<![CDATA[BPJS Kesehatan must be prepared with adequate financial reserves to pay participant claims, which requires careful financial analysis and management. One aspect of this analysis is estimating claim inter-arrival times and claim amounts using data patterns from various hospital types (A, B, C, and D). Given the time-varying intensity of claims, the Non-Homogeneous Poisson Process is the suitable method for this study. The best distribution models were selected based on the smallest Kolmogorov-Smirnov value. The findings indicate the best model for inter-arrival time data is a Pareto distribution, with different parameters for each hospital type. For claim amounts, the analysis shows claims from type A and D hospitals follow a three-parameter Weibull distribution, while claims from type B and C hospitals follow a two-parameter Weibull. Based on these results, BPJS Kesehatan needs to prepare average monthly reserve funds of IDR 10–11 trillion, with extreme scenarios requiring up to IDR 11–12 trillion per month.]]>
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