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All Journal Jurnal Kebijakan Kesehatan Indonesia Jurnal Jaminan Kesehatan Nasional
Sitorus, Susy Hartati Novintry
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Decision Sciences, Operations Research & Management Dentistry Health Professions Medicine & Pharmacology Public Health

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Persepsi Stakeholder Tentang Rancangan Model Kebijakan Insentif Pembayaran KBK dengan Indikator RPPT pada FKTP di Medan Sitorus, Susy Hartati Novintry; Puspandari, Diah Ayu
Jurnal Kebijakan Kesehatan Indonesia Vol 13, No 4 (2024): December
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.97643

Abstract

Data BPJS per Desember 2023 , Fktp yang mencapai kriteria rating 4 untuk indikator RPPT hanya 32% , untuk indikator Angka Kontak (AK) 42% dan indikator RRNS 83% dari total 273 fktp yang bekerja sama.  Dengan kondisi data seperti di atas , harus ada faktor yang bisa memotivasi FKTP untuk menaikkan nilai KBK nya salah satunya dengan pemberian insentif. Penelitian ini bertujuan untuk mengeksplorasi persepsi stakeholder tentang model KBK insentif dengan indikator penilaian RPPT di FKTP provider BPJS kesehatan cabang Medan. Persepsi stakeholder terkait rancangan model KBK insentif  yaitu target nilai RPPT antara 5% sampai dengan 10% dengan pemberian insentif secara rating/ bertingkat, indikator intermediet untuk DM adalah Hba1c dan untuk Hipertensi adalah tekanan darah, pembayaran insentif diberikan kepada FKTP, dan dikelola untuk mendorong kegiatan-kegiatan prolanis, serta pembayaran insentif haruslah rutin dan pasti
Stakeholders’ Perceptions of Performance-Based Capitation Design Using Chronic Disease Indicators at Primary Health Care Facilities Sitorus, Susy Hartati Novintry
Jurnal Jaminan Kesehatan Nasional Vol. 5 No. 1 (2025): Jurnal Jaminan Kesehatan Nasional
Publisher : BPJS Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53756/jjkn.v5i1.273

Abstract

Based on BPJS Kesehatan’s utilization review data (Social Security Administrative body for Health) until December 2023, only 32% of 273 primary healthcare facilities met the fourth level for the Controlled prolanis participant ratio (RPPT) indicator. This indicator reflects the percentage of Prolanis-registered patients diagnosed with Diabetes Mellitus (DM) or Hypertension (HT) who have achieved controlled fasting blood glucose (for DM) or controlled blood pressure (for HT), with a performance target of ≥ 5%. Meanwhile, 42% of facilities reached the Angka Kontak (AK/Contact Number) target, which measures the number of participants who contacted Primary Health Care Facilities (FKTP) compared to the total registered participants, multiplied by 1,000; the target is ≥ 150 per mille. However, 83% of facilities achieved the Non-Specialist Referral Ratio (RRNS) target, which compares the number of non-specialist case referrals to total referrals; the target is ≤ 2%. These findings highlight the need for stronger motivation mechanisms, such as financial incentives, to support FKTP in achieving better scores in the Performance-Based Capitation (KBK) model. This study explores stakeholder perceptions regarding an incentive-based KBK model using the RPPT indicator in FKTPs in Medan. Stakeholders shared several key perspectives: (1) RPPT targets should range between 5% and 10%, with incentives tied to rating levels; (2) intermediate outcome indicators should include HbA1c for DM and blood pressure for HT; (3) incentive payments should be allocated to FKTPs and managed to strengthen chronic disease services; and (4) these payments must be consistent and sustainable.
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