Analysis of Performance-Based Capitation Payments at the Community Health Services in Semarang City

Abstract

The health financing system at the community
health center is a pre-effort where funds are given at
the beginning of each period before health services
are carried out; this is called capitation. Starting
in November 2019, performance-based capitation
payments have been implemented in accordance
with Health BPJS Regulation No. 7/2019.
This study aimed to determine the amount of
performance-based capitation payments, the
mechanism for achieving performance-based
capitation payments, and the problems faced in
achieving performance-based capitation payments
referring to Health BPJS Regulation No. 7/2019.
This study used qualitative type with an evaluative
approach to see the implementation of the
performance-based capitation in the research locus.
Data were collected using triangulation with FGD
and in-depth interview and document review using
tools: interview guides, FGD guidelines, recording
devices, and cameras. Data were analyzed using
the Miles and Huberman model including data
reduction, presentation, and induction methods in
drawing conclusions.The results of the study show
that the Controlled Ratio Indicator of chronic disease
management program participants was the toughest
indicator to achieve, the decrease in capitation
payments affected revenues and expenditures of the
community health center, there was no legal aspect
for implementers and internal guidelines or SOP
for the implementation of the performance-based
capitation, the data entry mechanism was through
P-Care, not all outdoor activities could be stopped
and not all activities could be entered in real time,
monitoring and evaluation for achieving indicators
and capitation payments have not been structured
and scheduled, and there was no warning system for
indicator achievement.