Bureaucratic autonomy and policy capacity in the implementation of capitation payment systems in primary healthcare: comparative case studies of three districts in Central Java, Indonesia

Accrediting private providers with National Health Insurance to better serve low-income populations in Kenya and Ghana: a qualitative study

“…These findings align with other findings that capitation works best in a health system with a well-functioning and agile bureaucracy that can effectively monitor program implementation [ 62 , 63 ]. Other forms of purchasing, such as the Diagnosis Related Group (DRG)-based payment system currently found in Ghana, may be a more effective way for government to purchase health services from private providers in such a scenario.…”

Healthcare decommodification in decentralization context: Reviewing the ideational constructions of “classless hospital policy” initiatives in Kulon Progo Regency, Indonesia

“…The reason is because the government of Kulon Progo believes that the classless hospital policy has offered a generous feature promoting equality than BPJS‐Kesehatan system does. Such way is chosen by the government of Kulon Progo because under the decentralization policy, “the local governments [can use] their authority to issue district legislatures that shape local policy implementation to a large extent...even though [they] are bound to national regulations issued by the central authorities.” (Tan, , p. 2)..…”

“…These are BPJS ‐ Ketengakerjaan which administers work‐related accidents, retirement savings, healthcare and death benefits for employee in wide range sectors and BPJS ‐ Kesehatan which deals with national health insurance. “It is also tasked with integrating all the [regional] health insurance programs into a single player scheme known as the National Health Insurance scheme ( Jaminan Kesehatan Nasional‐ JKN).” (Tan, , p. 3) It must be noted that the adoption of the social insurance model is not fully applicable with the situations prevalent in Indonesia. This is mainly because almost 60 percent of Indonesia residents are classified as informal workers (Wilmsen, Kaasch, & Sumarto, ) and have no access to formal social protection programs through work‐based social insurance schemes.…”

“…On the other hand, it impedes an ambitious plan of the central government to extend universal health coverage (also known as Jaminan Kesehatan Nasiona l—JKN) on a large scale which is administered under the Health Security Administrative Body ( Badan Penyelenggara Jaminan Sosial bidang Kesehatan —BPJS‐ Kesehatan ). It arises as the result of decentralization policy which empowers the local governments to use their authority to issue district legislatures that “shape local policy implementation to a large extent...even though [they] are bound to national regulations issued by the central authorities.” (Tan, , p. 2).…”

An unintended consequence of provider payment reform: The case of capitation grants in the National Health Insurance reform of Indonesia

“…As community health centres started receiving substantial capitation grants from BPJS‐Health, district‐level regulations were enacted to give the providers more autonomy to decide on the utilisation of capitation grants. These autonomy‐enhancing regulations include giving the managers of the community health centres discretion to make decisions on the performance incentive for the existing staff in a more flexible manner and to hire more contract health workers to meet the rising health services demand resulting from the National Health Insurance expansion . While the managers generally have no direct authority to ask for more permanent health workers, whose deployment and distribution are dictated by the national government, they now have the ability to hire more contract health workers expeditiously based on the emerging health needs of the community health centres …”