Financial Sources Options for Telemedicine Program within Universal Health Coverage (UHC) Era in Indonesia

Background. Indonesia faces serious challenges to inequity of healthcare services. Entering this disruptive era, telemedicine offers opportunities to increase access to healthcare and enhancing the quality of health care to disadvantages populations. However, among the major challenges for implementation, financing system was considered as the bottleneck. National policy on health insurance that was enacted since 2014 expects to achieve universal health coverage (UHC) in 2019. Aim. Our research aim is to explore the potential financing options for implementation of telemedicine in Indonesia under the auspice of the UHC policy. Method. We conducted desk review and focus group discussion with key stakeholders and regulator related to this subject. Results. Telemedicine system already implemented in Indonesia through pilot project initiated by the Ministry of Health and telemedicine by Makassar local government. Limited studies and evidences were recorded regarding the firm regulation on financial sources to sustain telemedicine. However, options for telemedicine sources are available. These includes capitation scheme in primary care, diagnostic related group in secondary care, or fee for service. Beyond the healthcare services-related origin, other potential sources include research/grant, charity, special allocation fund or general allocation fund allocated in districts. Conclusion and recommendation. Various sources for telemedicine within UHC era are available. These include BPJS compensation fund, de-concentration fund from national health budget, special allocation fund from national health budget, research grant and charity. Technical guidelines to apply these options are urgently required to address inequity of healthcare access in Indonesia.