<![CDATA[Introduction: The high number of Indonesians seeking healthcare services abroad, particularly in Malaysia, Singapore, and Thailand, has led to leakage in national healthcare spending and reflects challenges to the competitiveness of domestic healthcare services. The Indonesian government has responded to this phenomenon by developing Cross-Border Medical Access (CBMA), including the establishment of Health Special Economic Zones (KEK) and strengthening the medical tourism ecosystem. However, the role of Regional General Hospitals (RSUD) in the CBMA strategy remains understudied. This article aims to analyze the position, opportunities, and repositioning strategies of Regional General Hospitals (RSUD) in the development of CBMA in Indonesia. Methods: The study employed a narrative literature review method by examining scientific publications, policy reports, and documents related to CBMA, medical tourism, and hospital development for the 2015–2026 period. The analysis was conducted thematically by integrating the concepts of place marketing, Porter’s Diamond, resource-based view, and healthcare governance. Results: The study shows that most RSUDs still play a passive role as regional referral service providers. However, several regional public hospitals (RSUD) possess geostrategic potential, excellent services, and connectivity to border areas and tourist destinations, which can be developed as cross-border medical access hubs. The analysis yields a three-tier repositioning framework: RSUD as a regional service provider, a center of excellence based on local excellence, and a strategic hub for cross-border medical access. Conclusion: RSUD have the potential to be repositioned as a strategic actor in the development of cross-border medical access. This repositioning has the potential to increase the competitiveness of regional healthcare services, reduce leakage of healthcare spending abroad, and support sustainable regional health and economic development.]]>
