Scenario Planning Analysis of BPJS Kesehatan in Facing the Deficit of Social Security Fund for Health

Abstract

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.