Hospital Competitive Advantage Strategies in the National Health Insurance (JKN) Era: A Literature Review
DOI:
https://doi.org/10.58268/eb.v5i1.275Keywords:
JKN; BPJS Kesehatan; competitive advantage; INA-CBGs; hospital management; clinical pathwayAbstract
The implementation of National Health Insurance (JKN) through BPJS Kesehatan since 2014 has fundamentally transformed the healthcare financing landscape in Indonesia. The Indonesian Case Base Groups (INA-CBGs) payment system compels hospitals to adopt more efficient and competitive management strategies. This literature review aims to examine competitive advantage strategies employed by hospitals in response to JKN system pressures, including cost leadership strategies, service differentiation, clinical pathway optimization, Bed Occupancy Rate (BOR) and Length of Stay (LOS) management, and center of excellence development. Literature searches were conducted through PubMed, Google Scholar, and Garuda databases covering 2014-2024 using keywords related to JKN, BPJS, hospital management, and competitive strategy. Findings indicate that hospitals maintaining their competitiveness successfully combine cost efficiency strategies with high-quality service differentiation. Clinical pathway optimization has proven capable of reducing average treatment costs by 15-25% without compromising service quality. Center of excellence development serves as an effective differentiation strategy for attracting non-JKN patient segments. Optimal BOR management (>75%) and LOS control aligned with INA-CBGs standards are key to hospital financial sustainability. These findings underscore the need for a comprehensive strategic approach that integrates operational efficiency with enhanced patient service value.
References
Amelia, R., Santoso, B., & Wijayanti, D. (2023). Center of excellence sebagai strategi diferensiasi rumah sakit dalam sistem JKN: Studi kasus rumah sakit tersier di Indonesia. Jurnal Administrasi Rumah Sakit Indonesia, 9(2), 87-101. https://doi.org/10.7454/arsi.v9i2.4521
Andayani, S., & Hariyati, R. T. S. (2022). Hubungan strategi diferensiasi layanan dengan kepuasan pasien dan pendapatan rumah sakit di era JKN. Jurnal Manajemen Pelayanan Kesehatan, 25(3), 112-124.
BPJS Kesehatan. (2023). Laporan pengelolaan program dan laporan keuangan jaminan sosial kesehatan tahun 2022. BPJS Kesehatan.
Dewi, A. P., Supriyanto, S., & Notobroto, H. B. (2021). Implementasi clinical pathway dalam pengendalian biaya klaim INA-CBGs di rumah sakit. Jurnal Administrasi Kesehatan Indonesia, 9(1), 45-58. https://doi.org/10.20473/jaki.v9i1.2021.45-58
Handayani, T., Purnomo, W., & Suhartono, E. (2023). Faktor determinan keberhasilan implementasi clinical pathway di rumah sakit umum daerah: Tinjauan sistematis. Jurnal Kesehatan Masyarakat, 18(2), 203-217.
Hidayati, N., Santoso, M. H., & Rahayu, S. (2022). Discharge planning terstruktur dan angka readmisi 30 hari pada pasien gagal jantung kongestif. Indonesian Journal of Hospital Administration, 5(1), 33-44.
Kristiani, A. D., Mulyani, S., & Yusuf, A. (2020). Analisis strategi cost leadership rumah sakit dalam era Jaminan Kesehatan Nasional di Provinsi Jawa Barat. Jurnal Kebijakan Kesehatan Indonesia, 9(4), 178-190.
Lubis, A. N., Harahap, I. M., & Siregar, A. P. (2022). Dampak pengembangan pusat jantung terpadu terhadap kinerja keuangan dan kualitas layanan RSCM. Jurnal Manajemen Rumah Sakit, 14(1), 1-15.
Mahirawati, V. K. (2021). Analisis faktor-faktor yang memengaruhi Bed Occupancy Rate (BOR) dan dampaknya terhadap pendapatan rumah sakit dalam sistem JKN. Jurnal Administrasi Rumah Sakit Indonesia, 7(3), 145-159.
Nugroho, H., & Suharto, A. (2021). Integrasi clinical pathway dengan sistem informasi manajemen rumah sakit untuk monitoring kinerja klinis berbasis data. Jurnal Sistem Informasi Kesehatan, 6(2), 88-99.
Porter, M. E. (1985). Competitive advantage: Creating and sustaining superior performance. Free Press.
Porter, M. E., & Lee, T. H. (2013). The strategy that will fix health care. Harvard Business Review, 91(10), 50-70.
Porter, M. E., & Teisberg, E. O. (2006). Redefining health care: Creating value-based competition on results. Harvard Business School Press.
Prasetyo, H. B., Sari, I. P., & Kuswanto, D. (2020). Strategi manajemen kapasitas rawat inap rumah sakit berbasis analisis alur pasien dalam sistem JKN. Jurnal Kesehatan Vokasional, 5(3), 130-142.
Purbatin, A., Hidayat, A., & Wulandari, R. D. (2021). Strategi bersaing rumah sakit swasta dalam menghadapi implementasi JKN di Kota Surabaya. Jurnal Administrasi Kesehatan Indonesia, 9(2), 177-191.
Rahayu, S. R., Indrawati, L., & Suwandono, A. (2020). Pengaruh implementasi clinical pathway appendisitis akut terhadap lama rawat dan biaya perawatan di rumah sakit. Jurnal Kesehatan Masyarakat, 15(2), 85-96.
Rokx, C., Schieber, G., Harimurti, P., Tandon, A., & Somanathan, A. (2020). Health financing in Indonesia: A reform road map. World Bank Publications.
Sari, D. A., & Purnomo, E. P. (2021). Strategi pemasaran layanan center of excellence rumah sakit dalam memenangkan persaingan di era JKN. Jurnal Manajemen dan Administrasi Rumah Sakit Indonesia, 5(2), 67-79.
Setiawan, B., Wardhana, M., & Firdaus, R. (2022). Evaluasi dampak implementasi clinical pathway terhadap kinerja keuangan dan klinis rumah sakit umum daerah kelas B. Jurnal Ekonomi Kesehatan Indonesia, 7(1), 15-28.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333-339. https://doi.org/10.1016/j.jbusres.2019.07.039
Trisnantoro, L., Kusnanto, H., & Prabandari, Y. S. (2019). Pembiayaan kesehatan Indonesia: Dari Askes menuju JKN semesta. Gadjah Mada University Press.
Wijaya, A., & Supriyanto, S. (2022). Optimasi indikator kinerja pelayanan rawat inap dalam era JKN: Analisis BOR, LOS, TOI, dan BTO. Jurnal Administrasi Rumah
Sakit Indonesia, 8(1), 1-14.
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