Indonesia : Republic of Indonesia: Improving the Spending Efficiency of the National Health Insurance System

Sovereign Project | 56127-001

The proposed TA will support the Indonesian government to improve the spending efficiency of its national health insurance scheme, with the aim of achieving financially sustainable universal health coverage that delivers good quality of care. The need for a sustainable universal health coverage scheme is even more pressing as the country restructures its health system in light of the COVID-19 pandemic. Both the Ministry of Health (MoH) and the national health insurance agency, Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS-K), will be closely involved in implementing the TA. The TA will assess the current level of efficiency in the current national health insurance operations. It will then diagnose the root causes and binding constraints that result in low efficiency, and thereafter design potential solutions to alleviate these constraints. The effectiveness of the solutions will be evaluated, with a view to identifying implementation constraints and scaling up successful elements.

Project Details

  • Project Officer
    Aji, Priasto
    Economic Research and Development Impact Department
    Request for information
  • Country/Economy
    Indonesia
  • Sector
    • Health
Project Name
Republic of Indonesia: Improving the Spending Efficiency of the National Health Insurance System
Project Number
56127-001
Country / Economy
  • Indonesia
Project Status
Active
Project Type / Modality of Assistance
  • Technical Assistance
Source of Funding / Amount
TA 10275-INO: Improving the Spending Efficiency of Indonesias National Health Insurance System
Source Amount
Japan Fund for Prosperous and Resilient Asia and the Pacific US$ 2.00 million
Operational Priorities
  • OP1: Addressing remaining poverty and reducing inequalities
Sector / Subsector
  • Health / Health insurance and subsidized health programs

Gender
Some gender elements
Description
The proposed TA will support the Indonesian government to improve the spending efficiency of its national health insurance scheme, with the aim of achieving financially sustainable universal health coverage that delivers good quality of care. The need for a sustainable universal health coverage scheme is even more pressing as the country restructures its health system in light of the COVID-19 pandemic. Both the Ministry of Health (MoH) and the national health insurance agency, Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS-K), will be closely involved in implementing the TA. The TA will assess the current level of efficiency in the current national health insurance operations. It will then diagnose the root causes and binding constraints that result in low efficiency, and thereafter design potential solutions to alleviate these constraints. The effectiveness of the solutions will be evaluated, with a view to identifying implementation constraints and scaling up successful elements.
Project Rationale and Linkage to Country/Regional Strategy
Indonesia's health insurance system, the Jaminan Kesehatan Nasional (JKN), has made important accomplishments since its establishment in 2014 but has also missed its target of achieving universal health coverage within five years of implementation. Partly due to heavy subsidization and high payouts, the JKN suffers from a high claim ratio - the ratio between expenditure on health services and revenue, which has consistently surpassed 100%. To address the issue the TA will delve into examining the JKN's low level of operational efficiency by constructing measurements for capturing the level of efficiency to help identify its possible root causes and devise possible solutions to it.
Impact

Universal coverage of quality essential healthcare services through an efficient and financially sustainable public healthcare service is achieved.

Project Outcome

Description of Outcome

More efficient delivery of JKN

Progress Toward Outcome

Implementation Progress

Description of Project Outputs

Trends in JKN operational efficiency measured and causes of low efficiency identified

Solutions to improve JKN operational efficiency tested out

Impact of solutions evaluated and support for scale up provided.

Capacity to use and analyze administrative data for measuring operational efficiency improved.

Status of Implementation Progress (Outputs, Activities, and Issues)
Geographical Location
Nation-wide

Summary of Environmental and Social Aspects

Environmental Aspects
Involuntary Resettlement
Indigenous Peoples

Stakeholder Communication, Participation, and Consultation

During Project Design
During Project Implementation

Business Opportunities

Consulting Services
Individual consultants will be recruited through framework agreements wherein shortlisted candidates may be hired as needed for the duration of the agreement to provide services on data analysis, report writing, and capacity-building activities. A firm will be recruited using a quality- and cost-based, and/or single-source selection method. ADB will engage consultants and carry out procurement following the ADB Procurement Policy (2017, as amended from time to time) and its associated project administration instructions and/or staff instructions.
Procurement
N/A

Contact

Responsible ADB Officer
Aji, Priasto
Responsible ADB Department
Economic Research and Development Impact Department
Responsible ADB Division
Macroeconomics Research Division (ERMR)
Executing Agencies
Ministry of Health

Timetable

Concept Clearance
20 Jun 2023
Fact Finding
04 Sep 2023 to 07 Sep 2023
MRM
-
Approval
25 Jan 2024
Last Review Mission
-
Last PDS Update
25 Jan 2024

Funding

TA 10275-INO

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
25 Jan 2024 - - 31 Dec 2026 - -
Financing Plan/TA Utilization
ADB Cofinancing Counterpart Total
Gov Beneficiaries Project Sponsor Others
0.00 2,000,000.00 0.00 0.00 0.00 0.00 2,000,000.00
Cumulative Disbursements
Date Amount
15 Jul 2024 0.00

Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.

The Access to Information Policy (AIP) recognizes that transparency and accountability are essential to development effectiveness. It establishes the disclosure requirements for documents and information ADB produces or requires to be produced.

The Accountability Mechanism provides a forum where people adversely affected by ADB-assisted projects can voice and seek solutions to their problems and report alleged noncompliance of ADB's operational policies and procedures.

In preparing any country program or strategy, financing any project, or by making any designation of, or reference to, a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

Title Document Type Document Date
Improving the Spending Efficiency of the National Health Insurance System: Technical Assistance Report Technical Assistance Reports Jan 2024

Safeguard Documents See also: Safeguards
Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

None currently available.


Evaluation Documents See also: Independent Evaluation

None currently available.


Related Publications

None currently available.


The Access to Information Policy (AIP) establishes the disclosure requirements for documents and information ADB produces or requires to be produced in its operations to facilitate stakeholder participation in ADB's decision-making. For more information, refer to the Safeguard Policy Statement, Operations Manual F1, and Operations Manual L3.

Requests for information may also be directed to the InfoUnit.

Tenders

No tenders for this project were found.

Contracts Awarded

No contracts awarded for this project were found

Procurement Plan

None currently available.