Indonesia trials JKN health insurance reforms in Muara Enim

The Indonesian Ministry of Health has launched a trial for the reform of the National Health Insurance (JKN) system in Muara Enim, South Sumatra. This initiative aims to overhaul the existing referral system to improve access, service quality, and financing effectiveness.

One major component is the Service Capability-Based Referral (RBKP) scheme. This replaces the traditional tiered referral process—moving from Type D to C, B, and finally A hospitals—with a system that directs patients directly to the facility best equipped to handle their specific medical diagnosis.

The reform includes three main pillars:

1. The RBKP scheme for streamlined referrals. 2. The implementation of Standard Inpatient Classes (KRIS), which standardizes 12 criteria for hospital rooms, including a maximum of four beds per room, central oxygen supply, nurse call buttons, and private bathrooms. 3. A transition in healthcare financing to the Indonesian Diagnosis Related Groups (iDRG) system, designed to make hospital claims more accurate based on the complexity of patient conditions.

Muara Enim was selected as a trial site alongside Bandung, Makassar, and Tulungagung due to its strategic geographic location. The 12-month trial will proceed effectively following the signing of a Presidential Regulation by President Prabowo Subianto.