ANALYSIS OF BPJS KESEHATAN’S RESERVES PORTION FOR CANCER CLAIMS

• Main Author: Lavinia Setiawan, Vicky
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/47715
• Institution: Institut Teknologi Bandung

Public health plays an important role in human development and so it does to the growth of a country. Since 2014, Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan has been present amidst Indonesian citizens to ensure that all of them are protected with the best quality of health insurance without discrimination. BPJS Kesehatan conduct social security scheme with cross-subsidization as its cornerstone. In its realization, the cross subsidies have never been enough to cover the total benefits paid out and this leads them to continued trillion-rupiah deficits. The huge difference between benefits and premiums is the root of this problem. Catastrophic illnesses, such as cancer, might be a good example due to its high-cost treatments. Data sets of medical expenses reimbursement in 2015-2016 from BPJS Kesehatan are used to support the reserves analysis in this project. In the end, the proper amount of premium which should have been paid by the members will be estimated.