The Social Security Administering Body for Health (BPJS Kesehatan), Indonesia, has won the ISSA Good Practice Award for Asia and the Pacific for its National Health Security Programme. This is the largest single-payer health scheme in the world, and the BPJS Kesehatan received the award during the Virtual Social Security Forum for Asia and the Pacific.
Indonesia is a rapidly growing middle-income country with a population of 271 million and is the largest archipelagic country in the world, with 17,491 islands. Established in 2014, BPJS Kesehatan is mandated by law to extend universal health coverage to all Indonesian citizens. It manages a single payer national health social security programme in a vast country with considerable geographical barriers.
Through an ambitious, proactive, and flexible approach, the BPJS Kesehatan managed to grow its health coverage from 133.4 million members in 2014 to 222.4 million members in 2020. In the same period, the number of primary health care providers increased from 18,437 to 22,953, and the customer satisfaction rate improved in parallel from 78.6 per cent to 81.5 per cent. Based on these achievements, BPJS Kesehatan won the ISSA Good Practice Award for Asia and the Pacific 2021.
“BPJS Kesehatan of Indonesia has set a great example in building universal health coverage, through digital innovation and organizational determination”, said Marcelo Abi-Ramia Caetano, ISSA Secretary General during the presentation and awarding ceremony at the Virtual Social Security Forum for Asia and the Pacific. Digital service transformation has contributed to improving business processes and supporting the growth of membership, revenue, health care providers and customer satisfaction.
The ISSA Good Practice Award for Asia and the Pacific drew a record participation of 168 entries from 30 social security organizations in 19 countries. Digitalization has been a core element in the organization’s strategy, and its innovative solution was based on the ISSA Guidelines on administrative solutions for coverage extension.
The BPJS Kesehatan developed its digital approach in four clusters:
Four clusters for a digital ecosystem
The BPJS Kesehatan defined its digital ecosystem into four clusters.
Members cluster: Services shifted from offline to self-service mobile apps, including conversational artificial intelligence chatbots.
Health care provider cluster: Digital credentialing and re-credentialing processes were established for health care facility providers, as well as digital solutions for services, administration, billing and claim verification, and fraud detection.
Bank and finance cluster: Online banking solutions were strengthened, and a network of 650,000 payment points established through financial institutions.
Interconnected stakeholder cluster: BPJS Kesehatan cooperated with various ministries, public and private organizations, associations, and communities to optimize data updating and expand membership in web-based services.
Many other good practices of ISSA member institutions from Asia and the Pacific were presented and discussed during the Virtual Forum. They can all be found in the ISSA Database of Good Practices, which counts close to 1200 good practices from around the world.