System dynamics simulation to determine financial strategy for social health insurance in Indonesia

Social Health Insurance (SHI) in Indonesia is still experiencing financial constraints because the financial condition of the SHI has continued to be a loss since it was established in 2014 until present so it becomes special attention needed to get achieving the Universal Health Coverage (UHC) target by the government. Therefore, this study intends to provide an appropriate SHI financial strategy recommendation by considering the stability of the balance of income and expense. In addition, a system dynamics simulation approach is needed to find optimal SHI financial strategies with variables including participant premium rates, average cost of benefits, number of health cases, and number of insurance participants. The data used came from BPJS Health data for 2016 and 2017. Afterwards, the equation used was Income ≥ Expenditures. In addition, there are several scenarios designed to reduce the level of financial losses that occur at SHI. The scenario of reducing the number of health cases is the best strategy recommendation decision. The results show that reducing average benefit costs and increasing premium rates also gets it can reduce financial problems. From the results that have been obtained, this study can contribute to the resolution of SHI Health financial problems in Indonesia.