Open Daily: 10am - 10pm | Alley door pickup 10am - 7pm 3038 Hennepin Ave Minneapolis, MN
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  • Open Daily: 10am - 10pm
    Alley-side Pickup: 10am - 7pm

    3038 Hennepin Ave Minneapolis, MN
    612-822-4611

Open Daily: 10am - 10pm | Alley-side Pickup: 10am - 7pm
3038 Hennepin Ave Minneapolis, MN
612-822-4611
Using Casemix System for Hospital Reimbursement in Social Health Insurance Programme: Comparing Casemix System and Fee-For-Service as Provider Payment

Using Casemix System for Hospital Reimbursement in Social Health Insurance Programme: Comparing Casemix System and Fee-For-Service as Provider Payment

Syukri, Eka Yoshida
Aljunid, Syed

Paperback

Health General

ISBN10: 1543761712
ISBN13: 9781543761719
Publisher: Partridge Pub Singapore
Published: Nov 26 2020
Pages: 216
Weight: 0.62
Height: 0.49 Width: 5.50 Depth: 8.50
Language: English
Social Health Insurance (SHI) is one of the vehicles in achieving Universal Health Coverage. However, in many low- and middle-income countries, implementation of SHI failed to provide efficient and effective coverage due to poor provider payment method. Indonesia has introduced social health insurance in 2014. With the population of more than 270 million, Indonesia is the biggest country in the world that implemented SHI with casemix system (INA-CBG) as the prospective provider payment method. In this book, we presented an outcome of a study implemented in the largest hospital in Jakarta, Indonesia that compared the impact of using casemix system as provider payment method with fee-for-service. A total 32,227 outpatients and 8,270 inpatients medical records were reviewed and included in the study. In addition, a survey was also conducted among billing administrators to assess the cost of the billing process and their perceptions on the two reimbursement methods. The total hospital charges, length of stay of inpatients, rate of unnecessary admissions and cost of billing process were among the indicators of efficiency compared in the study between the two provider payment methods. The book provides comprehensive evidence to confirm the advantages of casemix system as an efficient provider payment method in SHI programme.

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