The Effect of Capitation Value of Healthcare and Social Security Agency on Service Quality at Primary Clinics
Keywords:Healthcare and Social Security Agency, Fraud, Capitation, Primary Clinic, Quality, Services.
Indonesia started to apply the National Health Insurance System on January 1, 2014, and the legal entity
formed to administer this program is the Healthcare and Social Security Agency. Funding for the Healthcare
and Social Security Agency at primary clinic uses the capitation system where the funds are mostly used for
services and operations. The use of capitation funds at the primary clinic is fully managed by itself based on
the agreement. This actually creates the potential for fraud because of the lack of regulations on using the
capitation funds. Fraud at the primary clinic does not really appear on the surface like a fraud in hospitals. It
can be in the form of insufficient resources, facilities and service discrimination. Many studies have shown
a link between capitation funds and health services. A primary clinic needs to have an audit team to evaluate
whether the use of capitation funds is following the expected targets and needs.
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