Jurnal Jaminan Kesehatan Nasional (JJKN) https://jurnal-jkn.bpjs-kesehatan.go.id/index.php/jjkn <p style="text-align: justify;">Jurnal Jaminan Kesehatan Nasional (JJKN) (ISSN <a href="https://issn.lipi.go.id/terbit/detail/20210719591417451" target="_blank" rel="noopener">2798-7183</a> and E-ISSN <a href="https://issn.lipi.go.id/terbit/detail/20210719531194302" target="_blank" rel="noopener">2798-6705</a>) published by Social Health Insurance Administration Body (BPJS Kesehatan Republik Indonesia) since July 2021.</p> <p style="text-align: justify;">This journal is a forum to accommodate the ideas and thoughts of Duta BPJS Kesehatan, as well as the other parties who have high concern and awareness to develop the sustainability of the Social Health Insurance Program through scientific research and development.</p> BPJS Kesehatan en-US Jurnal Jaminan Kesehatan Nasional (JJKN) 2798-7183 Analisis Kebijakan dan Implementasi Peraturan Menteri Kesehatan Nomor 16 Tahun 2019 pada Program Jaminan Kesehatan Nasional https://jurnal-jkn.bpjs-kesehatan.go.id/index.php/jjkn/article/view/37 <p>The Minister of Health Regulation (PMK) Number 16 of 2019 concerning Fraud Prevention in the National Health Insurance Program (JKN) as a substitute for Minister of Health Regulation Number 36 of 2015 is still being evaluated and studied in its implementation. According to the mandate of PMK Number 16 of 2019, there is still the possibility of fraud in the implementation of JKN that has not been demonstrated and followed up on by the Fraud Prevention Team (TPF). Analyze PMK policy Number 16 of 2019 and investigate for other policy options so that their implementation works properly. The Bardach Criteria are used in the study to weight the alternative policy options that will be recommended next. The analysis result indicated that PMK Number 16 of 2019 is still stagnant, and optimizing the JKN TPF function is more feasible at this time, particularly that the PMK revision will require more time and be more complicated.</p> Dina Anjayani Copyright (c) 2021 Dina Anjayani https://creativecommons.org/licenses/by/4.0 2021-12-30 2021-12-30 1 2 81 94 10.53756/jjkn.v1i2.37 Social Security Fund as a Form of Constitutional Responsibility for the Right to Health https://jurnal-jkn.bpjs-kesehatan.go.id/index.php/jjkn/article/view/43 <p>Health is one of the human rights that has been recognized and enshrined in the constitutions of many countries. To achieve a high level of health, Indonesia is not unlike many countries that have implemented and ensured the sustainability of social security programs in the health sector. This requires a stable source of fund. This study aims to compare the recognition of the right to health in the constitutions of developed and developing countries and sources of funding for social security for health programs using a literature review method. Developing and developed countries have recognized the right to health in their constitutions and regulate the social security system. There are many ways to regulate the sources of fund for social security programs. The state pays the contribution for their employers and for the poor, as well as providing financial support for implementing social security programs.</p> <p>Keywords: constitution; contribution in social security funding; social health insurance; the right to health </p> Sisca F Usman Copyright (c) 2021 Sisca Usman https://creativecommons.org/licenses/by/4.0 2021-12-30 2021-12-30 1 2 95 106 10.53756/jjkn.v1i2.43 Pelaksanaan Audit Medis Rujukan Non Spesialistik (RNS) dengan Time, Age, Comorbid, Complication (TACC) pada Fasilitas Kesehatan Tingkat Pertama (FKTP) di wilayah Kota Administrasi Jakarta Utara https://jurnal-jkn.bpjs-kesehatan.go.id/index.php/jjkn/article/view/33 <p>In the era of the National Health Security (Jaminan Kesehatan Nasional-JKN) program, the Primary Care Health Facility (Fasilitas Kesehatan Tingkat Pertama-FKTP) has become a frontline to management of non specialistic diagnoses, although it is still possible for non specialistic diagnoses to be referred to hospitals on the grounds of Time, Age, Complication, and Comorbidity (TACC) at National Health Insurance (Badan Penyelenggara Jaminan Sosial- BPJS Kesehatan) application system, but it is not yet known whether TACC is only used as for passing referrals, even though the actual condition of the patient can still be handled completely at the first level, or FKTP is actually not able to handle the diagnosis. Purposes: Data collection for this study was carried out through medical audit activities aimed at detecting whether TACC has been used according to the actual patient's condition or only as a means for passing referrals. Methods: Medical audit has compare the suitability between the choice of TACC in the BPJS Health application system and the patient's medical record. Results: The results of the medical audit, it was found that 32,8% of participants had discrepancy between the diagnosis writing and the TACC choice in the BPJS Health application system and medical records; medical records of 35,75% of participants have not been written in full in accordance with Regulation of the Minister of Health No. 269/2008 concerning Medical Records; and 44,62% of participants still received medical treatment that did not refer to the prevailing medical consensus.</p> <p>Keywords: <em>TACC; Aplication System; Medical Record</em></p> Indrianti Wakhyuni Putri Wulandari Darmawan Purnama Elisa Adam Copyright (c) 2021 Indrianti Wakhyuni, Putri Wulandari, Darmawan Purnama, Elisa Adam https://creativecommons.org/licenses/by/4.0 2021-12-30 2021-12-30 1 2 107 122 10.53756/jjkn.v1i2.33 Net Promoter Score sebagai Tolok Ukur Ketercapaian Customer Loyalty Peserta Pekerja Penerima Upah Badan Usaha https://jurnal-jkn.bpjs-kesehatan.go.id/index.php/jjkn/article/view/34 <p><strong>Abstract: </strong>The National Health Insurance Program (JKN) organized by BPJS Kesehatan is a program that developed rapidly at the beginning of its existence in terms of achieving membership coverage. To maintain the continuity of the program, indeed, proper management of customer services is required at each service point. This study was conducted to measure the level of satisfaction of participants whose results can be used as a basis for decision making. Measurement through the Net Promoter Score method is carried out, the results will describe the customers' willingness to recommend a product or service to others and represent customer loyalty itself. The measurement of the Net Promoter Score that has been carried out for customers who receive wages for business entities (PPU BU) at BPJS Kesehatan Tondano Branch Office shows high results (92.41% and 90%). With these results, it is hoped that BPJS Kesehatan can continue to improve existing services in areas of improvement that can be developed. The development of innovation based on the participant's point of view must be considered with a focus on service simplification and the implementation of information technology for the realization of a quality JKN program.</p> <p><em>Keywords:</em> <em>Customer loyalty</em>; <em>Net Promoter Score; </em>BPJS Kesehatan</p> Nur Imam Rhamdani Copyright (c) 2021 Nur Imam Rhamdani https://creativecommons.org/licenses/by/4.0 2021-12-30 2021-12-30 1 2 123 135 10.53756/jjkn.v1i2.34 Analisis Take-Home Pay dan Perencanaan Anggaran terhadap Sustainabilitas Program Jaminan Kesehatan Nasional https://jurnal-jkn.bpjs-kesehatan.go.id/index.php/jjkn/article/view/39 <p>Abstract: <em>Dynamic regulation changes in JKN Program are made by the government to maintain the program’s financial health and sustainability by increasing the contributions, but the local government budget weakening during the Covid-19 pandemic is resulting in contribution receivable increasing. This study aims to compare the contributions from the collection of Civil Servant salaries and local government subsidies based on take-home pay compared to the previous calculation and the effect on the civil servants to analyze the compliance of local government budget planning and the obstacles on the budget insufficiency. This study uses a case study through the qualitative method with a descriptive analysis approach, this research uses secondary data in the form of documents and primary data in the form of interviews. The samples are conducted by purposive sampling as many as 127,341 civil servants in Aceh Province. The results showed the potential for an increase in income of 140.81 billion rupiahs,</em> <em>which was an increase of 47.52%. In total, the payment of contributions by deductions from the salaries of civil servants decreased by 281%. On the other hand, the contribution paid by the local government increased by 203%. In terms of budget, 5 of the 24 local governments have provided their budget availability for a 4% contribution. The regulation changes have positive impacts on the sustainability of the JKN program by increasing the program’s income and realizing mutual cooperation with equitable contribution and the involvement of local governments through a larger portion of the contribution budget. Coordination and guidance improvement between the central government and local government to monitor the implementation of</em> <em>Presidential Regulation Number 75 of 2019 as a national priority program and sanction enforcement for local governments which are in contribution arrears and insufficient budget.</em></p> <p>Keywords: <em>take-home pay; budgeting; sustainability; JKN Program</em></p> Ridwan Ridwan Doly Siregar Copyright (c) 2021 Ridwan Ridwan, Manda Ananda Doly Siregar https://creativecommons.org/licenses/by/4.0 2021-12-30 2021-12-30 1 2 136 151 10.53756/jjkn.v1i2.39 Improving Service Quality in the Customer Journey by Developing Innovations of Information https://jurnal-jkn.bpjs-kesehatan.go.id/index.php/jjkn/article/view/35 <p>To improve the service process requires the latest innovation and creativity to answer the needs of participants. This research uses research and development (R&amp;D) methods. All BPJS Health employees to carry out innovation initiatives by developing various methods to improve services to participants based on information technology that is easily accessible by participants anytime and anywhere. Most of our customers are millennials and tech-savvy (62%) so we need innovation in technology development to answer customer needs quickly and capture data. Hopefully with this technological innovation we can meet the needs and expectations of our participants, can provide services that are easier, faster and definitely without having to meet face to face..</p> <p>Keywords: BPJS Kesehatan; Costumer; Technology</p> <p>&nbsp;</p> <p>Abstrak: <strong>U</strong>ntuk meningkatkan proses pelayanan membutuhkan inovasi dan kreativitas terkini untuk menjawab kebutuhan peserta. Penelitian ini menggunakan metode penelitian dan pengembangan (R&amp;D).<strong> S</strong>eluruh pegawai BPJS Kesehatan untuk melakukan inisiatif inovasi dengan mengembangkan berbagai metode untuk meningkatkan pelayanan kepada peserta berbasis teknologi informasi yang mudah diakses oleh peserta kapan saja dan dimana saja. <strong>Sebagian</strong> besar pelanggan kami adalah milenial dan melek teknologi (62%) sehingga kami membutuhkan inovasi dalam pengembangan teknologi untuk menjawab kebutuhan pelanggan dengan cepat dan menangkap data. Semoga dengan <strong>inovasi teknologi ini</strong> kami dapat memenuhi kebutuhan dan harapan para peserta kami, dapat memberikan pelayanan yang lebih mudah, cepat dan pasti tanpa harus bertatap muka.</p> Irwanto Irwanto Copyright (c) 2021 Irwanto Irwanto https://creativecommons.org/licenses/by/4.0 2021-12-30 2021-12-30 1 2 152 165 10.53756/jjkn.v1i2.35 Manajemen SDM dalam Penyelenggaraan Program JKN-KIS: Sebuah Tinjauan Literatur https://jurnal-jkn.bpjs-kesehatan.go.id/index.php/jjkn/article/view/47 <p><em>The practice of human resource management has developed rapidly. Various figures and experts have explained theories and best practices about HR management in an organization. Employees are no longer considered just a resource that will run out over time. Currently, organizations in various sectors have placed employees as valuable assets that must be managed properly so that they are expected to be able to make an optimal contribution in supporting the achievement of organizational targets. BPJS Kesehatan as the only public legal entity that organizes the National Health Insurance-Indonesian Health Card (JKN-KIS) program is deemed necessary to place the function of HR management as one of the strategic aspects that must be managed optimally. This study aims to provide an overview of the suitability of the implementation of HR management at BPJS Kesehatan with various existing literature references and best practices in companies or other organizations that have succeeded in becoming market leaders in their fields. This study uses a literature study based on references in the form of books and previous research on HR management. An important finding in this study is the implementation of HR management at BPJS Kesehatan is following the HR Four Role Model proposed by Ulrich (1997) which has been recognized as one of the references in HR management practices in organizations.</em></p> Syarifuddin Syarifuddin Chandra Nurcahyo Andi Afdal Copyright (c) 2021 Syarifuddin Syarifuddin, Chandra Nurcahyo, Andi Afdal https://creativecommons.org/licenses/by/4.0 2021-12-30 2021-12-30 1 2 166 193 10.53756/jjkn.v1i2.47