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"Tesis ini membahas mengenai praktek Collaborative Governance dalam penanganan defisit anggaran pada program Jaminan Kesehatan Nasional (JKN) di Indonesia. Pemerintah telah melaksanakan banyak program top-down dalam penanggulangan defisit anggaran pada program JKN-KIS, tetapi upaya tersebut belum menunjukkan tren positif pada peningkatan penerimaan pada Badan Penyelenggara Jaminan Sosial (BPJS) bidang Kesehatan. Keprihatinan terhadap kondisi tersebut telah menjadi perhatian berbagai pihak. Dengan berkembangnya ilmu pengetahuan dan  tekhnologi serta tingkat partisipasi masyarakat, upaya kerjasama dalam penanganan masalah publik kini tidak lagi hanya di inisiasi oleh pemerintah. Lembaga swadaya masyarakat pada kenyataannya dapat menjadi penggerak dalam tata kelola pemerintahan kolaboratif. Penelitian ini bertujuan menjelaskan kecenderungan model collaborative governance yang digunakan pada penanganan difisit anggaran pada program JKN-KIS di Indonesia. Basis teori yang digunakan adalah collaborative governance dengan pengujian dan analisis melalui model collaborative governance yang dikembangkan oleh Ansell dan Gash (2007) dan Emerson dan Nabatchi (2015). Peneliti menggunakan pendekatan postpositivism dengan metode hybrids yakni melalui analisis data kualitatif serta melakukan konversi hasil penelitan kedalam bentuk grafik keuantitatif. Hasil penelitian menunjukkan bahwa dalam praktik kolaborasi yang terjadi tidak terdapat kecenderungan yang dominan pada masing-masing model yang ada. Akan tetapi terdapat tiga kondisi yang terjadi: (1) kecenderungan pada salah satu, (2) percampuran hybrid dari kedua model kolaborasi, dan (3) tidak memiliki cenderung pada model yang ada.  Akan tetapi, terdapat perbedaan antara model collaborative governance yang dirumuskan berdasarkan kasus-kasus yang diteliti oleh Ansell dan Gash (2007) maupun Emerson dan Nabatchi (2015). Terakhir, penulis meyakini bahwa tidak ada one-size-fits-all pada setiap model dan memberikan rekomendasi yang relevan dengan hasil penelitian ini.

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This thesis discusses the practice of Collaborative Governance in dealing with budget deficits in the National Health Insurance (JKN) program in Indonesia. The government has implemented many top-down programs in overcoming the budget deficit on the JKN-KIS program, but these efforts have not shown a positive trend in increasing revenues at the Health Social Security Organizing Agency (BPJS Kesehatan). These conditions have become the concern of various parties. Through the development of science and technology and the level of community participation, efforts to collaborate in handling public problems are no longer just initiated by the government agency. In fact, non-governmental organizations can be a driver in collaborative governance. This study aims to explain the tendency of collaborative governance models used in handling budget deficits in the JKN-KIS program in Indonesia. The theoretical basis used is collaborative governance with testing and analysis through collaborative governance models developed by both Ansell and Gash (2007) and Emerson and Nabatchi (2015). This research conducted through postpositivism approach with the hybrids method that is qualitative data analysis and converting the results of the research into quantitative graphs. The results of the study show that in collaborative practices that occur there is no dominant tendency in each existing model. However, there are three conditions that occur: (1) the tendency of one, (2) hybrid mixing of the two collaboration models, and (3) not having a tendency to the existing model. However, there are differences between collaborative governance models formulated based on the cases examined by Ansell and Gash (2007) and Emerson and Nabatchi (2015). Finally, the authors believe that there is no one-size-fits-all on each model and provide relevant recommendation to the results of this study."

"Warga negara berhak untuk mendapatkan perlindungan dasar agar kebutuhan dasar dapat terpenuhi, walau merupakan program yang masih baru Jaminan Sosial yang dihadirkan oleh negara berdampak sangat besar bagi kesehatan dan kesejahteraan rakyat Indonesia, namun implementasinya jaminan sosial yang berbasis skema iuran ini terdapat permalahan yaitu defisit iuran yang dihimpun dengan jumlah klaim yang harus dibayarditambah dengan beban operasional sehingga tiap tahun terus terjadi peningkatan defisit. Dengan menggunakan pendekatan kualitatif, hasil penelitian ini menunjukan bahwa proses penanggulangan defisit secara kolaboratif belum memenuhi seluruh unsur kolaboratif karena rendahnya partisipasi masyarakat dan dukungan dari para pengusaha dan swasta akan keberlangsungan program ini. Adapun upaya membangun kolaborasidalam penanggulangan defisit program jaminan sosial nasional adalah dengan membentuk komitmen dengan antar stakeholders, sikap saling memiliki dan saling ketergantungan, serta adanya sikap saling menghormati hingga pemahaman bersama diantara stakeholders, dukungan politik dan dukungan masyarakat yang dilibatkan menjadi inti membangun kolaborasi terutama menanamkan asas gotong-royong pada masyarakat

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Citizens are entitled to basic protection social security, social security presented by the state is very large for the health and welfare of the people of Indonesia, but the implementation of this contribution-based social security scheme has problems. This contribution deficit collected by the number of claims to be paid plus operational expenses so that each year the deficit continues to increase. By using a qualitative approach, the results of this research indicate that the collaborative deficit reduction process has not fulfilled all collaborative elements due to the low community participation and support from entrepreneurs and the private sector for the sustainability of this program, The effort to build collaboration in overcoming the deficit of the national social security program is by forming commitments among stakeholders, attitude of mutual ownership and interdependence, and the existence of mutual respect to mutualunderstanding among stakeholders, political support and community support that are involved are at the core of building collaboration especially instilling the principle of mutual cooperation in the community."

"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."

"ABSTRAKSejak implementasinya pada tahun 2014, program Jaminan Kesehatan Nasional (JKN) telah mendorong peningkatan utilisasi pelayanan kesehatan baik di Fasilitas Kesehatan Tingkat Pertama (FKTP) maupun di Fasilitas Kesehatan Rujukan Tingkat Lanjutan (FKRTL). Tingginya utilisasi ini berdampak terhadap tingginya biaya pelayanan kesehatan yang ditanggung oleh BPJS Kesehatan sebagai pelaksana JKN. Di sisi lain, sasaran utama program JKN yaitu peserta PBI masih dianggap belum optimal dalam pemanfaatan pelayanan kesehatan, berbeda dengan peserta PBPU yang dianggap overutilisasi. Dengan metode analisa cross section, penelitian ini melihat bagaimana karakteristik utilisasi pelayanan kesehatan dari peserta JKN pada kelompok pesertaPenerima Bantuan Iuran (PBI) dan kelompok peserta Pekerja Bukan Penerima Upah (PBPU) di FKRTL khususnya rumah sakit. Teknik Principal Component Analysis (PCA) dipilih untuk mereduksi variabel-variabel durasi perawatan, biaya rumah sakit dan tingkat keparahan menjadi variabel baru berbentuk indeks utilisasi rumah sakit. Kemudianmenggunakan model estimasi Ordinary Least Square (OLS) untuk menganalisa tingkat utilisasi rumah sakit. Kami menemukan bahwa terdapat dua jenis utilisasi rumah sakit dengan hasil yang berbeda, pada utilisasi frekuensi, PBPU memiliki tingkat utilisasi lebih banyak dari PBI, namun pada utilisasi status kesehatan saat berobat, peserta PBI lebih buruk dibandingkan dengan peserta PBPU dengan signifikansi pada tingkat 1%. Temuan ini menunjukkan bahwa ketika peserta PBI berobat di rumah sakit akan memiliki kecenderungan dirawat lebih lama, dengan biaya lebih besar dan dengan status kesehatan yang lebih parah jika dibandingkan dengan peserta PBPU. Hasil penelitian ini jugamenunjukkan bahwa kelompok peserta PBI dengan frekuensi berobat yang lebih sedikit dibandingkan PBPU memiliki status kesehatan yang lebih buruk.

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ABSTRACTSince its implementation in 2014, the National Health Insurance (JKN) program has encouraged increased utilization of health services both at the First Level Health Facility (FKTP) and at the Advanced Referral Health Facility (FKRTL). This high utilization has an impact on the high cost of health services borne by the Health BPJS as JKN`s Operator. On the other hand, the main target of the JKN program is that PBI are still considered to be not optimal in the utilization of health services, in contrast to PBPU who are considered to be overutilized. With the crosssection analysis method, this study looks at how the characteristics of health service utilization of JKN participants in the contribution group of Contribution Beneficiaries (PBI) and the group of Non-RecipientWorkers (PBPU) in FKRTL especially hospitals. Principal Component Analysis (PCA) technique was chosen to reduce variables of the duration of treatment, hospital costs and severity to new variable in the form of hospital utilization index. Then we use the Ordinary Least Square (OLS) estimation model to analyze the level of hospital utilization. We foundthat there are two types of hospital utilization with different results, in frequency utilization, PBPU has more utilization rates than PBI, but in health status utilization during treatment, PBI are worse than PBPU with significance at 1% level. These findings indicate that when PBI participants seek treatment at a hospital will have a tendency to be treated longer, at a higher cost and with a more severe health status when compared to PBPU participants. The results of this study also showed that the PBI participant group with less frequency of treatment compared to PBPU had worse health status."

"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. "

"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."

"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. "

"Implementasi Program Jaminan Kesehatan Nasional (JKN) memberikan kemudahan masyarakat dalam menikmati layanan kesehatan yang disediakan oleh Pemerintah dan bertujuan mewujudkan Universal Health Coverage bagi seluruh rakyat Indonesia. JKN membawa perubahan sistem pembiayaan kesehatan dari Fee For Service Payment (FFS) menjadi Prospective Payment System (PPS) dengan sistem paket INA CBG?s. Ketakutan bahwa JKN merugikan Rumah Sakit tidak berlaku untuk 31 Rumah Sakit Vertikal Kementerian Kesehatan. setelah implementasi JKN terjadi kenaikan pada pendapatan khususnya pendapatan layanan secara rata-rata pada 31 Rumah Sakit Vertikal Kementerian Kesehatan. Terjadi penurunan yang drastis juga pada masa penagihan piutang. Likuiditas Rumah Sakit Vertikal Kementerian Kesehatan sangat tinggi terlebih setelah JKN diimplementasikan. Likuiditas tinggi belum tentu baik karena dapat diartikan lemahnya manajemen kas.

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National Health Insurance (NHI) programe implementation gives easiness to people for enjoying the health service from Govermance and aimed to complish the Universal Health Coverage for all Indonesian citizen. NHI brings great 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't happen on 31 State Hospitals Under The Ministry of Health. After the implementation of NHI, there's an increasing on average revenue especially comes from service activity of 31 State Hospitals Under The Ministry of Health. Theres also a decresing of collectible receivable periode. Liquidity of state hospital is very high especially after JKN implemented. High liquidity is not necessarily good for hospital because it can be interpreted as weakness in hospital cash management."

"Penelitian ini membahas mengenai faktor-faktor yang mempengaruhi keputusan pembelian Jaminan Kesehatan Nasional pada pedagang kaki lima. Rancangan penelitian adalah analitik kunatitatif dengan pendekatan potong lintang. Hasil penelitian menunjukkan bahwa dari 100 responden yang diteliti, 43 responden telah membeli JKN. Hasil uji Chi-square menunjukan bahwa ada hubungan yang signifikan antara usia, pendapatan, risiko riwayat penyakit kronis keluarga, risiko finansial keluarga,harga/iuran JKN, tempat/lokasi BPJS Kesehatan, tempat/lokasi rumah sakit, bukti fisik BPJS Kesehatan; dan SDM (Sumber Daya Manusia) BPJS Kesehatan dengan keputusan pembelian Jaminan Kesehatan Nasional pada pekerja sektor informal (pedagang kaki lima) di Kota Bogor Tahun 2017.

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This study analyzed the factors affecting the decision for purchasing National Health Insurance (JKN Program) among street vendors. The study design was analytical quantitative with cross sectional approach. The result of research showed that from 100 respondents who had been interviewed, 43 respondents had bought National Health Insurance. Chi-square test showed that there were significant results between age, income, family history of chronic disease, family financial risk, premium of JKN Program, the location of BPJS Kesehatan, the location of hospital, proof of BPJS Kesehatan, and human resources of BPJS Kesehatan with decision for purchasing national health insurance among street vendors in Bogor 2017."

"Berdasarkan Praturan Presiden No 111 Tahun 2013 tentang pasal 6 yang menyebutkan bahwa kepesertaan jaminan kesehatan bersifat wajib dan mencakup seluruh penduduk Indonesia. Dalam upaya pencaian Universal Health Coverage pada tahun 2019, baik badan usaha besar dan menengah paling lambat mendaftar 1 Januari 2015 sedangkan badan usaha mikro paling lambat mendaftar 1 Januari 2016. BPJS Kesehatan terus meningkatkan kepesertaannya, jumlah badan usaha di BPJS Kabupaten Bogor tercatat 1.470 kelompok badan usaha yang sudah terdaftar dan jumlah badan usaha yang belum mendatar tercatat 245.Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempegaruhi keikutsertaan badan usaha dalam Program Jaminan Kesehatan Nasional di wilayah kerja BPJS Kesehatan Kabupaten Bogor tahun 2017.Penelitian ini menggunakan metode penelitian kualitatif dengan menggunakan tehnik wawancara mendalam kepada salah satu perwakilan badan usaha yang menangani jaminan kesehatan karyawan. Variabel yang diteliti mengunakan teori perilaku konsumen dalam pengambilan keputusan pembelian yaitu modifikasi model teori Kolter dan Amstrong 2009, Kolter dan Keller 2009.Hasil dari penelitian menunjukkan bahwa keikutsertaan Badan Usaha menjadi peserta BPJS Kesehatan karena adanya peraturan wajib untuk mendaftar, premi lebih murah dan pelayanan yang diberikan komprehensif. Bagi badan usaha yang belum mendaftar merasa kurang puas dengan produk dan askes pelayanan kesehatan yang diberikan di fasilitas kesehatan yang bekerjasama dengan BPJS Kesehatan.

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Based on Peraturan Presiden No 111 Tahun 2013 Pasal 6 article 6 explain that membership of health insurence is a must for indonesian citizen. In order to achieve universal health coverage, large and middle scale company must register their membership in national health insurance by January 1 39 st, 2015 at the latest, while small company on January 1 39 st, 2016. BPJS Kesehatan has been increasing their membership, the companies which already become member of BPJS Kesehatan in Bogor Regency were recorded 1.470. But there are still 245 companies which are not become member yet.

The purpose of this research to know the factors influencing companies to become member of National Health Insurance programme in Bogor Regency in 2017.

This research using qualitative method by depth interview to each company representative who handle employee health insurance. As the variable of this research using the theory of consumer behaviour in making buying decision by Kotler and Amstrong 2009, Kotler and Keller 2009 modification theory.

The result of this research show that the company like to join BPJS Kesehatan because of the regulation state that membership is obligatory. Beside that, BPJS Kesehatan offering cheaper insurance premium and comprehensive services. But some companies which are not joining BPJS Kesehatan feel not satisfied with the product and health service access in BPJS Kesehatan health facilities. "