Policy options to integrate HIV services into Social Health Insurance (JKN) in Indonesia

Abstract

Background: HIV and AIDS program in Indonesia is planned to be financed by domestic sources after depending on external sources for many years. Indonesia has started its Social Health Insurance scheme so called Jaminan Kesehatan Nasional (JKN) program in 2014, that covers HIV treatment including opportunistic infection. Research question is whether JKN could expand its benefit package to public health interventions without hampering service provision. Converting HIV program that has been subsidizied by the Government needs careful considerations. The study aimed to assess scenarios on cost and utilization to support decision on integration of HIV interventions into the JKN benefit package. Methods: The study assessed the current coverage and funding mechanisms for HIV-related services, JKN membership, key target populations, and estimated premium for HIV services up to 2019. We captured cost and utilization from national and subnational levels as the baseline through an observational study. Researchers developed model and scenarios on the projection of cost and utilization of various HIV program activities and its consequences. Results: We developed scnearios based on benefit covered by JKN. current services mostly covered by government. The Care and treatment could be possibly covered by the JKN, with support from government for prevention and ART. Conclusion: The scenarios show that provision of HIV services within the basic benefits package of JKN would require a reasonable cost per member per month, depending on the comprehensiveness of the benefit. A clear roadmap should be developed to ensure all services provided are affordable and in good quality. (Health Science Journal of Indonesia 2019;10(1):67-76)