T

he Jakarta administration is issuing a gubernatorial decree to increase the amount of reimbursement given to hospitals involved in the city'€™s free healthcare program.

The decision was influenced by a number of complaints issued by private hospitals over financial losses incurred as a result of the Kartu Jakarta Sehat (KJS) healthcare program.

Losses have continued to increase since the city administration applied the Indonesia Case-Based Group (INA-CBG) system '€” which applies a fee-for-diagnostic reimbursement system '€” as the rates were deemed too low. The INA-CBG system has been used in the national healthcare scheme (Jamkesmas) run by state-owned PT Askes.

'€œWe are preparing a gubernatorial decree to allow us to reimburse 100 percent of medical claims in accordance to the rates set in the INA-CBG system, up from previously only 75 percent as regulated by the central government,'€ Deputy Governor Basuki '€œAhok'€ Tjahaja Purnama said after an evaluation meeting with KJS stakeholders at City Hall on Monday.

Jakarta Health Agency head Dien Emmawati said the issuance of the decree would prevent hospitals from suffering further losses.

'€œWe want to cover 100 percent of hospital claims, as such we need a gubernatorial decree as a legal basis,'€ Dien said, emphasizing that a team consisting of KJS stakeholders was still evaluating the reimbursement system'€™s medical rates.

'€œWe will finalize the new rates in mid-June. The rates will then be reviewed every six months,'€ she added.

Ahok acknowledged the difference between medical rates applied by the city administration and some of the hospitals.

'€œThe system'€™s medical rates were made without taking medical rates at private hospitals into consideration,'€ he said, adding that '€œwe should acknowledge that the standard of medical services in Jakarta hospitals differs from other regions.'€

Ahok also said the new medical rates would be applied retroactively.

'€œWe also won'€™t apply double rates,'€ he said. Previously, the city administration planned to differentiate medical rates for private and public hospitals. While being relieved that the system is being improved, hospitals emphasized their support for the INA-CBG reimbursement system.

City-owned Tarakan Hospital president director Koesmedi acknowledged that the implementation of a fee-for-diagnostic reimbursement system had forced doctors to be more efficient.

Although the doctor suggested that the city administration should evaluate service standards and assess the remuneration system for doctors.

'€œDoctors usually have different standards of medical treatments depending on their backgrounds. This issue should also be addressed,'€ he said.

Before INA-CBG was introduced to the current healthcare scheme, the city administration applied the Essential Service Package fee-for-service reimbursement system, where services were unbundled and paid for separately. Under this system, the city administration reimbursed up to 90 percent of costs spent by hospitals serving patients of the city'€™s healthcare program.

The Health Ministry'€™s director general for health development, Akmal Taher, emphasized that the INA-CBG system would not be removed as the implementation of the system had been regulated by the central government.

'€œHowever, the system is not a holy bible that cannot be revised,'€ he said.