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rivate hospitals taking part in the city'€™s healthcare program Jakarta Health Card (KJS), have complained about unfavorable rates for medical services that have caused financial difficulties for hospitals.

Representatives of 16 hospitals conveyed their problems regarding the implementation of the healthcare program at a hearing with KJS stakeholders at the Jakarta Legislative Council on Thursday.

'€œMedical rates set by the healthcare system cover only 30 percent of the expenses we incur,'€ Thamrin Hospital, deputy president director Abdul Barry Radjak said. Thamrin Hospital along with the Admira Hospital have officially withdrawn from participation in the program.

Sukapura Islamic Hospital finance director Inggit concurred and said that the wide gap between actual costs and medical fees covered by the city administration had caused them financial losses.

'€œAlthough we are a non-profit hospital, we still have to pay our staff wages. Therefore, we urge the administration to evaluate the system and rates without risking treatment quality,'€ she said.

Even so, representatives of 16 hospitals renewed their commitment to supporting the city administration'€™s program to serve the poor. '€œWe have never rejected KJS patients. However, we call for an evaluation of the INA-CBG system,'€ Sumber Waras Hospital spokesman Anthio said.

The INA-CBG (Indonesia Case-Based Group) system is a diagnostic-based reimbursement system that has been applied in the healthcare scheme since the administration appointed state-insurer PT Askes to manage KJS funds totaling Rp 1.2 trillion (US$122.8 million) in April.

It will also be applied by the Social Security Provider (BPJS) in implementing the national healthcare program (Jamkesmas) in January 2014.

The INA-CBG system replaced the previous fee-for-service reimbursement system used in the regional healthcare system, where services were unbundled and paid for separately. The previous system allowed physicians to provide more treatments because payment was dependent on the quantity of care, rather than quality of care.

Chairulsjah Sjahruddin representing Admira Hospital said that the hospital would rejoin the program once a review of the system was made.

Jakarta Health Agency head Dien Emmawati acknowledged the INA-CBG system'€™s shortcomings, saying that the agency and other relevant authorities were intensively evaluating the rates. '€œWe will adjust medical rates used in the INA-CBG system and consult with the Health Ministry. Hopefully with the new rates, medical service providers will be able to improve services,'€ Dien told reporters after the hearing.

Dien emphasized that the adjustment would not affect the budget for the KJS program. '€œI am sure even after we adjust the rates, our spending on the KJS program won'€™t exceed Rp 1.5 trillion,'€ she said.

Achmad Soebagio of the National Case Mix Center said that among subjects for evaluation were the unit costs applied in different hospitals across Jakarta. '€œWe will check the unit costs in hospitals across Jakarta and study why there is such a wide divergence between the unit costs and reimbursement rates. However, we guarantee that we will never risk the quality of medical treatment,'€ he said.

The evaluation is expected to be completed within a month. PT Askes Jakarta region head Ikhsan said that an adjustment of medical rates would not halt the implementation of the healthcare program in the field.