TINJAUAN PUSTAKA: TANTANGAN DAN IMPLEMENTASI PEMBAYARAN JASA KESEHATAN DALAM SISTEM JAMINAN KESEHATAN NASIONAL (JKN)
Main Article Content
Ayu Rindwitia indah Peanasari
Vip Paramarta
This study aims to examine the challenges and implementation of medical service payments within the National Health Insurance (JKN) system in Indonesia through a literature review. The implementation of JKN demonstrates significant efforts to strengthen healthcare governance, including through the implementation of INA-CBGs-based payment mechanisms, the use of the Mobile JKN application, and strengthening the membership system. However, the literature review reveals that various challenges remain, such as barriers to socialization in certain regions, limitations in the usability of digital applications, the potential for fraud in the claims system, inefficiencies in drug planning and procurement, and issues with the sustainability of membership and the implementation of the tiered referral system. These findings confirm that the effectiveness of medical service payments within JKN is determined not only by the claims mechanism but also by social, technological, regulatory, and healthcare governance factors. Therefore, strong synergy is needed between the government, BPJS Kesehatan (Social Security Agency for Health), healthcare facilities, medical personnel, and the community to ensure the achievement of JKN's primary objectives, namely equitable access and sustainable improvement of healthcare quality.
Ahmadi, D. A., Annisa, R., Refiana, R., & Purba, S. H. (2025). Tantangan dan Peluang Penggunaan JKN di Indonesia. VitaMedica: Jurnal Rumpun Kesehatan Umum, 3(1), 85-92.
Akbar, M. I., & Ahmad Imran, L. O. (2020). Studi Implementasi Program Jaminan Kesehatan Nasional. Jkmc, 1(03), 1–6.
Anggriani, Y., Rosdiana, R., & Khairani, S. (2020). Evaluasi Perencanaan dan Pengadaan Obat di Era Jaminan Kesehatan Nasional (JKN) di Puskesmas Kabupaten Cianjur Evaluation of Medicines Planning and Procurement in the Era of National Health Insurance (JKN) In Health Center Cianjur District. Pharmaceutical Journal of Indonesia, 17(02), 425–438.
Arimbi, D., Fuady, A., Satrya, A., & Dewi, A. (2022). Peluang dan tantangan dalam jaminan kesehatan nasional di Indonesia: Studi kebijakan. Jurnal Kebijakan Kesehatan Indonesia, 11(1), 14-27.
Gutama, A. S., Fedryansyah, M., & Nuriyah, E. (2023). Alokasi Dasar Dan Ketentuan Sosial Pada program BPJS Kesehatan di provinsi Jawa Barat. Focus: Jurnal Pekerjaan Sosial, 6(1), 37-45.
Mariawati, A. S., Indralaga, D., & Paramarta, V. (2023). Literatur Review: Strategi Bisnis Rumah Sakit di Era Jaminan Kesehatan Nasional (JKN). Journal of Systems Engineering and Management, 2(2), 177-183.
Nur Annisa, Dharma Surya Pradana, & Wildan Suharso. (2020). Evaluasi Aplikasi Mobile Jaminan Kesehatan Nasional (JKN) di Kota Malang Ditinjau Dari Aspek Usability. Jurnal Repositor, 2(12), 1689– 1699.
Sari, A. P., Jati, S. P., & Shaluhiyah, Z. (2022). Implementasi Kebijakan Pencegahan Fraud Dalam Pelaksanaan Program Jaminan Kesehatan Di Rumah Sakit Nasional Diponegoro Jawa Tengah. JKM (Jurnal Kesehatan Masyarakat) Cendekia Utama, 10(1), 128.
Sinaga, E. S., Ginting, I. R., Kusumaratna, R. K., Marthias, Tiara. (2021). Evaluasi Implementasi Program Jaminan Kesehatan Nasional (JKN) di Provinsi DKI Jakarta ,Indonesia. Jurnal Kebijakan Kesehatan Indonesia, 10, nomor (3), 1-9
Tarigan, I. N., & Lestari, F. D. (2022). Penundaan Pembayaran Klaim Jaminan Kesehatan Nasional Oleh Bpjs Kesehatan Di Indonesia: Sebuah Scoping Review. Jurnal Ekonomi Kesehatan Indonesia, 7(2), 3.
Yuditia, A., Hidayat, Y., & Achmad, S. (2021). Pelaksanaan Jaminan Kesehatan Nasional Oleh Bpjs Berdasarkan Undang-Undang No. 40 Tahun 2004 Tentang Sistem Jaminan Sosial Nasional. Jurnal Magister Ilmu Hukum, 6(1), 43-61.
