PERUBAHAN KONSEP

BISNIS RUMAH SAKIT

CHANGES ON
HOSPITAL BUSINESS
CONCEPTS
JKN
Akreditasi RS

Widodo J Pudjirahardjo
2014 HOW TO CREATE
BARGAINING POWER
KITA SEDANG
MEMASUKI
TURBULENSI
 ERA JKN
dan
AKREDITASI RS
4
JKN TIDAK
DAPAT
DITOLAK

5
 PERUBAHAN POLA
“BEBAS” JKN “KONTRAK”
4 Drivers for Change:
1. Regulatory Changes;
2. New Kind of Competition;
3. New Client Demands;
4. Collaboration Trend.

TEMPO DULU MASA DEPAN

6
 CRUSIAL ISSUES
1. Defining New Strategy;
2. Insurance Contract: Value,
Content, and Context;
3. Marketing Strategy and
Marketing Mix;
4. Course of Action (K3-S);
5. Cost Containment;
6. Verification Procedures.
Defining Strategic Fit: What is your
Strategic Business Opportunity?
Tomorrow’s Opportunity

New Skills; Growth

GrowthPath;
& Development;
Product Innovation;
Repositioning. Sustainable Business;
Trajectory.
Made of Order. Social Awareness.

Internal External
Focus Focus

Operational
Cost & Product Stewardship;
Reputation;
Excellence Institutional Partnership
Risk Reduction. Legitimacy.

Today’s Market
Adapted from S. Hart (2005),
Capitalism at the Crossroads
 PRO-AKTIF
APA YANG HARUS DILAKUKAN RS
1. Membentuk Unit Pengendali Yan-JKN;
2. Sosialisasi Sistem Secara Komprehensif;
3. Menata Alur dan Prosedur Pelayanan;
4. Menata Manajemen Klinik;
5. Penyesuaian SIM-RS, khususnya Billing;
6. Monitoring Secara Real-Time;
7. Audit Secara Terstruktur & Holistik;
8. Komunikasi dan Umpan Balik Secara Sistematik.
10
PENATAAN MANAJEMEN PELAYANAN

S • Kecermatan;
• Kecepatan; Kemampuan RS Ter-
D • Kepatuhan; Bersaing
standarisasi
+ + Asuransi
M • Standarisasi.

FOKUS PD PASIEN
SIM-RS
 MAIN TOPICS
1. Business Concepts;
2. Business Infra-
structures;
3. National Health
Insurance Scheme;
4. Area of Changes; EXCELLENT BUSINESS
5. Conversion 6-P to 6-C/6-K;
6. Competitive Advantages
Framework / Bargaining
Power.
BAD BUSINESS
BUSINESS CONCEPTS
PERUBAHAN KONSEP
Ada Pembatasan;
JKN Ada Pengaturan;
Akreditasi RS Ada Persyaratan.
PAYUNG HUKUM 1. Konsumen;
1. Undang-Undang; Oleh
2. PP / Perpres; Eksternal RS: 2. Produk;
3. Peraturan Menteri; 3. Biaya.
4. Surat Edaran Menteri.
Perubahan Konsep Pelayanan;
PERUBAHAN
Perubahan Konsep Mutu;
KONSEP
Perubahan BISNIS
Konsep Marketing.
 BUSINESS CONCEPTS
1. Agreement; Hospital Function:
Services  EBM;
2. Transaction; Education  LO – OL;
R & D  EBM;
3. Awareness & Willingness.
Marketing Focus:
• Needs, Preference, Choices, Demand;
• Process, Price, People, Product, Promotion + +;
• Condition, Collaboration, Comprehensible ++.
 BUSINESS CONCEPTS
1. Agreement;
• Marketing Management Hospital Function:
Services  EBM;
• Financial
2. Transaction;
Management Education  LO – OL;
• Strategic & Operational Mg’t R & D  EBM;
3. Awareness & Willingness.
Marketing Focus:
BUSINESS REQUIREMENT:
• Needs, Preference, Choices, Demand;
MARKET
• Process, INFORMATION,
Price, People, Product, Promotion + +;
COMMUNICATION,
• Condition, & NETWORK++.
Collaboration, Comprehensible
SEJARAH PELAYANAN KESEHATAN

MORAL HAZARDS +/-

BI-PARTIED
SERVICES
PPK + FEE FOR SERVICES PASIEN
DEMAND

IMBALANCE KNOWLEDGE
18
SEJARAH PELAYANAN KESEHATAN
PEMERINTAH
LEMBAGA
ASURANSI ATAS

MENENGAH
1. SOSIAL ATAS
2. SOSIAL
KOMERSIAL MENENGAH

TRI-PARTIED MENDEKATI MISKIN

MISKIN
SANGAT MISKIN
SERVICES
PPK PASIEN
DEMAND
NEEDS FOR
FOR SERVICES

PPK-1 PPK-2 PPK-3

Dr Umum Dr Sp. Dr Sub-Sp.
19
NATIONAL HEALTH INSURANCE
SCHEME
Premi
Health Insurance
COMMUNITY Organization
Perlindungan

Primary HC Secondary Tertiary HC

Provider HC Provider Provider
General Practitioners Medical Specialization Medical Sub-
Specialization
C-Class Hospital C-Class Hospital
B-Class Hospital B-Class Hospital
A-Class Hospital A-Class Hospital
Primary Care
D-Class Hospital

Contract
 NATIONAL HEALTH INSURANCE
SCHEME

Health Insurance
COMMUNITY Organization-BPJS
Special Cases / Emergency
Perlindungan Needs
1 2 ‘SEP’ 3 SEP 4 SEP

Primary HC 3 Secondary 4 Tertiary HC

Provider HC Provider Provider
General Practitioners Medical Specialization Medical Sub-
Specialization

Service
 STRUKTUR PEMBIAYAAN
KESEHATAN MASYARAKAT ERA JKN

ATAS OUT OF POCKET

OUT OF POCKET
MENENGAH ASURANSI SWASTA
ATAS
ASKES PNS

MENENGAH ASABRI JKN-BPJS +

JAMSOSTEK ASURANSI
SWASTA
MENDEKATI MISKIN SPM/SKTM
MISKIN JAMKESDA

SANGAT MISKIN JAMKESMAS

S/d 2014 Ssdh 2014
22
 AREA OF CHANGES
ASPECT PRE DURING & FUTURE
Main Issues Product & Price Policy, Process, and Cost
Potential Customer Individual Institution with group policy holder
Customer Focus Single Layer (Patients) Two Layer (Patients & Ins. Agent)
Product – Price – Place Collaboration – Comprehensible –
Marketing Mix
‘There is – Promotion Competence – Communication
Value Meet Demand Meet Needs, Policy & Rules
nothing so Mechanism
Individual –
Institutional Agreement (Contract)
Transactional
difficult as Accountability Public Accountability Policy & Public Accountability
initiating Patient Position • Buyer & User
• Primary Customers
• User & Indirect Buyer
• Secondary Customers
change’ Marketing Strategy Multi Alternatives
Limited Alternative (Focus,
Collaboration, Collective Bargaining)
(Michavelli)
Financial Strategy Investment & Price Cost Containment
 DEFINITION OF
BUSINESS REENGINEERING

The fundamental rethinking and radical

redesign of core business processes to
achieve dramatic improvements in
critical performance measures such as
quality, cost, and cycle time.
Source: Adapted from Hammer and Champy, Reengineering the Corporation, 1993
DEFINITION OF
BUSINESS REENGINEERING
The fundamental rethinking and
radical redesign of core business
processes to achieve dramatic
improvements in critical
performance measures such as
quality, cost, and cycle time.
Source: Adapted from Hammer and Champy, Reengineering the
Corporation, 1993
STRATEGIC ADVANTAGES

Porter's Generic Strategies Model

PORTER GENERIC STRATEGY
STRATEGIC MARKETING BOARD
 FUNGSI & PERAN
PEMASARAN KEUANGAN
1. Menentukan Strategi 1. Menentukan Strategi
Pemasaran; Investasi & Pembiayaan;
2. Menentukan 4-P yang 2. Menentukan Producton Cost
sesuai dengan Kastemer; & Promotion Cost yang
3. To generate customer Cost Effective;
knowledge & preference; 3. To generate profits &
4. Mengendalikan proses shareholder value;
penjualan. 4. Mengendalikan Cash-Flow.
 KONVERSI 6-P  6-C / 6-K
Product Collaboration Kolaborasi
Price Comprehensible Komprehensif
People Competence Kompetensi
1. Kecermatan
Process Course of Action K-3 2. Kecepatan
3. Kepatuhan
Place Coverage Keterjangkauan
Promotion Communication Komunikasi
THANK
YOU