Ministry Of Health Completes KRIS Program Roadmap For BPJS Health Participants

ILLUSTRATION BETWEEN

JAKARTA - The Ministry of Health has compiled a Standard Inpatient Class Program Infrastructure Roadmap (KRIS) for participants of the National Health Insurance Program (JKN) BPJS Health.

"The KRIS policy at the Ministry of Health level must ensure that all infrastructure is ready and we have built a KRIS infrastructure roadmap," said Budi Gunadi Sadikin while attending the Commission XI DPR's Hearing Meeting (RDP) with BPJS Health, reported by Antara, Monday, July 4.

Budi said there are three substances from the Basic Health Needs (KDK), including all health interventions that are greater for promotive and preventive activities, so that in terms of costs and the quality of life of the community is much better.

In addition, the Ministry of Health also needs to ensure that the services provided to participants are not excessive so that it has the potential to trigger financial losses or fraud. "Because it will reduce the sick ration of other people. All services that are fraudulent must be controlled," he said.

Budi said it was necessary to adjust the INA-CBGs system as an application used for filing claims for hospitals and first-level health facilities (FKTP) that prioritizes the principle of justice.

The Ministry of Health encourages the adjustment of the capitation rate in FKTP so that the amount is in accordance with current conditions. "There are also many INA-CBGs tariffs that have not been reviewed for a long time. We want to make sure this capitation is based on a sense of justice, there are areas that are difficult to reach, compared to urban areas which are relatively easier to reach," he said.

The Ministry of Health also encourages future capitation to be more performance-based.

"It's not like a blank check that can be used for all kinds of things. We will give it when the performance is achieved," he said.

For the adjustment of claims at hospitals, Budi said, improvements were made to the INA-CBGs system based on differences in the level of diagnosis, severity, and certain types of categories such as regionalization and hospital class.

Another important thing in the KDK, said Budi, is the role of additional health insurance, so that people who get BPJS Health insurance facilities are opened up to opportunities to increase their benefits by connecting the insurance they receive now with additional services for people who are more affluent.

Budi said that the Ministry of Health needs to pay attention to the final decision regarding the form of classes in KRIS services so that the Ministry of Health can adjust infrastructure readiness.

The KRIS program is currently being piloted in five government hospitals until the end of July 2022. BPJS Kesehatan plays a role in managing registration, fees and guaranteeing the cost of health services for JKN participants, as well as ensuring optimal service quality.

The trial mainly looked at the hospital's readiness to apply nine to 12 KRIS criteria that had been established, for example the availability of a maximum of four beds in one room, the standard of the availability of health workers, the standard of room temperature and so on to improve service standards, safety and comfort for participants.

"What needs to be the concern of the Ministry of Health is the final decision on how the class will be structured, so that the Ministry of Health can adjust the readiness of its infrastructure after there is an agreement on the understanding of KRIS between the National Social Security Council (DJSN) and BPJS Health," he said.