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Jakarta Post

City reviews healthcare scheme rates

Governor Joko 'Jokowi' Widodo said on Wednesday that stakeholders of the Jakarta Health Card (KJS) program were considering different rates for public and private hospitals signed-up to the program

Sita W. Dewi (The Jakarta Post)
Jakarta
Thu, May 30, 2013 Published on May. 30, 2013 Published on 2013-05-30T10:58:35+07:00

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overnor Joko 'Jokowi' Widodo said on Wednesday that stakeholders of the Jakarta Health Card (KJS) program were considering different rates for public and private hospitals signed-up to the program.

'We are still calculating it. We are also discussing adjusting the rates to address the worries voiced by hospitals and doctors,' Jokowi told reporters at City Hall.

Assistant to city secretary for people's welfare Oloan Siregar said that the Health Ministry had the final authority on the medical rates applied to the healthcare scheme.

'One thing to consider is that public hospitals are subsidized by the government, while the private hospitals are not,' Siregar said.

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

The INA-CBG system replaced the previous fee-for-service reimbursement system used in the regional healthcare system, where services were paid for separately. The same system was applied to the national healthcare scheme (Jamkesmas) in 2009. Further, it will also be used by the Social Security Provider (BPJS) in implementing the Jamkesmas program in January 2014.

The rates applied by the system are currently the object of evaluation as many private hospitals incorporated in the program complained about the low rates.

As a result, two private hospitals ' Thamrin and Admira ' withdrew from the program after failing to cope with losses incurred from covering KJS patients' medical expenses. The hospitals, however, pledged to rejoin the program once the rates were revised. New rates are expected in June.

PT Askes service director Fajri Adinur said the implementation of double rates was still the subject of debate among stakeholders.

'There will be no technical problems because we only have to create two different applications. However, if it doesn't work, it will be more complicated to return it to single-pricing system in the SJSN [National Social Security System] era,' Fajri told The Jakarta Post.

According to Siregar, a team consisting of representatives of the Development Finance Comptroller (BPKP), the city administration's legal bureau, the city administration inspectorate, the Jakarta Development Planning Agency and the Jakarta Health Agency, also discussed whether the new medical rates would apply retroactively.

'We are discussing whether or not we can pay the divergence between the hospitals' unit costs and reimbursement rates for hospital claims from April to June,' Siregar said, adding that 'we are studying the legal basis.'

Results of the team's discussions will be recommended to the central government, he cited.

Meanwhile, the Jakarta Legislative Council plans to question Jokowi regarding the healthcare fiasco is yet to make any progress.

'We will submit the results of our meeting to the council speakers. The decision ' whether the plan will materialized or not ' has not yet been made,' Dwi Rio of the Democratic Party of Struggle (PDI-P), a member of Commission E overseeing people's welfare, told the Post.

As many as 32 lawmakers, mostly from President Susilo Bambang Yudhoyono's Democratic Party, as well as some from Coordinating Economic Minister Hatta Rajasa's National Mandate Party and the United Development Party (PPP), penned their signatures in support of the planned petition to use their right for interpellation.

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