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All Journal Jurnal Ventilator: Jurnal Riset Ilmu Kesehatan dan Keperawatan
Sih Retno Widiyati
Universitas Noor Huda Mustofa
Health Professions Nursing Public Health

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Optimasi Anggaran UHC JKN melalui Kebijakan Mapping Kepesertaan Sih Retno Widiyati; Luthfiana Nur; Mustofa Haris; Novi Anggraeni; Eny Susanti
Jurnal Ventilator Vol. 4 No. 2 (2026): Juni : Jurnal Ventilator
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ventilator.v4i2.2455

Abstract

Universal Health Coverage (UHC) through Indonesia’s National Health Insurance (JKN) program aims to ensure equitable access to quality healthcare without causing financial hardship. In Bangkalan Regency, the PBPU and Local Government Contribution (BP Pemda/PBI D) segment represented around 19% of JKN participants in 2024. However, the rapid increase in membership was not supported by adequate regional budget capacity for premium payments. This study analyzed how participant mapping policies through verification and validation processes could improve budget efficiency and support the sustainability of the UHC JKN program. A descriptive qualitative approach was applied using purposive sampling involving 10 heads of primary health centers (puskesmas) and one informant from the Population and Civil Registration Office. Data were collected through questionnaires and document reviews related to JKN membership and health financing regulations, then analyzed thematically. The number of PBPU and BP Pemda participants increased from 108,779 in January to 130,097 in July 2024, while the allocated budget ceiling decreased compared to 2023. Key challenges identified included invalid participant data, weak implementation of local JKN regulations, moral hazard among financially capable residents shifting to subsidized schemes, and limited monitoring mechanisms. The study found that membership mapping through systematic verification and validation could improve targeting accuracy, reduce inefficient premium payments, and strengthen budget sustainability. Strengthened local regulations, intersectoral coordination, and funding support from DBHPR, DBHCHT, and earmarked DAU are crucial for effective implementation.
Co-Authors Eny Susanti Luthfiana Nur Mustofa Haris Novi Anggraeni