Increasing Achievements Expansion of BPJS Health Participants Segment of Workers Receiving Wages for Business Entity (PPU BU) At the Semarang Branch Office

Chaerul Anwar Kopa, Rosalendro Eddy Nugroho

DMAIC, fishbone diagram, 5W+2H, 5why.

Health insurance aims to ease the burden of costs caused by health problems due to illness or accident. One of the health insurances in Indonesia is BPJS, but several BPJS segments have not yet reached the target. This study aims to determine the root cause of the low effectiveness of BPJS telemarketing and to find out the proposed improvements to the implementation of BPJS telemarketing. Obstacles faced by BPJS as of July 2020, BPJS Kesehatan participants in the PPU BU segment in the Semarang Branch only cover 93%. This research is a descriptive analysis research on RO BPJS KC Semarang staff for the period of June 2020 with quantitative research methods. Data retrieval using Fishbone Diagram and proposed improvements using the 5W+2H method. The obstacles faced by BPJS include 56% of BU data that are invalid and 25% of BUs that cannot be contacted, and there are various factors causing the problem which are classified in the Fishbone Diagram. Improvements using the DMAIC method showed an increase in the success rate of BPJS telemarketing by 293%. There are 6 causes of problems based on human factors, methods, materials, machines, and the environment which are then proposed for improvement starting from coordination, classifying data, making summary and activity logs, monitoring and evaluating, mapping activities, and briefing employees.

https://doi.org/10.31871/IJNTR.8.2.7