Bandung, IO – The Ministry of Health, the National Social Security Council (DJSN), and BPJS Kesehatan have selected Bandung as one of the pilot locations for reforming the National Health Insurance (JKN) system. The pilot will overhaul patient referral procedures to make healthcare access faster, more targeted, and more equitable, including by removing the existing hospital class-based referral system.
The pilot program was further developed during a cross-agency advocacy visit to Bandung on Thursday, September 24, 2026. Before the visit, officials from the Ministry of Health, DJSN, and BPJS Kesehatan conducted field inspections at Santosa Bandung Central Hospital and Advent Hospital.
The delegation met with hospital management and assessed bed capacity, facilities, and infrastructure to determine whether healthcare facilities were ready to implement the three pillars of JKN reform. Apart from Bandung, the pilot, which will run for a maximum of 12 months, will also be conducted simultaneously in Makassar, Tulungagung Regency, and Muara Enim Regency.
Ministry of Health Secretary-General Kunta Wibawa Dasa Nugraha said the reform would be built around three main pillars.
The first is Competency-Based Referrals (RBKP), which will eliminate the conventional requirement for patients to be referred sequentially from primary healthcare facilities to Class D, C, B, and A hospitals. Instead, healthcare facilities will be classified according to their ability to treat specific conditions: Basic, Intermediate, Advanced, and Comprehensive.
“If a patient at a community health center needs heart surgery, they will be referred directly to a healthcare facility with the appropriate expertise. This will make referrals faster and ensure patients receive treatment suited to their condition,” Kunta said.
The second is implementing Standard Inpatient Care (KRIS). All hospitals will be required to meet 12 standards for inpatient rooms, including a maximum of four beds per room and an ensuite bathroom. Kunta said nearly all hospitals in Bandung were currently ready to implement the standards.
The third pillar involves adjusting treatment reimbursement rates through the Indonesia Diagnosis Related Group (iDRG) scheme. The system will replace the existing Indonesia Case Based Groups (INA-CBG) scheme and is designed to better reflect the complexity of each medical condition.
The new system is expected to significantly reduce treatment times. A simulation involving a gallstone patient in West Java showed that the conventional referral system required up to 38 days for treatment and administrative procedures, with total claims reaching Rp36.4 million. Under the RBKP and iDRG schemes, the case could be resolved in 13 days, while the claim cost would fall to Rp19.9 million by eliminating unnecessary repeat visits.
Addressing concerns that the reform could lead to an influx of patients at Hasan Sadikin Hospital (RSHS), West Java’s highest-level referral hospital, Kunta said the new system would instead distribute patients more evenly.
“Most of the conditions currently treated at RSHS actually fall under the intermediate and basic competency levels. Going forward, such cases will be handled by regional public hospitals or other hospitals at those levels. RSHS will focus on advanced and comprehensive cases,” he said.
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Bandung Mayor Muhammad Farhan welcomed the pilot program, highlighting the pressure on healthcare facilities in the city, which have long served as major referral centers for patients from other parts of West Java.
“Hospitals in Bandung often become the final referral point for patients from neighboring cities and regencies. We expect that a more precise referral system will significantly improve the speed of medical services while making healthcare financing more efficient,” Farhan said.
On KRIS implementation, Farhan said standardizing inpatient rooms would significantly improve the quality of public healthcare services.
“Our current focus is meeting all 12 KRIS criteria without compromising hospital bed occupancy rates (BOR), which will demonstrate the readiness of our healthcare ecosystem, from primary services to comprehensive care,” he said.
Meanwhile, BPJS Kesehatan Deputy Director for Research, Innovation and Development Irfan Humaidi said the success of the pilot would depend heavily on coordination among stakeholders on the ground. He said Bandung’s achievement of priority Universal Health Coverage (UHC) status provided a strong foundation for the program.
“Close cooperation between healthcare facilities and the local government is absolutely essential for these three reforms to be implemented effectively,” Irfan said.
Beyond the three main pillars, the government will also address two gaps in the health insurance system: coverage for healthcare services across regional borders and a solution for medical expenses incurred by victims of violence, which are currently not covered by BPJS Kesehatan. (est)
