Heart Disease Cases Reach 29.7 Million, BPJS Strengthens Outcome-Based Services
Heart disease has become a major focus within the National Health Insurance (JKN) Programme due to high service utilisation and the significant costs involved. In 2025, heart disease cases covered by the JKN Programme were recorded at over 29.7 million, with financing amounting to approximately Rp17.35 trillion.
The President Director of BPJS Kesehatan, Prihati Pujowaskito, stated that this condition is driving a transformation in cardiac services through a Value-Based Health Care approach. This approach prioritises health outcomes and total costs throughout the service cycle as the basis for creating value for participants.
The high cost of healthcare also poses a challenge to the sustainability of the JKN Programme. In 202<0xA0>5, the total cost of healthcare services under the JKN Programme reached Rp191.3 trillion, with approximately 87.1% of the realised financing originating from hospital services. “The challenge of increasing healthcare costs is evident from the high level of hospital financing,” explained Pujo on Wednesday.
According to Pujo, the control of heart disease needs to be strengthened starting from primary healthcare facilities (FKTP) through promotional and preventive efforts. These steps include blood pressure and blood sugar control, HbA1C monitoring, medication adherence, and the monitoring of high-risk participants.
Meanwhile, in hospitals, BPJS Kesehatan is encouraging services oriented towards quality and outcomes. The approaches being developed include decision-making through ‘Heart Teams’, clinical management according to guidelines, Fractional Flow Reserve (FFR) examinations, and staged revascularisation.
Quality monitoring indicators are also being redirected from process towards outcomes, covering critical response time, post-procedure safety, intervention accuracy, recovery quality, protocol compliance, and the efficiency of the referral system. “We want to change the paradigm from paying for services to purchasing better outcomes, from treating events to preventing events, and from measuring utilisation to measuring outcomes,” said Pujo.
The Head of Dustira Level II Hospital, Muchlas Fahmi, noted that the use of cardiac services by JKN participants at the hospital is quite high. From January to August 2026, RS Dustira has served 975 cathlab patients, all of whom were JKN participants.
Representing the Commander of the Siliwangi Military Regional Command (Kodam) III, Tri Adrijanto Santoso, stated that the quality of healthcare is determined not only by technology but also by ease of access and speed of service. Kodam III Siliwangi supports promotional and preventive efforts through community education and cross-sector collaboration.
The Coordinator of BPJS Watch, Timbul Siregar, stated that heart disease requires attention through the strengthening of promotional and preventive efforts, including the implementation of healthy lifestyles. He also encouraged the application of the Value-Based Health Care approach to increase the efficiency of the JKN Programme.