Evaluation of the Implementation of the National Health Insurance Program by the Social Security Administration Agency for Health in Medan City

Anggy Mutia; Tunggul Sihombing; Asima Yanty S Siahaan

doi:10.30829/komunikologi.v10i1.31173

Evaluation of the Implementation of the National Health Insurance Program by the Social Security Administration Agency for Health in Medan City

Anggy Mutia, Tunggul Sihombing, Asima Yanty S Siahaan

Abstract

This study evaluates the implementation of Medan City’s population-identity-based free healthcare program integrated with BPJS Kesehatan. Using a descriptive qualitative design, data were collected through interviews, observation, documentation, and triangulation involving twelve purposively selected informants. The findings show that the program achieved 98.96% universal health coverage and improved financial protection and healthcare access. However, implementation remains constrained by incomplete population data, limited referral understanding, unequal facility capacity, workforce burden, and unmet minimum service standards. The study concludes that program sustainability requires integrated data, stronger primary care, improved staffing, better coordination, and continuous quality-oriented evaluation across participating healthcare institutions in Medan.

Keywords

BPJS Kesehatan; implementation evaluation; public healthcare; universal health coverage; Medan City

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DOI: http://dx.doi.org/10.30829/komunikologi.v10i1.31173