalui Indikator-Indikator implementasi kebijakan. Jumlah Informan dalam penelitian ini berjumlah 15 orang, teknik pengumpulan data dengan menggunakan wawancara mendalam dan observasi. Hasil dari Implementasi Program JKN (Jaminan Kesehatan Nasional) di RSUD Pasar Rebo adalah masih banyak masalah yang disebabkan oleh minimnya SDM, kerumitan sistem INA-CBG's, masalah pembiayaan klaim dan sosialisasi JKN.

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This research is about the implementation of JKN Program (National Health Insurance) in Pasar Rebo Hospital. This study uses a post-positivist approach which aims to determine the Program Implementation JKN (National Health Insurance) in Pasar Rebo Hospital as measured by Indicators of policy implementation. Number of Informants in this study around to 18 people, the techniques of data collection using in-depth interviews and observation. Result of the Implementation of JKN Program (National Health Insurance) in Pasar Rebo Hospital is still having a lot of problems caused by the lack of human resources, the complexity of the system INA-CBG's financing problems and socialization JKN claims."

"ABSTRAKKebijakan pemerintah dalam penerapan paket tariff INA-CBG’s untuk pasienJaminan Kesehatan Nasional (JKN) mengakibatkan adanya perbedaan/ selisihantara tariff INA-CBG’s dengan tariff rumah sakit menjadi latar belakangpenelitian ini. Penelitian ini bertujuan untuk mengetahui faktor-faktor apa sajayang mempengaruhi selisih tarif rawat inap INA-CBG’s dengan tarif rumah sakitpasien Jaminan Kesehatan Nasional (JKN) RSUD Leuwiliang periode Januari-April 2014. Jenis penelitian ini adalah kuantitatif yang bersifat deskriptif analitikdengan menggunakan pendekatan cross sectional. Sampel penelitian sebanyak1.853 pasien yang dirawat di ruang perawatan dewasa, anak, bedah, dankebidanan.Hasil penelitian menunjukkan bahwa cakupan pasien Jaminan Kesehatan Nasional(JKN) mencapai 62,45% dari total kunjungan pasien rawat inap. Hasil penelitiandiperoleh jumlah tariff rawat inap INA-CBG’s sebesar Rp 6.176.721.650 dantariff rumah sakit sebesar Rp 2.650.973.448 sehingga terdapat selisih sebesar Rp3.629.344.980 atau sebesar 233%. Terdapat selisih tariff sebesar antara Rp1.902.169 sampai Rp 2.015.095 per pasien di luar dari biaya obat-obatan danbahan medis pakai habis, lebih besar tariff INA-CBG’s dibandingkan dengantariff rumah sakit. Terdapat perbedaan selisih tariff antar : kelas perawatan,jumlah diagnose, lama hari rawat, dan tingkat keparahan penyakit. Faktor yangmempengaruhi selisih tariff rawat inap INA-CBG’s dengan tariff rumah sakitpasien Jaminan Kesehatan Nasional (JKN) adalah kelas perawatan, jumlahdiagnose, dan tingkat keparahan penyakit

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ABSTRACTGovernment policy in the application of INA-CBG tariff package for the patient'sNational Health Insurance (NHI) results in disparities / differences between INACBG'stariff with tariff hospital into the background of this research. This studyaims to determine the factors that influence the difference in hospitalization ratesINA-CBG's rate hospital patients National Health Insurance (NHI) HospitalLeuwiliang the period January to April 2014. Kind of research is quantitativedescriptive analytical approach cross sectional. The study sample as many as1,853 patients were treated in adult treatment, pediatric, surgery, and obstetrics.Results showed that patients coverage of the National Health Insurance (NHI)reached 62.45% of the total inpatient visits. The result showed the number ofinpatient tariff INA-CBG's tariff of Rp 6,176,721,650 and Rp 2,650,973,448hospital so that there is a difference of Rp 3,629,344,980 or by 233%. There is adifference between the tariff of Rp 1,902,169 to Rp 2,015,095 per patient outsideof the cost of medicines and medical materials of its life, greater tariff INA-CBG'scompared to the tariff hospital. There are differences in the tariff differencebetween: class treatment, the number of diagnoses, long day care, and diseaseseverity. Factors affecting the difference in tariff inpatient INA-CBG's with tariffhospital patients of the National Health Insurance (NHI) are a class of treatment,number of diagnosis, and disease severity."

"Program Kader JKN-KIS telah berjalan selama satu tahun, sejak April 2017 di BPJS Kesehatan Kantor Cabang Depok. Penagihan dan pengumpul iuran pada kelompok PBPU menjadi tujuan utama dari program tersebut. Penelitian ini membahas efektivitas implementasi program Kader JKN-KIS melalui evaluasi input, process, dan output di BPJS Kesehatan Kantor Cabang Depok tahun 2018. Jenis penelitian ini adalah kualitatif menggunakan wawancara mendalam, Focus Group Discussion FGD, dan telaah dokumen. Variabel yang diteliti menggunakan gabungan Model CIPP Context, Input, Process, Product dan Model George Edward III. Hasil dari penelitian menunjukkan komunikasi, sumber daya, disposisi, struktur birokrasi, dan kegiatan program Kader JKN-KIS sudah berjalan dengan baik dan sesuai dengan pedoman pelaksanaan serta terdapat peningkatan angka kolektabilitas kelompok PBPU dari 61,32 menjadi 68,80 pada bulan Januari 2018 dan tersisa 25,59 jumlah penduduk kota Depok yang belum terdaftar sebagai peserta JKN. Walaupun demikian terdapat beberapa hal yanng perlu ditingkatkan dalam program ini, yaitu pengelolaan kembali SDM dan peninjauan kembali insentif untuk Kader.

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National Health Insurance JKN KIS Cadre Program has been running for one year, since April 2017 in BPJS Health Depok Branch Office. Billing and collection of contributions to PBPU group are the main objectives of the program. This study discusses the effectiveness of JKN KIS Cadre program implementation through input, process, and output evaluation in BPJS Kesehatan Depok Branch Office 2018. This type of research is qualitative using in depth interview, Focus Group Discussion FGD , and document review. The variables studied use a combination of CIPP Model Context, Input, Process, Product and George Edward III Model.

The result of the research shows that communication, resources, disposition, bureaucracy structure, and program activity of Kader JKN KIS have been run well and in accordance with the implementation guidelines and there is an increase of collectability rate of PBPU group from 61.32 to 68.80 in January 2018 and the remaining 25.59 of the total population of Depok city that has not been registered as a participant of JKN. Nevertheless, there are several things that need to be improved in this program, namely the re management of human resources and incentive review for the Cadre. "

"This paper is a literature review laying out empirical evidence of healthcare access inequity within an implementation of social health insurance (SHI) programs. The research question of this paper is: in what way, and how, inequity in healthcare access potentially happens, even if a type of SHI covers the whole, or most, of a society. This paper is mainly motivated by the implementation of Jaminan Kesehatan Nasional (JKN), an SHI program in Indonesia. Even though the program aims to create better equity in healthcare access, the existing health system and the program’s design may prevent the achievement of this goal. By laying out evidence on how healthcare access inequity in other countries remains within an SHI mechanism, this paper illuminates that JKN may face the same risk. In reviewing the papers, this study applied Goddard and Smith’s (2001) concept of healthcare access inequity in the area of availability, quality, cost, and information. The findings suggest that healthcare access inequity could happen despite the implementation of an SHI program. Four types of circumstances that might have led to healthcare access inequity include geographical disparities of health facilities; adequacy of insurance program’s reimbursement and healthcare providers’ financial motive; healthcare providers’ prejudices toward patients; and unequal personal advantages of health treatment seekers. When applied to the context of JKN implementation in Indonesia, the risks of healthcare access inequity are imminent, mostly due to the uneven concentration of health facilities, the program’s segmented tariff rates, and the socioeconomic diversity among JKN members. The findings imply that JKN members might be at risk of healthcare access inequity. While the risks are plausible, this study is limited to predicting the potential inequity within JKN, mirroring from the empirical evidence. This study signifies the need for further empirical research on this area, which will potentially inform policymakers to improve the program."