Evaluation Of Management Of Capitation Funds
Authors: Rachmawati Amalia , Syaodih Erliany , Widjaja Yani Restiani 
Published: December 2024

Universal Health Coverage (UHC) adalah program yang menjamin setiap manusia mendapatkan akses pelayanan kesehatan tanpa menimbulkan kerugian finansial penggunanya. Indonesia menerapkan UHC dengan Jaminan Kesehatan Nasional (JKN). Pelayanan kesehatan di tingkat primer diberikan oleh FKTP. Sistem pembayaran JKN pada FKTP oleh BPJS Kesehatan adalah dengan sistem kapitasi. Klinik Pratama Albar adalah FKTP di Kabupaten Bandung yang melayani peserta JKN dan mengelola dana kapitasi. Adanya peningkatan jumlah kapitasi terdaftar, kenaikan tarif kapitasi, dan kunjungan pasien belum sejalan dengan peningkatan laba dan pemanfaatan dana kapitasi yang ada sehingga diperlukan adanya evaluasi manajemen keuangan klinik dalam mengelola dana kapitasi. Tujuan penelitian ini adalah mengevaluasi pengelolaan dana kapitasi Klinik Pratama Albar dalam penganggaran dan pemanfaatannya. Penelitian ini adalah deskriptif kualitatif dengan metode observasi, wawancara, dokumentasi, dan triangulasi. Hasil penelitian menunjukkan kerjasama Klinik Pratama Albar dan BPJS Kesehatan berlangsung satu arah dan proses pencairan dana kapitasi berlangsung lancar. Klinik Pratama Albar telah memiliki struktur manajemen dan alur keuangan, namun belum dilakukan perencanaan anggaran yang baik. Dana kapitasi adalah sumber pemasukan terbesar klinik mencapai 86% dan pemanfaatannya untuk gaji staff dan biaya operasional dengan proporsi 59:41. Penelitian ini menyimpulkan bahwa pentingnya evaluasi pengelolaan dana kapitasi untuk menyusun strategi pengembangan klinik. Kata Kunci : Klinik Pratama, Dana Kapitasi, Evaluasi Manajemen Keuangan ABSTRACT Universal Health Coverage (UHC) is a program that ensures every human being gets access to health services without causing financial losses to its users . Indonesia implements UHC with the National Health Insurance (JKN) . Health services at the primary level are provided by FKTP . The JKN payment system at FKTP by BPJS Health is with a capitation system. Klinik Pratama Albar is an FKTP in Bandung Regency that serves JKN participants and manages capitation funds. The increase in the number of registered capitations, the increase in capitation rates, and patient visits have not been in line with the increase in profits and the utilization of existing capitation funds, so it is necessary to evaluate the clinic's financial management in managing capitation funds . The purpose of this study is to evaluate the management of capitation funds of the Klinik Pratama Albar in budgeting and its utilization. This research is qualitative descriptive with observation, interviews, documentation, and triangulation methods. The results of the study showed that the collaboration between the Klinik Pratama Albar and BPJS Health took place in one direction and the process of disbursing capitation funds went smoothly. Albar Pratama Clinic already has a management structure and financial flow, but good budget planning has not been carried out. 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