📋 Tender Overview
Scope :
The proposed ta will support the indonesian government to improve the spending efficiency of its national health insurance scheme, with the aim of achieving financially sustainable universal health coverage that delivers good quality of care. the need for a sustainable universal health coverage scheme is even more pressing as the country restructures its health system in light of the covid-19 pandemic. both the ministry of health (moh) and the national health insurance agency, badan penyelenggara jaminan sosial kesehatan (bpjs-k), will be closely involved in implementing the ta. the ta will assess the current level of efficiency in the current national health insurance operations. it will then diagnose the root causes and binding constraints that result in low efficiency, and thereafter design potential solutions to alleviate these constraints. the effectiveness of the solutions will be evaluated, with a view to identifying implementation constraints and scaling up successful elements.
Indonesias health insurance system, the jaminan kesehatan nasional (jkn), has made important accomplishments since its establishment in 2014 but has also missed its target of achieving universal health coverage within five years of implementation. partly due to heavy subsidization and high payouts, the jkn suffers from a high claim ratio - the ratio between expenditure on health services and revenue, which has consistently surpassed 100%. to address the issue the ta will delve into examining the jkns low level of operational efficiency by constructing measurements for capturing the level of efficiency to help identify its possible root causes and devise possible solutions to it.
Health / health insurance and subsidized health programs
Concept Clearance: 20 Jun 2023
Fact Finding: 04 Sep 2023 to 07 Sep 2023
MRM: -
Approval: 25 Jan 2024
Last Review Mission: -
Last PDS Update: 25 Jan 2024
