ABSTRACT
Background: The implementation of National Health Insurance (JKN) had
been started since 1 January 2014. In the first semester, several problems are found
in the admission department. First, it is found that there about 10% or 4,400
participants are they who are suffering for disease or have used the health
insurance. Second, there are participants who are already undergoing treatment at
the hospital and turning out a large cost then they are newly registered as JKN
participants.
Objective: To monitoring the implementation of independent participants
policy of the National Health Insurance (JKN) in Yogyakarta.
Methods: This research is a case study with qualitative and quantitative
approaches. Research will be conducted in the BPJS Yogyakarta, Academic Hospital
of the Gadjah Mada University, the Office of the Provincial Council Commission D
Yogyakarta, Yogyakarta Provincial Health Office in April 2015. The study was
conducted by in-depth interviews as well as filling the form of independent patient
data.
Results: The viewpoint of the national health insurance participant is positive.
Independent participants consider it is important to enforce the national health
insurance program. Participants also consider it is reasonable for them to pay the
monthly dues. Their motivation to register as an independent participant is already
going to take advantage of health services, a precaution and to protect themselves
against the risk of illness. Compliance participants who pay dues are in arrears to
pay dues by 27%. The impact of independent participants is people who are already
sick or have health services and will utilize it for about 123% claims ratio. It is better
for the hospital to do socialization, add more facilities and infrastructure, improve
the hospital services, leadership and bureaucracy.
Conclusion: Independent participants policy is to motivate people who are
already sick to register as a participants and 27% of participants who had recovered
in arrears to pay.The fundamental improvement in the independentparticipants
policy is an improvement on Presidential Decree No. 12 of 2013, especially chapters
4 and 5, Presidential Decree No. 111 of 2013 chapter 16F, and The Health Minister
regulations No. 71 of 2013 article 21 paragraph 1 and 22 paragraph 1
Keywords: impact, independent participant,National Health Insurance (JKN)