Smart Health Payment System: Digitalization of Co-Payments Toward Efficiency and Equity in JKN Financing in Indonesia

Abstract

Increasing the financing burden of the National Health Insurance (JKN) requires an innovation in the financing system that is efficient, fair, and sustainable. One potential effort is the implementation of a co-payment mechanism, which is joint financing between participants and insurance providers. However, its implementation in Indonesia still faces obstacles in the form of delays in claim verification, low cost transparency, and the lack of integration of digital systems in the payment process. This article aims to analyze the idea of implementing the Smart Health Payment System, which is an integrated co-payment digitalization model to improve the efficiency and fairness of JKN financing in Indonesia. This study uses a systematic literature review approach by examining national and international scientific articles published between 2020–2025 through the PubMed, DOAJ, and BMC databases. The results of the study show that the application of digital technologies such as blockchain, artificial intelligence (AI), and real-time claim integration can speed up the administrative process, reduce the risk of fraud, and increase the accuracy and transparency of payments. In addition, the digitization of co-payment also supports social justice through adaptive contribution schemes based on participants' economic capabilities. The concept of the Smart Health Payment System has the potential to be an innovative strategy in JKN financing reform towards an efficient, transparent, and equitable national health system.