OPTIMIZING NATIONAL HEALTH INSURANCE MEMBERSHIP REDISTRIBUTION TO REMEDIATE THE DELIVERY OF HEALTHCARE SERVICE IN THE BANGLI REGENCY

Abstract

The recent collaboration between the Indonesia Social Security Administrative Body (SSAB) and the Ministry of Health emanated the notion to optimize the National Health Insurance (NHI) membership redistribution program. This latest scheme aims to enable health access comprehensively and improve the healthcare service quality through equal member distribution in the primary care health facilities (PCHF). This was a descriptive study using an evaluation approach, summative, and observational design. A Context, Input, Process, and Product (CIPP) evaluation model was followed to assess the membership transfer redistribution scheme. Data were collected from February to March 2022 through observation, interview, and documentation techniques. Subsequently, the data were then analyzed using the CIPP Evaluation Model and Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis with Focus Group Discussion (FGD). Based on the CIPP evaluation, five and eight PCHFs were executing outstanding (>14,893 or 80.79%) and good level of transferring and receiving scheme practices (11,123 – 14,892 or 60%-79%), respectively. Thus, it could be argued that the membership transferring redistribution procedure has been delivered adequately. Regardless, we still encourage efforts to foster the monitoring and evaluation process. Further, future studies are suggested to include additional evaluation elements to provide a more thorough finding and allow constant membership redistribution program improvement, acquiring the program end goals to the fullest extent.