Hospital surveillance tougher in National Health Insurance era

Hospital surveillance tougher in National Health Insurance era

The government assures access to public health service through the National Health Insurance (JKN) and Indonesia Healthy Card (KIS) programs. (Doc. ANTARA/sh)

This means that with this mechanism established, hospital management is making better efforts, and this is part of the effort to regulate
Jakarta (ANTARA) - The supervision of hospital services was getting more stringent in the era of National Health Insurance (JKN), Secretary General of the Ministry of Health Oscar Primadi has said.

The adoption of accreditation and recommendations for decreasing hospital classes related to the JKN services since the beginning of 2019 has given rise to a new mechanism in the health insurance program management system, Oscar was quoted as saying in a ministry press release in Jakarta Monday. "This means that with this mechanism established, hospital management is making better efforts, and this is part of the effort to regulate," Oscar said in response to recommendations for the downgrade of 615 partner hospitals of the Healthcare and Social Security Agency (BPJS Kesehatan) in JKN services.

The Ministry of Health had previously recommended a downgrade of 16 state-owned and private hospitals throughout Indonesia based on a review of the fulfillment of requirements regarding the type of hospital.

Recommendations to downgrade the hospitals were issued following inefficiencies in paying JKN service fee claims, in which BPJS Kesehatan had to pay claims to hospitals with classes that were higher than they should.

Before recommending the downgrade, at the beginning of 2019, the government also required 720 hospitals that had not received accreditation certificates from the Hospital Accreditation Committee (KARS) to undergo the accreditation process.

Ownership of an accreditation certificate is one of the conditions for a hospital to work with BPJS Kesehatan in implementing the JKN-KIS program.

The government already has in place regulations regarding accreditation and hospital classes, Oscar explained. The JKN system ensures the monitoring of quality and service at all times.

"This means that the credentialing process, the assessment process, and the accreditation process have stages. And of course, quality improvement is not only on regular issues that are carried out annually but at all times must be maintained," he said.

Submission of recommendations for class reduction and the obligation to accredit hospitals, is part of an effort to curb health facilities, according to him.

"In the JKN era, everything must be truly measurable and structured. This is part of the effort to regulate the emergence of our society to get quality and affordable health services," Oscar said.

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