Presentation (CTI)

OBJECTIVES: Indonesia implemented the revised National Standard Tariff for Health Services through PermenkesNo. 3/2023 to improve equity, cost control, and sustainability within the National Health Insurance System (JKN). This study aims to (1) analyze the structure and adequacy of the new tariff system (Kapitasi, Non‑Kapitasi, INA‑CBG, Non‑INA‑CBG), (2) assess alignment with national health financing reforms including Coordination of Benefits (KAPJ), and (3) evaluate implications for provider behavior, financial protection, and efficiency
METHODS: A descriptive policy analysis was conducted using official government regulations (Permenkes 3/2023; KMK 1117/2025 on KAPJ), BPJS Kesehatan program data (2014-2025), and national financing projections. Comparative assessment was performed across four domains: payment mechanisms, tariff adequacy, incentives for service provision, and alignment with Universal Health Coverage (UHC) targets. A conceptual evaluation adapted the ISPOR Health Technology Assessment and health financing framework.
RESULTS: tariff adequacy varies across regions and facility types, with evidence of rising catastrophic expenditure driven by cardiovascular diseases, cancer, and chronic conditions. Efficiency incentives remain constrained by variability in hospital cost structures and limited transparency in actual cost-of-service delivery.
CONCLUSIONS: The updated national tariff standard strengthens Indonesia’s provider payment system through clearer classifications, risk‑adjusted capitation, and structured INA‑CBG refinements. When combined with KAPJ, the system enables better financial protection and flexibility for beneficiaries. Nonetheless, future optimization requires periodic cost-of-service recalibration, improved hospital cost reporting, and alignment with health technology adoption to ensure long‑term sustainability of JKN.