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"Era JKN sudah menjadi isu nasional bagi Negara Indonesia sejak lama. Rumah sakit sebagai penyedia layanan kesehatan harus segera berbenah diri. Dengan skema pembayaran yang berubah dari fee for services menjadi Case based group menuntut rumah sakit untuk berlaku efisien dalam menggunakan sumber daya seperti: obat dan tindakan medis maupun penunjang medis. Siloam Hospitasl Balikpapan mengalami selisih dalam penagihan oleh karena itu dilakukan analisa terhadap faktor-faktor yang merugikan keuangan dengan metode perbandingan pada clinical pathway dan metode kualitatif pada informan. Didapatkan bahwa clinical pathway yang ada belum menjadi pengendali mutu dan biaya. Sehingga harus dilakukan review terhadap penggunaan clinical pathway karena dibutuhkan pengendali biaya dan mutu dalam pelayanan kesehatan di rumah sakit khusus rumah sakit dengan skema pembayaran Case based group.

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JKN era has become a national issue for the State Indonesia since long time. Hospital as a health care provider must immediately improve itself. By changing the scheme of payment of fees for services became Case-based group requires hospitals to apply efficient use of resources such as drugs and medical procedures and medical support. Siloam Hospitals Balikpapan has difference in billing therefore conducted an analysis of the factors that the financial adverse by the method of comparison on clinical pathways and qualitative methods to informant. It was found that the existing clinical pathways have not become a controlling quality and costs. So it should be a review of the use of clinical pathways because it takes control of cost and quality in health care in special hospitals hospitals with Case payment scheme based group."

"ABSTRAKNama : Imas Rahmi WisdianiProgram Studi : Kajian Adminstrasi Rumah SakitJudul Tesis : Analisis Implikasi Sistem Pembayaran JKNterhadap Pendapatan Rumah Sakit di Dua RumahSakit Swasta Kelas C di Karawang Tahun 2017 Studi Kasus Herniotomi Tanpa Penyulit Besaran tarif yang diatur dalam INA-CBG mendorong rumah sakit untukmenciptakan berbagai macam upaya khususnya berupa usaha pengendalian biayaagar tercipta efisiensi yang baik dan mutu pelayanan kesehatan tetap berkualitas.Penelitian ini bertujuan untuk menganalisis implikasi system pembayaran JKNterhadap pendapatan rumah sakit di dua rumah sakit swasta kelas C berdasarkantarif BPJS dan tarif rumah sakit.Desain penelitian ini berupa studi kasus di dua rumah sakit swasta kelas C dengandesain potong lintang dan melihat tren yang terjadi pada periode tahun 2014 ndash; 2016.Pengumpulan data dilakukan dalam dua bagian, analisis kuantitatif bertujuan untukmenganalisis selisih pendapatan berdasarkan tarif BPJS dan tarif rumah sakit danmenganalisis komponen-komponen yang menentukan besaran tarif rumah sakit.Analisis kualitatif bertujuan untuk mendapatkan informasi kebijakan-kebijakan danupaya-upaya yang dilakukan oleh pihak manajemen rumah sakit dalam meresponselisih biaya. Penelitian dilakukan pada bulan Mei ndash; Juni 2017 di RS A dan RS Bdengan karakteristik rumah sakit yang mirip dan bekerjasama dengan BPJS sejaktahun 2014.Terdapat selisih negatif antara pendapatan berdasarkan tarif umum denganpendapatan berdasarkan tarif BPJS pada periode tahun 2014 ndash; 2016 baik di RS Amaupun di RS B. Selisih negative di RS A sebesar 21,2 dari nilai pendapatanberdasarkan tarif umum, dan selisih negative di RS B sebesar 50,5 dari nilaipendapatan berdasarkan tarif umum. Besaran tarif dan metode pembayaran INACBGsmenyebabkan adanya upaya-upaya efisiensi dan kendali biaya rumah sakitbagi pasien BPJS berupa pembayaran jasa medis yang lebih rendah, penggunaanobat generik, pengendalian pemeriksaan penunjang, pengendalian biaya di ruangoperasi serta pengendalian jumlah hari rawat.Kata kunci : pembayaran JKN, pendapatan Rumas sakit, Rumah Sakit swasta,

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ABSTRACTNama Imas Rahmi WisdianiProgram Studi Hospital AdministrationJudul Tesis Analysis on JKN Payment System and its relationto Hospital Income in two type C private hospitals inKarawang, 2017The implementation of payment system using INA CBGs bundling has leadhospital to improve efficiency to provide good quality of care. The purpose of thisstudy is to analyze implication of JKN payment system toward hospital revenue intwo type C private hospitals.This case study in two type C private hospitals was done using Cross Sectionaldesign. Data was retrospectively collected to capture trend for period 2014 2016,and analysed to compare hospital revenue using hospital charge vs BPJSpayment scheme as set up by BPJS. The study was conducted in May June 2017covering 548 cases with Herniotomy in the two private hospitals with similarcharacteristics and contracted as BPJS service provider since 2014.The study revealed that both hospitals tend to have lower revenue from BPJS usingbundling scheme as compared to hospital charge, for period 2014 2016. The resultshowed that in hospital A 21,2 loss and in hospital B was 50,5 loss, this maycaused by unefficient use of resources, or no proper monitoring system. The twohospitals have tried to improved efficiency, implement cost containment such asfee adjustment, use of generic drug, proper length of stay, cost containment inproviding medical exam and operation.Key words JKN payment, private hospital, revenue"

"[ABSTRAKPer 1 Januari 2015, pemberi kerja diwajibkan untuk mendaftarkan tenaga kerjanya pada program JKN. Terdapat sanksi bagi badan usaha yang melanggar peraturan tersebut. Sebagian besar badan usaha mendaftar JKN dikarenakan peraturan pemerintah yang mewajibkan untuk mendaftar. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik dan persepsi peserta badan usaha di BPJS Kesehatan KCU Bekasi terhadap penyelenggaraan program JKN. Penelitian menggunakan metode kuantitatif dengan pendekatan cross sectional yang dianalisa secara univariat, jumlah sampel sebanyak 75 responden badan usaha yang diambil secara purposive sampling. Karakteristik responden badan usaha, paling banyak didominasi oleh badan usaha yang berasal dari sektor industri pengolahan (44%), jumlah tenaga kerja > 99 orang (62,7%), upah tenaga kerja seluruhnya dibayar sesuai dengan UMK (44%), lama kepesertaan pada program JKN ≥ 8 bulan (57,3%), tenaga kerja sudah seluruhnya didaftarkan (56%), dan sudah memiliki asuransi kesehatan sebelum JKN (86,7%). Sedangkan persepsi badan usaha dilihat dari 5 aspek yakni persepsi terhadap peraturan JKN, kepesertaan JKN, kontribusi iuran, pelayanan kesehatan, dan prosedur pendaftaran. Hasil penelitian menunjukkan 5,3% badan usaha dengan persepsi kurang; 77,3% dengan persepsi cukup; dan 17,3% dengan persepsi baik. Beberapa hal yang masih perlu ditingkatkan seperti sosialisasi, pelayanan medis pasien JKN, dan pelayanan di BPJS Kesehatan.

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ABSTRACT

;"In January 1, 2015, employer are required to register their employee in"

"Jaminan Kesehatan Nasional (JKN) program. There are penalties for enterprises that against these rules. Most enterprises register JKN due to government regulations that require to register. This study aims to describe the characteristics and perceptions of enterprise participants in BPJS Kesehatan KCU Bekasi about the implementation of JKN. This study used quantitative method with cross sectional approach and univariate analysis, a total sample of 75 enterprise respondents were taken by purposive sampling. Characteristics of enterprise respondents, the most widely dominated by enterprise from the manufacturing sector (44%), the amount of employee > 99 people (62.7%), employee wages paid entirely in accordance with the UMK (44%), length of membership in JKN program ≥ 8 months (57.3%), employee has been fully registered (56%), and already have health insurance before JKN (86.7%). While the perception of enterprise seen by 5 aspects which are perceptions of JKN regulatory, JKN participation, contribution fees, health services, and registration procedures. The results showed 5.3% of enterprises with less perception;"

"77.3% with sufficient perception; and 17.3% with good perception. Some things need to be improved such as socialization, medical services for JKN patients, and services in BPJS Kesehatan.", "In January 1, 2015, employer are required to register their employee in"

"Jaminan Kesehatan Nasional (JKN) program. There are penalties for enterprises that against these rules. Most enterprises register JKN due to government regulations that require to register. This study aims to describe the characteristics and perceptions of enterprise participants in BPJS Kesehatan KCU Bekasi about the implementation of JKN. This study used quantitative method with cross sectional approach and univariate analysis, a total sample of 75 enterprise respondents were taken by purposive sampling. Characteristics of enterprise respondents, the most widely dominated by enterprise from the manufacturing sector (44%), the amount of employee > 99 people (62.7%), employee wages paid entirely in accordance with the UMK (44%), length of membership in JKN program ≥ 8 months (57.3%), employee has been fully registered (56%), and already have health insurance before JKN (86.7%). While the perception of enterprise seen by 5 aspects which are perceptions of JKN regulatory, JKN participation, contribution fees, health services, and registration procedures. The results showed 5.3% of enterprises with less perception;"

"77.3% with sufficient perception; and 17.3% with good perception. Some things need to be improved such as socialization, medical services for JKN patients, and services in BPJS Kesehatan."]"