Summary An Effective National Health Insurance System

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3.1.1 Summary

The primary inputs to achieve this EOPO are technical advice from an international health financing expert; an international training program to improve the hospital payment system which is based on Case Based Groups CBG both of these are high cost activities; and policy advice from the PTS. The effectiveness of the international expert has been limited due to the poor engagement with the BPJS which has not been open to receiving international expert advice. A number of meetings took place between DFAT and BPJS in this reporting period to negotiate this but it did not result in any further engagement. On the other hand the PTS is accepted as a lead adviser on the key expert group, bringing into question the value of a full time expert. The training program for the hospital provider payment system CBGs is likely to have a larger impact on the management of the hospital payment system and cost control once the training is implemented in the next reporting period. The scoping mission conducted in April received a strong interest from many stakeholders across government, the hospital sector and BPJS. There is clear high demand for this type of knowledge. The results or changes from the activities being implemented require more time; however, emergent results are improved advisory for quality and cost control; closer stakeholder collaboration to manage the hospital payment system; an emerging collaboration; and the early stages of institutionalisation of HTA in Indonesia. Adequacy of Inputs: The input of the international expert has been limited by poor access to BPJS. Measuring the uptake of advice is difficult at this early stage. Progress: Adequate overall. Policy advice and uptake does not work according to clear schedules but technical and policy advice has been provided, and policy notes have been produced and disseminated. Sustainability: Difficult to assess the sustainability of international TA, but advice has been taken up by some government authorities and the advice from the PTS has a higher probability of sustainability. This is evidenced through the policies adopted and decisions made under his guidance. HTA activities are highly sustainable as they will be included in national budget plans. Next Steps: Implementation of the training program for hospital provider payment; continuation of HTA activities; PTS to continue to provide guidance and the HTA activities are ongoing. Gender Social Inclusion and Disabilities: The main emphasis of the intervention is on providing improved access to affordable and adequate health care for disadvantaged groups.

3.2 Minimum Service Standards MSS to support Primary Health Care Delivery