<![CDATA[JKN demands cost-efficiency while syariah hospitals must uphold Islamic values consistently. Interoperable syariah systems in INA-CBGs-based JKN hospitals are examined for their influence on managerial practice, service quality, and operational efficiency. This research using a mixed-method, multi-case study in private Type B and C syariah hospitals. Syariah interoperability is operationalized as the alignment of syariah values and policies, governance, and hospital information systems with clinical and administrative processes, measured through Likert-scale surveys and qualitative analysis of open-ended responses and documents. Syariah values, policy frameworks, integration of MUKISI/DSN-MUI standards, managerial practices, service quality, and efficiency are all rated high, and efficiency initiatives are not perceived to erode syariah compliance. Nonetheless, JKN’s prospective payment generates tensions between cost containment and justice for the poor in high-cost cases, so strong syariah interoperability and data-driven management improve Islamic service quality and efficiency but cannot fully resolve conflicts with maqashid al-syariah.Keywords: Sariah hospital interoperability, Hospital management, JKN national health insurance, Service quality, Operational efficiency]]>
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