In 2016, BPJS Kesehatan has introduced Kapitasi Berbasis Komitmen (KBK) scheme for Puskesmas (community health centres) to encourage primary health care utilization. This study aimed to evaluate its effects based on claims data.
BPJS Kesehatan is one of the largest single purchasers in the world. It manages the national health insurance or the JKN in Indonesia. In 2016, BPJS has introduced Kapitasi Berbasis Komitmen (KBK) scheme for puskesmas (community health centres) which combined capitation-based payments and performance-based financing to enhance primary health care utilization. This study aimed to evaluate its effects of based on three incentivized outcomes: the fraction of insured visiting the puskesmas, the fraction of chronically ill with a puskesmas visit and the hospital referral rate for insured with a non-specialistic condition.
BPJS Kesehatan claims data from 2015 to 2016 from a stratified one percent sample of its members was used to analyze by using Difference-in-Differences (DID) study design and estimate a two-way fixed effects regression model. Findings showed that KBK performance-based capitation reform has not been very successful in substituting secondary care use by greater primary care use. This article was published in Social Science & Medicine.