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Abstract

One of the private hospital successful implementation the National Health Insurance with cost efficiency without neglecting the quality of service is X Hospital. This study aimed to finding out the strategy of X Hospital in the implementation of the National Health Insurance with Balanced Scorecard. The research was conducted in May 2018 using qualitative approach. Data was collected through in-depth interview to 7 informants from hospital and 2 informants from BPJS Kesehatan. The subjects were selected purposively and the data was analyzed using thematic analysis. The results show that there are several strategies that have been developed and implemented, including: (1) financial perspective (adding types of services, increasing the capacity of inpatients and polyclinics, increasing doctor practice slots, completing medical equipment, applying the principle of low cost and increasing working capital); (2) customer perspective (choosing target market, develop 5 values propotition, complaint management); (3) internal business processes perspective (develop standard operating procedures, develop drug formulary and clinical pathways, carry out operational and audit controls, build business models, form case mix teams and claim management);(4) learning and growth perspective (develop training, giving reward and good salaries, build a competitive work environments, and pay attention to employee career paths). Through this strategy, X Hospital is able to implement the JKN Program well and still record a surplus without sacrificing service quality.

Bahasa Abstract

RS X merupakan salah satu rumah sakit swasta di Tangerang yang berhasil mengimplementasikan JKN (Jaminan Kesehatan Nasional) dengan efisiensi biaya tanpa mengabaikan mutu layanan. Penelitian ini bertujuan untuk mengetahui strategi RS X dalam pelaksanaan Program JKN dengan metode Balanced Scorecard. Penelitian dilakukan pada Mei 2018 dengan pendekatan kualitatif. Data dikumpulkan melalui wawancara mendalam kepada 7 informan pihak RS dan 2 informan dari BPJS Kesehatan. Subjek dipilih berdasarkan purposive sampling dan dianalisis dengan analisis tematik. Hasil penelitian menunjukkan ada beberapa strategi yang telah dikembangkan dan diterapkan yaitu dari (1) Perspektif keuangan (menambah jenis layanan, meningkatkan kapasitas pada rawat inap dan poliklinik, menerapkan prinsip low cost dan meningkatkan modal kerja, menambah slot dokter, melengkapi perawatan medis menerapkan prinsip low cost, dan meningkatkan modal kerja); (2) Perspektif pelanggan (menentukan target market, mengembangkan 5 nilai tambah, dan manajemen komplain); (3) Perspektif proses bisnis internal (pembuatan standar operasional prosedur, menyusun formularium dan clinical pathway, melakukan pengendalian dan audit operasional, menetapkan bisnis model, pembentukan tim casemix, serta manajemen klaim); (4) Perspektif pembelajaran dan pertumbuhan (reward dan gaji bagi karyawan, lingkungan kerja kompetitif serta memperhatikan jenjang karir karyawan). Melalui strategi tersebut, RS X mampu mengimplementasikan Program JKN dengan baik dan tetap membukukan surplus tanpa mengorbankan kualitas pelayanan

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