Indonesia is entering a new chapter in the financing system of the National Health Insurance (JKN) with the transition from the INA-CBG’s payment mechanism to the Indonesia Diagnosis Related Groups (IDRG). This shift is driven by the urgent need for a system that is more accurate, equitable, and self-sustaining. This topic was highlighted by students of the Master of Hospital Accreditation and Health Services Management (KARS) Study Program at the Faculty of Public Health, Universitas Indonesia (FPH UI) through the 2025 KARS National Seminar held online on Friday, 21 November 2025. Under the theme “Hospital Strategies in Facing the Transition from INA-CBG’s to IDRG,” the event featured two expert speakers and opened a comprehensive space for discussion.
Dr. Ahmad Irsan A. Moeis, S.E., M.E., Head of the Center for Health Financing and Decentralization Policy at the Ministry of Health, served as the first speaker and emphasized that the primary objectives of transforming the health financing system are independence and improved accuracy.
INA-CBG’s is a case-based grouping system used within the JKN program, whereas IDRG was developed to address major issues in the previous system, particularly those related to tariff deficiencies.
Based on the Ministry of Health’s assessment, these problems do not solely stem from low tariff values but largely from weaknesses in classification. “It turns out that around 60,000 cases have no group within CBG’s. The absence of these groups means the absence of tariffs, which drives coders to search for the closest group with the highest tariff. This naturally leads to overspending and increases claim disputes between hospitals and BPJS Kesehatan,” explained Dr. Irsan.
To address these issues, IDRG introduces significant improvements, including the expansion of Severity Levels—now comprising five levels of patient severity—and the refinement and simplification of groups, resulting in more than 1,300 groups. Beyond tariff adjustments, IDRG will also serve as an instrument for quality and cost control, contributing to more accurate epidemiological data and reducing miscoding that may cause incorrect disease reporting, thereby helping the government avoid misallocation of health budgets.
From the service provider side, the transition requires substantial preparation from hospitals. Primaya Hospital’s Corporate Medical Operation Manager, dr. Yopen Damingus, M.A.R.S., AAK, emphasized that the main challenges lie in three pillars: People, Process, and Technology. “The challenges in IDRG are similar to those in INA-CBG’s, particularly in the completeness of medical documentation or medical records,” noted dr. Yopen.
He explained that Primaya Hospital has conducted simulations and intensive training for coders—staff responsible for converting patient diagnoses and medical procedures into standardized alphanumeric codes based on the ICD Indonesian Modification with greater detail.
In addition, dr. Yopen stressed the importance of technological integration in hospital readiness. He noted that robust information technology systems are essential for automating coding and claims processes to minimize undercoding or overcoding, which frequently occur due to incomplete physician summaries.
As an academic institution committed to strengthening the national health system, FPH UI views a deep understanding of the transition from INA-CBG’s to IDRG as essential for future health professionals, hospital managers, and policymakers.
Through the organization of the 2025 KARS National Seminar—part of the FPH UI Online Seminar Series 12—FPH UI not only serves as a center for scientific advancement but also as a driving force for strategic discourse that directly impacts the governance of health services in Indonesia. Moving forward, FPH UI will continue to strengthen its contributions in producing graduates and research that are relevant, excellent, and impactful for the transformation of the health system, in line with Universitas Indonesia’s aspiration to remain an Excellent and Impactful institution. (ITM)