strategi rsmenghadapi pelaksanaan bpjs ditinjau dr sistem remun dan analisis fator2 nya

7/25/2019 Strategi RSmenghadapi Pelaksanaan BPJS Ditinjau Dr Sistem Remun Dan Analisis Fator2 Nya

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Curiculum Vitae: Dr.dr.Sutoto,MKes

TEMPAT/TGL LAHI :P!"#KET#, $% &!LI ' %()$&A*ATA+ SEKAA+G:%. Ketua KAS T $-%$-%0

$. Ketua umum PESI T $--($-%$/$-%$$-%)1. De2a3 Pem4i3a MKEK IDI Pusat. De2a3 Pem4i3a AIP+I 5Asosiasi I3stitusi

Pe3didi6a3 +ers I3do3esia7). A388ota Komite Keselamata3 Pasie3 uma Sa6e

Keme3teria3 Keseata3 .I

9. De2a3 Pe3a3tu3 S Mata Cice3do,Pusat Mata+asio3al

PE+GALAMA+ #GA+ISASI;. Ketua :ISPI 5I6ata3 S Pe3didi6a3 I3d7 T $--)

$--00. Ketua :ASPI 5Asosiasi S Pe3didi6a3 I3d7 T $--0

$-%-(. Ketua IS&AM 5I6ata3 S &a6arta Metro Di. Ga?amada

1. S III Ma3a?eme3 Pe3didi6a3 !3i>ersitas +e8eri &a6arta 5Cumlaude7

PE+GALAMA+ KE&A. Dire6tur S!D *a3umas &a2a Te38a %(($$--%

). Dire6tur !tama S!P =atma2ati &a6arta $--% $--)

9. Dire6tur !tama S Ka36er Darmais &a6arta $--)$-%-

;. Sesdit?e3/Plt Dir?e3 *i3a3med KEME+KES .I 5=e4&uli $-%-7


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STATEGI S ME+GHADAPI PELAKSA+AA+ *P&S

DITI+&A! DAI

SISTEM EM!+EASI DA+A+ALISA TEHADAP =AKT# ' =AKT# @A+G

MEMPE+GA!HI TEHADAP

PEM*ELAK!A+ SISTEM EM!+EASI PEGA"AI

D.Dr.Sutoto,M.Kes


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P#K#K *AHASA+

1. STRATEGI MENGHADAPI BPJS

2. REMUNERASI DI ERA JKN DANFAKTOR-FAKTOR YANGMEMPENGARUHI

PEMBERLAKUAN SISTEMREMUNERASI


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Micael Hammer da3 &ames Cam


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E=#MASI PELA@A+A+ S

%. AKEDITASI +ASI#+AL *E STA+DA I+TE+ASI#+AL

$. &AMI+A+ KESEHATA+ +ASI#+AL/!+IVESAL HEALTH

C#VEAGE


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UNIVERSAL HEALTH COVERAGEFinancia P!"#$c#i"n

Millions sufer nancial ruin when they usehealth services:

Globally around 150 million sufer severenancial hardship/ catastrophic healthexpenditures each year.

100 million are pushed into povertybecause they must pay outo!poc"et at

the time they receive health services.


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!+IVESAL HEALTH C#VEAGE

5"H#7

CHA!"#$ %#R& 'A$(

)*+C CHA!"# +! M+!-$#(


11/43

&K+

$#(#!"AH HA(+

A.B! #$#HA(A! : /,10 $#HAR*$!&A

0

$*B$+-+ BBM /2 (

$*B$+-+ .B+ 19 (

R$ 33


12/43

PE!*AHA+ SISTEM PELA@A+A+ KESEHATA+

*AGI PASIE+ *P&S

.asien B.J$

$*(4(4 .#R$+ 1/

15 .#R*BAHA! $+$(#M R*J*A!

/5 .#R*BAHA! $+$(#M .#MB+A&AA!65 .#R*BAHA! $+$(#M .#MBA&ARA!

.#R*BAHA! +!+ &A!" HAR*$ -+ A!(+$+.A$+ 47#H R$


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PE!*AHA+ SISTEM DI S

SISTEM =EE =#SEVICE

&K+

R*J*A! 'R## '748 B#RJ#!JA!"

.#MB+A&AA! 4*( 4'.4C#(

+*R B+A&A .-B.J$

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+!A CB"s

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SISTEM =EE =#SEVICE

&K+

.#MBA"+A!JA$A

'R## '4R$#R%+C#

R#M*!#RA$+


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TAI= I+A C*Gs

(erlalu Rendah

8aar

(erlalu (inggi


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16/43

TAI=

=EE =# SEVICE

M#M*-AHA! R$, BA"+ .+HA

.#MBA&AR $*7+(

$#$*A+ .#7A&A!A! &A!"

-+B#R+A!

74$ .A!JA!" 55 (AR+' B#$AR

4BA( MAHA7*!(*!" B#$AR

+!'#$+ !4$44M+A7574$

!A+55(AR+' !A+55

#'+$+#! 333 (A .#R7* AR#!A

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.R4'#$+ 55(A HAR*$, 5

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M*-AH

M#M*-AHA! .+HA

.#MBA&AR55

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JA$A &A! -A! JA$A $ARA!A 74$ .A!JA!" 55 R$ R*"+

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+!'#$+ !4$44M+A7 !A+

574$ !A+55 R$ R*"+55

M#MBA"+ JA$A .#7A&A!A!R#M*!#RA$+

TAI=

I+A C*Gs


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AKEDITASI

..+

.A(+#!( $A'#(&

.A(+#!( C#!(#R#- CAR#;.M.:

R$ HAR*$ A-A .. &" -+$#R(A+

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C7+! .A(H555

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#!-A7+ M*(* .. -A!C7+!+CA7 .A(H8A&

TAI=

I+A C*Gs


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+!.*( .R4$#$ 4*(.*( 4*(C4M#

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+M.AC(

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$(A!-AR .#7A&A!A!

$*(4(4


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$*(4(4


20/43

Selaa38 Pa3da38

Imersal Healt Co>era8e di +e8ara Teta388a

da3 emu3erasi Do6ter3a

Taila3d

Pili


21/43

GDP

+!-4!#$+A 6,=

MA7A&$+A >,>=

(HA+7A!- ,?2

.H+7+.+!A /,?=


22/43

//

Taila3dCountry Profile

@ Population 63 millions (2006)

@ Gross National Income per capita in 2006 $2,990

@ Total government bugets spening on !ealt! "0#2in 2002

%ealt! &are 'eorm

"999 *ecentrali+ation ct 200" -universal coverage. an t!e slogan -30 /a!t

ee or curing ever isease.

$upaanunti5 $iripen,5 'inancing for pulic health in insurance systems#periences sharing from (hailand5 $eminar on +!A


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Estimate of doctors salary++ per

month

Public !ospital 10,000 "10,000 ba!ts

($",00 1,000 )

Private !ospital 0,000100,000 ba!ts

($2,300",000 )


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Estimate of final charges to the insurer or

OOP

&aesarean eliver 4o complicating *5 Public %ospital "2,1 ba!ts ($"7)

Private %ospital 30,0001,000 ($",000$",100)

Inonesia /59=/59/

(8elas c severit level " reg ")


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Pili


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I3


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Case ate :

Sam


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DoctorBs =ees


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Ca%$&i'(DRG S)%#$& an*G"+a B,*$# in Maa)%ia

#asemix $ystem introduced in Malaysiasince 1%%& 'iloted in 1( M)* *ospitals and + ,eachin- *ospitals

n 00: #asemix M23G4 was ociallylaunched on teachin- hospital M23G4

n 006: 78723G Grouper was launched

n 010: 787#9G Grouper with $ubacute #hronic 2iseases #lassication$ystem with ,op 7p !or $pecial Group

8an .uteh5 $harifa #Eat5 Hospital (ari in Malaysia5 -epartment Community Health, $eminar !asional $tandar (arif -oter, Jaarta, 4ctoer /21/5ff


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Pame3t Hos


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Ga?i Do6tor !mum Pemeri3ta

66

1 RM : Rp 6522

>, uta

Rp 1>, uta Rp /= uta

Rp 9, uta


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REMUNERASI ..

EA *P&S ..EM!+EASI "A&I*

LA@AK, ADIL

MEM*EI PE+GHAGAA+ PADA PEKE&AA+ DA+

KI+E&A DA+ MASA KE&A

ME+I+GKATKA+ M#TIVASI KE&A

TIDAK M!DAH.


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emu3eratio3 scemes:

Create some oFnership mentality y the staff Must motivate staff and retain staff

Reinforce that every interaction, every dollar,

every client, every transaction and every

Gmoment of truthG must C4*!(

Must e simple, transparent, consistent and

easily calculated y staff5

$taff must e already paid at maret rate andperceive etter value in Foring at our practice

than any other competitor5


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THE KE@ T# AV#IDI+G A+D

ES#LVI+G C#+=LICT

Being thoughtful Fhen you assign os to grades

'olloFing the same process for everyone

Maing the process as open and transparent as is practical

Having respected people assign os to grades

Having some ind of appeal process this can e informalI 8hen there is a dispute loo for the underlying usiness issue i5e5

this

ey employee is going to uitI rather than focusing on the

mechanics of

(he system i5e5 they are at the pay maimum of the gradeI


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@ Proporsionalitas, ukuran (size) dan jumlah aset yang

dikelola, tingkat pelayanan@ Kesetaraan, Memperhatikan industri pelayanan yg

setara@ Kepatutan, kemampuan Penerimaan RS@ Kinerja operasional, indikator keuangan, pelayanan,

mutu dan manfaat

PRINSIP DASAR REMUNERASI


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%. Pa or


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Pa) 0"! P$!0"!&anc$ +$!ai#an *$nan ca/aian #a!$#in$!3a )an #$a4 *i"n#!ain$!3aan*i+a)a!an %$ca!a /$!i"*i %$%,ai$+i3aan ,ni# $!3a("!ani%a%i.

+$!,/a in%$n#i0 *an(a#a, +"n,%5+$!%i0a# 6a!ia+$7

;)M')8


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A. KNO9 HO9

1. K"&/$#$n%i T$ni% 5/$n$# : $#!a&/ian%,+%#an%ia 7

/$n*i*ian8 /$a#i4an *an /$naa&an $!3a. 2. K$&a&/,an Mana3$!ia 5"&/$%i#a%

$/$&i&/inan7

;. K"&,nia%i

B. PROBLEM SOLVING


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CORPORATE GRADEC#P

GADE

+ILAITE

TI+GGI&+D

+ILAITE

E+DAH

C#PGADE

$- $-

%( %(

%0 %-;)- $-F 09-- STATEGIC LEADE %0

%; 0)(( $-F 90)- MEDIK SL )Stratejik

Korporasi III

(DIRUT)

%;

%9 90( $-F );( M; Sp 2 - K2Surgery

SL Stratejik

Korporasi II(DIRKTUR)

%9

%) );0 %0F ($ M9Sp 2 - K2

!on SurgerySp 2 - K"Surgery

SL 1Stratejik

Korporasi I%)

% (% %0F 1901 M)Sp 2 - K"

!on SurgerySp "

Surgery#PEASI#+AL LEADE SL $

StratejikUsaha II

%

%1 190$ %0F 1-- MSp "

!on Surgery #L

Stratejik#perasiona$ II

SL %StratejikUsaha I

%1

%$ 1--1 %0F $9$ M1 % Senior #L 1Stratejik

#perasiona$ I %$

%% $9% %0F $-%0 M$%

Interme&iate PEA"AT PE+!+&A+G MEDIK #L $

Super'isi#perasiona$

%%

%- $-%; %0F %9) M% % unior +) %astery PM) %astery #PEASI#+AL STA== #L %Super'isi

Teknis%-

( %9)1 %0F %1)9 KETEA+GA+ : + pert PM pert #S )*na$is

Konseptua$ II(

0 %1)) %0F %%%% M MEDIK +1 Competen+e PM1 Competen+e #S *na$is

Konseptua$ I0

; %%%- $-F 000 + +!SE +$ Interme&iate PM$ Pro,ession #S 1*na$is Dasar

Trampi$;


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/

FORMULA PERHITUNGAN

REMUNERASI PEGAWAI RS

NILAI (INDE

PEKERJAANIKI IKU

NOMINALPOIN

Niai N"&ina P"in a*aa4 niai %a#,an !,/ia4 )an *i#$#a/an +$!*a%a!%nanai%a 4a%i $!3a !,&a4 %ai# *an /$n$#a/an ana!an !$&,n$!a%i.

In*$% Kin$!3a Uni# 5 IKU 7 *i#$#a/an +$!*a%a!an /$nca/aian #"#a #a!$# ,ni# $!3a #$&/a#/$$!3aan /$a@ai /$&$an /$$!3aan #$!%$+,# *aa& %#!,#,! "!ani%a%i.

Niai /$$!3aan(Job Value a*aa4 a&+a!an /!" %,a#, /$$!3aan a#a%%$,!,4 0ac#"!-0a#"! /$niaian a#a, /$ni&+an )an *in)a#aan *aa& #"#aniaiIn*$% Kin$!3a In*i6i*, 5 IKI 7 *i#$#a/an &$a,i %,a#, /$niaian )ai#, *$nan&$&+an*inan an#a!a /$nca/aian #"#a #a!$# *$nan Sa#,an Kin$!3a In*i6i*, 5SKI7 /a*a0a#"!-0a#"! )an *i#$n#,an *an *i#a!$#an.


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TEIMA KASIH

strategi rsmenghadapi pelaksanaan bpjs ditinjau dr sistem remun dan analisis fator2 nya

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