Good Practices in Social Security Good Practices in Social Security

The identification and sharing of good practices helps social security organizations and institutions to improve their operational and administrative efficiency.

In the context of the ISSA, a good practice is defined as any type of experience (e.g. an action, a measure, a process, a programme, a project, or a technology) implemented within a social security organization that fosters the improvement of its administrative and operational capacities, and/or the efficient and effective delivery of programmes. The good practices selected by the ISSA focus on topics related to the priorities as defined in the programme and budget of the Association. The good practices are from member institutions of the ISSA and are primarily collected through the work of the  ISSA Technical Commissions and the ISSA Good Practice Awards.

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Commitment-based capitation as Indonesia’s model for performance-based payment system for primary care providers: Resolving the challenges of implementing the KBK Scheme in Indonesia’s National Health Security Program

Commitment-based capitation as Indonesia’s model for performance-based payment system for primary care providers: Resolving the challenges of implementing the KBK Scheme in Indonesia’s National Health Security Program

Social Security Administering Body for the Health Sector | Indonesia
Commitment-based capitation as Indonesia’s model for performance-based payment system for primary care providers: Resolving the challenges of implementing the KBK Scheme in Indonesia’s National Health Security Program

After a year of implementing the National Health Insurance program (Jaminan Kesehatan Nasional – JKN), the Social Security Administering Body for the Health Sector (BPJS Kesehatan) instituted in 2015 a Pay for Performance (P4P) scheme in the capitation system for primary care providers. P4P or Kapitasi Berbasis Komitmen Pelayanan (KBK) is commitment-based capitation that aims to measure the commitment of primary care providers to deliver primary care services comprehensively. Unfortunately, resistance from primary care providers hindered its full execution. It was then agreed that KBK would be postponed until 2016 and applied only to state primary care providers or state health community centers (Puskesmas) in provincial capitals. Since 2017, all Puskesmas have been applying the KBK except those in remote areas. In 2018, all private primary care providers are to implement the KBK. Three main indicators are used to monitor the KBK system, namely, contact rate, percentage of active Disease Management Program (DMP) member visits, and non-specialized referral ratio. The three indicators reveal improvements from January to December 2017 thus showing an improvement in the role of primary care providers as gatekeepers and care coordinators. Nevertheless, challenges still emerge and continuing improvements are essential.

Implementation year2019
Topics: Service quality
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