<![CDATA[In the National Health Insurance (JKN) era, hospitals are required to maintain a balance between service quality and financial sustainability. This study aims to analyze the performance of RS Windu Husada Badung in 2024 based on unit cost, profitability, efficiency, and service quality. A quantitative descriptive approach with a case study design was employed. Data were analyzed using Activity-Based Costing (ABC) to determine unit costs; GPM, NPM, and ROA ratios to measure profitability; BOR, ALOS, TOI, and BTO indicators to assess efficiency; and patient satisfaction to evaluate service quality. The results reveal a discrepancy between unit costs and service rates in several units—particularly the operating room—resulting in cost deficits. Conversely, the hospital's financial performance is considered satisfactory, with a GPM of 75.61%, NPM of 2.15%, and ROA of 1.36%. Efficiency indicators met ideal standards, and service quality was rated as good based on patient satisfaction. These findings indicate that the hospital's primary challenges lie in cost control and rate optimization rather than operational efficiency or service quality. From a managerial perspective, the hospital needs to periodically evaluate unit costs, review the alignment of rates with cost structures, and optimize the management of deficit-generating service units to enhance financial sustainability without compromising the quality of healthcare services.]]>
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