Opportunities, Challenges and Strategies in Implementing Indonesian Health Insurance Scheme: Case Study at a Hospital Class C

Harie Moeljono Wiknjopranoto, Bernadia Linggar Yekti Nugraheni

Abstract


Research regarding the implementation of Indonesia Health Insurance patient services in hospitals has been conducted in previous studies.  However case study research regarding challenges, opportunities and strategies for implementing Health Insurance services in class C hospitals has been overlooked. This research aims to determine the challenges, opportunities and strategies carried out by Hospital X, a class C hospital, in serving Health Insurance patients so that it succeeds in optimizing its financial performance. Payment using the package system rates imposed by BPJS is both challenge and opportunity for hospitals that serve Health Insurance patients because this system is different from the fee for services payment system that is usually applied in hospitals. This research used a qualitative approach by conducting interviews with 8 participants at Hospital X. The data was analysed using the theory of institutional logics and institutional work. This research found the role of actors in the process of institutionalizing the Health Insurance system at hospital X as a reference for others hospital actors in assuring quality and cost control policies that can improve hospital financial performance.


Keywords


health insurance; fee for services; institutional logics; institutional work

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References


Alsharari, N.M. (2022). Cloud computing and ERP assimilation in the public sector: Institutional perspectives. Transforming Government: People, Process and

Policy, 16(1), 97–109. https://doi.org/10.1108/TG-04-2021-0069

Apelina, T., Apelina, T, & Nugraheni, BLY (2022). Analysis of Enterprise Resource Planning (erp) Implementation: Institutional Work and Institutional Logics

Perspectives. Journal of Business Accounting, 20(1), 29–50. http://103.243.177.137/index.php/jab/article/view/4373/pdf

Berg Johansen, C., & Waldorff, S. B. (2015). What is Institutional Logics—And Where is the Perspective Taking Us? Academy of Management Proceedings,

(1), 14380. https://doi.org/10.5465/ambpp.2015.14380abstract

Chiwamit, P., S. Modell, and C.L. Yang. 2014. The Societal Relevance of Management Accounting Innovations: Economic Value Added and Institutional Work in

the Fields of Chinese and Thai State-Owned Enterprises. Accounting and Business Research 44(2): 144-180

Covaleski, M. A., Dirsmith, M. W., & Michelman, J. E. (1993). An institutional theory perspective on the DRG framework, case-mix accounting systems and

health-care organizations. Accounting, Organizations and Society, 18(1), 65–80. https://doi.org/10.1016/0361-3682(93)90025-2

Edya, F. (2017). Comparative Analysis of Ina-Cbg's Rates With Hospital Rates And Cost Recovery Rates For Inpatient Patients By Bpjs Kesehatan Participants

(Case Study at RSUD Dr. Achmad Mochtar Bukittinggi) [Thesis]. Andalas University.

Garrido, N. (2017). The Method of James Spradley in Qualitative Research. Enfermería: Cuidados Humanizados, 6(Especial), 43–48. https://doi.org/10.22235/ech.v6iEspecial.1450

Lawrence, T. B., & Suddaby, R. (2006). Institutions and Institutional Work. In S. Clegg, C. Hardy, T. Lawrence, & W. Nord, The SAGE Handbook of Organization

Studies (pp. 215–254). SAGE Publications Ltd. https://doi.org/10.4135/9781848608030.n7

Moloeng, L. (2017). Qualitative Research Methods. PT Teen Rosdakarya.

Nugraheni, BLY, Cummings, LS, & Kilgore, A. (2022). The Localized Accounting Environment in the Implementation of Fair Value Accounting in Indonesia.

Qualitative Research in Accounting & Management, 19(4), 416–440. https://doi.org/10.1108/QRAM-08-2020-0126

Perkmann, M., & Spicer, A. (2008). How are management fashions institutionalized? The role of institutional work. Human Relations, 61(6), 811–844.

https://doi.org/10.1177/0018726708092406

Sugiyono. (2017). Qualitative Research Methods. CV. Alphabet.

Suryantoko, S., Agnes, A., & Faisol, A. (2020). Implementation of a Hospital Management Information System to Improve the Quality of Service at the

Cilandak Marine Corps Hospital. Indonesian Journal of Hospital Management and Administration (MARSI), 4(2), 155–165.

https://doi.org/10.52643/marsi.v4i2.999

Thornton, P. H., & Ocasio, W. (2008). Institutional Logics. In R. Greenwood, C. Oliver, R. Suddaby, & K. Sahlin, The SAGE Handbook of Organizational

Institutionalism (pp. 99–128). SAGE Publications Ltd. https://doi.org/10.4135/9781849200387.n4

Vianti, A., & Pujiyanto. (2022). Overview of Caesarean Section Costs with Clinical Pathway for JKN Patients at Hermina Jatinegara Hospital in 2021. 7(9).

https://doi.org/: http://dx.doi.org/10.36418/syntax-literate.v7i9.9197

Zilber, T. B. (2013). Institutional Logics and Institutional Work: Should They Be Agreed? In M. Lounsbury & E. Boxenbaum (Eds.), Institutional Logics in Action,

Part A: Vol. 39 Part A (pp. 77–96). Emerald Group Publishing Limited. https://doi.org/10.1108/S0733-558X(2013)0039AB007




DOI: https://doi.org/10.24167/jmbe.v6i1.10983

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