The BPJS Insurance System will Change its Class Structure

President Joko Widodo of Indonesia has officially abolished the class 1, 2, and 3 system of BPJS social insurance by issuing Presidential Decree 59/2024. In its place, the Jokowi administration will implement the Standard Inpatient Class System (KRIS).

The Health Social Security Administration Agency (BPJS) will begin implementing the KRIS system in all affiliated hospitals by June 30, 2024. Meanwhile, the new contribution system for participants will take effect on July 1, 2025.

With the introduction of KRIS, BPJS contributions will also change. Previously, BPJS membership was divided into categories 1, 2, and 3, which determined the monthly contributions participants had to pay. These classes also determined the quality of inpatient care received; the better the inpatient class, the higher the monthly contribution.

The government has not yet determined the contribution amounts for the KRIS system, as they are still being calculated. Changes in the contribution rates under the KRIS system are detailed in Article 103B of Presidential Decree No. 59 of 2024. Section 6 of Article 103B states that the Minister of Health will assess the facilities of procedural rooms in each hospital in collaboration with BPJS, the National Social Security Council, and the minister responsible for state financial affairs.

Furthermore, Section 7 of the same article specifies that the assessment and coordination of procedural rooms in inpatient services will form the basis for determining benefits, rates, and contributions. However, Section 8 of the article states: "The determination of benefits, rates, and contributions, as referred to in point (7), shall be finalized no later than July 1, 2025." Therefore, significant changes are not expected until next year.

The new KRIS insurance system sets standards for inpatient class wards, which include 12 criteria. According to KRIS requirements, hospitals will need to separate procedural rooms based on the patient's gender, whether the patient is a child or an adult, and whether the disease is infectious or non-infectious.

Other criteria require service providers to consider the density of the procedural room and the quality of the beds, provide curtains or partitions between beds, and ensure bathrooms in inpatient wards meet the standards.

Sources: nasional.tempo.co, cnnindonesia.com