Partnership as an Independent Segment Participation Management Strategy in the National Health Insurance Program

Abstract

Madiun is one of 6 regions in East Java that has reached UHC with the level of community participation in the JKN KIS program reaching more than 95%. Madiun City is included in the working area of ​​the BPJS Kesehatan Madiun Branch Office which has the most work areas compared to other branch offices that have reached UHC. In the implementation of the JKN Cadre program there is an interesting thing there that the 15 Cadres who are still surviving in 2020 are known to have quite high loyalty and resilience, they have a minimum 3 year partnership period in the program, besides that there are two JKN Cadres from the Branch Madiun, who was ranked first and ranked third, achieved the highest contribution collectibility at the East Java regional office level. The National Health Insurance Program emerged in an effort to achieve Universal Health Coverage (UHC) in Indonesia by establishing BPJS Health as the implementer. In its financial management, BPJS Kesehatan always runs a deficit from 2014 to 2020. The biggest contributor to the deficit is the independent segment participants. The JKN-KIS Cadre partnership program which is expected to be able to increase the growth of the number of participants and increase the collectability of BPJS Health contributions for the independent participant segment has not been effective in its implementation. This study uses a qualitative descriptive paradigm with a case study method in researching and analyzing the partnership model in the JKN-KIS BPJS Kesehatan Cadre program in the Madiun branch office area. Informants were determined purposively based on certain considerations. Primary data was obtained directly from informants from the JKN Cadre and BPJS Health, while secondary data was taken from supporting documents and media reports. The validity of the data in this study was tested using observation and triangulation of data sources. The results of this study indicate that the partnership model used includes the subordinate union of partnership. With a level 3 partnership level, namely partnership (formal contracts through work agreements, new resources, risk sharing and rewards through the applied service reward system). Great support from the government for the JKN program is one of the main strengths in the success of the program. The work system used is considered quite appropriate by conducting direct house-to-house visits and involving the local community as partners directly because they have social and cultural closeness in conducting socialization and approaches to the community, especially the fostered families.

 Keywords: BPJS Health, JKN Cadre, Partnership, UHC