Bali Ready to Become Pilot for Competency-Based Health Referral Reform

Bali Governor Wayan Koster has stated his readiness should Bali be appointed as a model in reforming the Competency-Based Service Referral (RBKP) system.

“This requires regulatory changes, and I will certainly support it because it makes things easier for the public. I strongly agree and support it. Bali has sufficient policy capital and regulatory infrastructure to become a pilot region,” he said in Denpasar on Thursday.

Koster conveyed this readiness to become a pilot region for reforming the national competency-based health service referral system while receiving a visit from Ministry of Health Secretary General Kunta Wibawa Dasa Nugraha.

Even if Bali is not selected as a pilot region, the Governor affirmed that the Bali Provincial Government is ready to support any necessary regulatory changes at the national level.

This reform is considered capable of shortening the lengthy referral process while accelerating public access to medical services according to need and hospital competency levels.

The Bali Provincial Government has previously issued Bali Governor Regulation Number 104 of 2018 concerning the National Health Insurance-Krama Bali Sejahtera (JKN-KBS), as well as regulations on integrated referrals.

“If there is already a presidential regulation, that would be even better. So in Bali it is relatively good, although I continue to push for it to be better and better,” he said.

For him, improving the quality of health services does not only concern membership coverage, but also the public’s experience when accessing health facilities. Therefore, patient comfort and service quality are a focus of the regional government.

In addition to supporting the reform of the health referral system, Koster affirmed his commitment to continue improving Universal Health Coverage (UHC) in Bali so that more people obtain health insurance protection.

Expanding membership coverage goes hand in hand with improving the quality of health services.

“I continue to push for it to be better and better. We also pay attention to services so that the public and patients entering hospitals are more comfortable,” said Koster.

Improving the quality of the health system is also seen as closely linked to the development of Bali’s tourism sector, amid efforts to promote health-based tourism or health tourism.

A number of health services are considered to have potential to be developed as new attractions for foreign tourists, including dental care, plastic surgery and various other medical services.

“If our health services continue to improve and become competitive, foreign tourists can seek health services in Bali,” said the Bali Governor.

Ultimately, reform in the health sector not only benefits the people of Bali, but can also enhance Bali’s competitiveness as an international tourism destination.

Koster hopes that the reform of the referral system, expansion of JKN coverage, implementation of standard inpatient classes, and development of health tourism will proceed in tandem so that Bali can build a health service system that is increasingly accessible, high-quality and competitive.

Ministry of Health Secretary General Kunta Wibawa Dasa Nugraha then said that reforming the health referral system is one of the important matters that needs to be undertaken after more than a decade of implementing the national social security system.

According to him, health services have so far largely relied on a tiered referral system. This model can make the patient handling process longer, so changes are needed towards a competency-based referral system.

“It is time for reform. We need to improve public health services. If it is currently referral-based and the process is lengthy, in the future we need to be competency-based,” said Kunta.

With a competency-based system, patients can be directed immediately to health facilities that have the capabilities matching their medical needs, whether hospitals with intermediate, advanced, or comprehensive competencies.

“Whether intermediate, advanced, or comprehensive, go directly. Whatever the patient’s needs, they are handled more quickly. This is a change in mindset,” he said.

He expressed hope that Bali can become a region that implements the concept earlier with the support of the Bali Provincial Government.

Kunta also expressed appreciation for Bali’s performance in expanding social security coverage, noting that JKN coverage in Bali has reached around 88 percent and its growth is said to be higher than the national percentage.

Kunta also encouraged the optimal implementation of Standard Inpatient Classes (KRIS), further ensuring equality of service quality for all members of the public.

The condition of inpatient rooms that accommodate too many patients in one room needs to be continuously improved. According to him, ideally the number of beds should be limited to a maximum of four per room with an en-suite bathroom and other supporting facilities.