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Development of package payment based on UNU-CBGs Casemix system for provider payment in Aceh Health Insurance, Indonesia

Authors
Journal
BMC Health Services Research
1472-6963
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Volume
12
Identifiers
DOI: 10.1186/1472-6963-12-s1-o8
Keywords
  • Oral Presentation
Disciplines
  • Law
  • Medicine

Abstract

Development of package payment based on UNU-CBGs Casemix system for provider payment in Aceh Health Insurance, Indonesia ORAL PRESENTATION Open Access Development of package payment based on UNU-CBGs Casemix system for provider payment in Aceh Health Insurance, Indonesia Irwan Saputra*, Syed Mohamed Aljunid, Amrizal Muhammad Nur From The 6th International Casemix Conference 2012 (6ICMC2012) Kuala Lumpur, Malaysia. 6-7 June 2012 Background The Aceh Health Insurance (JKA) has been established since June 1, 2010. Presently, the provincial Government of Aceh faces difficulty in getting adequate budget to fund JKA program that tends to increase every year. In the year 2010, the second year of JKA implementation, the govern- ment was only able to allocate Rp. 382 billion from the total requirement of Rp. 482 billion. The figure will possi- bly continue to increase next year because of the increase in the overall hospital tariff of adjustments where there was an increase over 50%. In addition, there were complaints that quality of care is not optimum. The fee for service reimbursement system in JKA is one of the reasons for increase in cost of JKA. The main purposes of this study are to develop and implement the Casemix system as a provider payment mechanism and to assess its feasibilities to improve the performance of JKA program. Method Qualitative approach using in-depth interview will be con- ducted in this research to evaluate the current reimburse- ment system of JKA. Major stakeholders in the JKA program such as governor, representative council, and head of health directors of hospital will be sampled in this study. Quantitative methods will be applied to collect the data for Casemix implementation from selected hospitals on the data of disease coding and hospital costing. Costing data will be analyzed using Clinical Cost Modeling (CCM) software, whereas the coding data use UNU-CBGs grouper software to develop new hospital tariff for JKA. Result The expected result of this re

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