ABSTRACT

Semarang City UHC financing using APBD II increases every year and is integrated into BPJS Health, as well as capitation income from UHC financing in 37 Semarang City Health Centers. This study aims to analyze the cost of health insurance for the Universal Health Coverage (UHC) program at 37 health centers in the city of Semarang. This study uses a qualitative research method with an exploratory approach (exploratory approach). The research was conducted at the Semarang City Health Office as the OPD that manages the health insurance fund for the Semarang City government's UHC program. The unit of analysis in this study is the health insurance financing program in the Universal Health Coverage (UHC) program specifically on the receipt of capitation funds at 37 Semarang City Health Centers and data on the utilization of health insurance for the UHC program. The result of the research is that the amount and capitation in 37 Puskesmas is still used for a maximum of 30% of capital and 70% is used for services and other operational expenditures. The Capitation Fund obtained by the Puskesmas is used for Individual Health Efforts (UKP) and is not sufficient for the SME program. The recommendation given is that the Regional Government and the Central Government must budget for promotive and preventive Public Health Efforts (UKM) activities.

Keywords: health insurance costs, Universal Health Coverage (UHC)