Scenario Planning Analysis of BPJS Kesehatan in Facing the Deficit of Social Security Fund for Health
Downloads
The National Health Insurance (JKN) program organized by BPJS Kesehatan faces sustainability challenges due to the risk of Social Security Fund (DJS) deficits. This risk is triggered by fiscal pressures, membership dynamics, and uncertainty in the external environment. This study aims to analyze scenario planning that can be used by BPJS Kesehatan in responding to these uncertainties and developing adaptive strategies to maintain the sustainability of the JKN program. The research approach used is exploratory qualitative with the TAIDA (Tracking, Analyzing, Imaging, Deciding, Acting) analysis method, with a limited scope up to the Deciding phase. The analysis was strengthened with the PESTEL framework and Porter's Five Forces to map external factors. The results showed three main driving forces (Politics, Economics, Legal) and three critical uncertainties (Rivalry among Competitors, Bargaining Power of Customers, Threat of Substitutes) that formed four future scenarios: BPJS Kesehatan Emas, BPJS Kesehatan Tumbuh, BPJS Kesehatan Tangguh, and BPJS Kesehatan Vulnerable. In response, BPJS Kesehatan is advised to implement five cross-scenario strategies that take into account its core competencies.
Downloads
1. Arlinta, Deonisia. (2024, 13 November). Tanpa Intervensi, Program JKN Berisiko Terjadi Gagal Bayar. Kompas [online], halaman 2. Tersedia: https://www.kompas.id/ [2025, 23 Januari]
2. Badan Penyelenggara Jaminan Sosial. (2011). Nomor 24 Tahun 2011 Tentang Badan Penyelenggara Jaminan Sosial. Jakarta: Sekretariat Negara.
3. Badan Penyelenggara Jaminan Sosial. (2011). Undang-Undang Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial. Tanggal pengundangan: 25 November 2011.
4. Cabalza, D. (2025, 14 Januari). PhilHealth benefits now cover outpatient emergency services. Philippine Daily Inquirer, [online], halaman 1. Tersedia: https://newsinfo.inquirer.net/2024369/philhealth-benefits-now-cover-outpatient-emergency-services [2025, 21 April].
5. Cheng, S.-H., Chen, C.-C., & Chang, W.-L. (2009). Hospital response to a global budget program under universal health insurance in Taiwan. Health Policy, 92(2–3), 158–164. https://doi.org/10.1016/j.healthpol.2009.03.008
6. Chermack, T. J. (2011). Scenario planning in organizations: How to create, use, and assess scenarios. Berrett-Koehler Publishers.
7. Chermack, T. J. (2022). Using scenarios: Scenario planning for improving organizations. Berrett-Koehler Publishers, Inc.
8. Chou, W.-Y. S., Iles, I. A., Gaysynsky, A., & Klein, W. M. P. (2025). Public health communication approaches for building common ground. American Journal of Public Health, 115(4), 511–518. https://doi.org/10.2105/AJPH.2024.308003
9. Federal Joint Committee (G-BA). (2025, 13 Mei). Structure of the Federal Joint Committee (G-BA). Gemeinsamer Bundesausschuss. Tersedia: https://www.g-ba.de/english/structure/
10. Da Costa, A., Otang, A. S., Djamhari, E. A., Arfandi, H., Tengku Harja, I., Lauranti, M., Rijkers, M., Saleh, M. D., & Thabrany, H. (2018). Mewujudkan jaminan kesehatan nasional yang non-diskriminatif. Perkumpulan Prakarsa.
11. David, F. R., & David, F. R. (2017). Strategic management concepts and cases: A competitive advantage approach. British Library Cataloguing-in-Publication Data.
12. Eliana, S.K.M., & Sumiati, S., S.Pd., M.Kes. (2016). Kesehatan masyarakat. Kementerian Kesehatan Republik Indonesia.
13. Lim, Seung-Ji & Jang, Sung-in (2025). Leveraging National Health Insurance Service Data for Public Health Research in Korea: Structure, Applications, and Future Directions. National Institutes of Health
14. Lindgren, M., & Bendhold, H. (2009). Scenario planning: The link between future and strategy. Palgrave Macmillan.
15. Machmudi. (2024, 25 September). Satu Dekade, 98,67% Penduduk Terdaftar JKN. Media Indonesia [online], halaman 1. Tersedia: https://mediaindonesia.com/ [2025, 23 Januari]
16. Newton, P., & Bristoll, H. (2014). What is the PESTLE Analysis. ISBN 139788740308341.
17. Paramadita, S., Umar, A., & Kurniawan, Y. J. (2020). PESTEL analysis towards Gojek’s penetration in Indonesia. Jurnal Pengabdian dan Kewirausahaan, 4(1), 37-49.
18. Pasaribu, R. D., Shalsabila, D., & Djatmiko, T. (2023). Revamping business strategy using Business Model Canvas (BMC), SWOT analysis, and TOWS matrix. Heritage and Sustainable Development, 5(1), 1–18. https://doi.org/10.37868/hsd.v5i1.125
19. Pessanha, R., Mendes, A. & Silva, G., 2024. Monitoring Financial Healthcare Protection in Brazil: Evolution and Challenges. Public Health
20. Prasetio, A., Rahman, D. A., Sary, F. P., Pasaribu, R. D., & Sutjipto, M. R. (2022). The role of Instagram social media marketing activities and brand equity towards airlines customer response. International Journal of Data and Network Science, 6(4), 1195–1200. https://doi.org/10.5267/j.ijdns.2022.6.014
21. Republik Indonesia. (2011). Undang-Undang Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial. Tanggal pengundangan: 25 November 2011.
22. Riawan, T. B. A., Pasaribu, R. D., & Sutjipto, M. R. (2024). Review of scenario planning and future strategy of PT. Telkomsel's fixed mobile convergence (FMC) service implementation. Journal of Multidisciplinary Academic Business Studies, 1(2), 109–123. https://doi.org/10.35912/jomabs.v1i2.1898
23. Rizkia, N. D., S.H., MH, et al. (2020). Metodologi penelitian. Media Sains Indonesia dan Penulis.
24. Saxena, A. (2009). Transforming Singapore’s healthcare delivery system: Health care integration in Singapore. International Journal of Integrated Care, 9, Conference Abstract. Presented at the 9th Annual Integrated Care Conference, Vienna, Austria, 3–6 November 2009. http://www.ijic.org/
25. Sekaran, U., & Bougie, R. (2016). Research methods for business.
26. Setyadi, A., Pawirosumarto, S., & Ariana, S. (2023). Manajemen strategi: Seni dalam menghadapi persaingan bisnis dan manajemen era digital. Penerbit Mitra Wacana Media.
27. Siregar, T., & Pramono, T. H. (2023). Kerangka kinerja ekselen Baldrige: Proven leadership and management practices for high performance.
28. Sugiyono, Prof. Dr. (2022). Metode penelitian kualitatif (untuk penelitian yang bersifat: eksploratif, interpretif, interaktif, dan konstruktif). Alfabeta.
29. Yatminiwati, M. (2019). Manajemen strategi: Buku ajar perkuliahan bagi mahasiswa
Copyright (c) 2025 Luqman Azis, Dr. Ir. Rina Djunita Pasaribu, M.Sc., CPM., EPC

This work is licensed under a Creative Commons Attribution 4.0 International License.