Health clinics are generally in the profit-oriented business category, a concept that aims to make maximum profits. However, as time goes by, the management of health clinics experiences dynamic developments.

One of the ways this is marked by the rise of clinics that provide free services for underprivileged communities from social institutions in Indonesia. This charity concept clinic relies on donations from benefactors to maintain its existence and quality of service.

Clinic Management with the Social Enterprise Concept

Cita Sehat Foundation (CSF) implements management clinic with the concept of social enterprise (SE). In contrast to profit-oriented businesses and social-oriented charity schemes, SE or social enterprise is a business idea that combines the basic concepts of business with the obligation to help the social environment. In the SE concept, companies maximize profits to provide benefits to underprivileged communities.

CSF currently manages 7 clinics in 6 cities in Indonesia with the SE spirit, namely 2 clinic units in Bantul, Yogyakarta and 1 clinic unit each in Medan, Pekanbaru, East Jakarta, Semarang and Surabaya.

At the Pratama clinic managed by CSF, there are three categories of patients served, namely:

1. Member patients are beneficiaries of the health empowerment program who have registered and receive regular program interventions.
2. BPJS patients are patients who have registered with BPJS and registered the CSF clinic as a first level health facility.
3. General Patients are people who are not member patients and BPJS patients who access services at the CSF Pratama clinic by paying independently.

Member patients will get several facilities from CSF through health services at clinics in each city. The facilities obtained by member patients are:

• Consultation with health workers and general practitioner examination services;
• Maternal and child health examination services, namely four Ultrasonography (USG) examinations, postpartum control and family planning procedures;
• Ambulance delivery service.

Apart from receiving health services through clinics, member patients also receive preventive services in the form of health education and regular religious guidance.

Clinic Financing

Clinic funding comes from several sources, namely funds from BPJS for BPJS patients and funds from paid general patients. As an alternative for financing members from poor families, CSF optimizes profits from general patients and collaborates with partners.

The financing mechanism from partners for Pratama clinic patients can be done in 3 ways, namely:

1. Capitation scheme. Partners can pay a certain amount of funds each month to CSF ​​for certain clinics according to the number of registered members without taking into account the type of service accessed by the patient. This scheme is similar to the BPJS capitation outlined in Article 1 Number 3 Minister of Health Regulation Number 21 of 2016 which  states  that  the  Capitation  Fund  is  the  amount  of  monthly  payments  which  are  paid  in  advance  to  FKTP  based  on  the  number  of  participants  who  are  registered  without  taking  into  consideration  the  type  and  amount  of  health  services  provided.
2. Claim scheme. CSF can claim payments from member patients to partners according to the type of health services accessed at any given time period.
3. Partners can hand over funds to CSF ​​according to the agreement, then CSF will optimize these funds to support member financing at the Pratama clinic.

Challenges of Primary Clinic Management

A survey was conducted by MarkPlus in 2020 involving 110 respondents regarding public behavior regarding health services. This survey revealed that 71.8% of respondents admitted that they had never visited a hospital or clinic since Covid-19 began. As many as 64.5% of respondents preferred to restore their health independently by resting and consuming healthy food.

Instead, digital health consultations are an option. 65.5% of respondents admitted that they consulted digitally more often because of the ease of consultation without having to visit a clinic or hospital.

Changes in societal behavior are forcing clinics, hospitals and the healthcare industry in general to adapt. Pratama Cita Sehat Clinic tries to continue to adapt to these changes, including by

1. Implementing online registration using the WhatsApp center so that patients can save time without having to queue since the morning,
2. Partnering with third parties to provide online consultations or what is often called telemedicine, and
3. Providing home service to patients which can be accessed by calling the clinic call center number.

Redaksi: Susilowati, S.Gz (Clinic Department Head – Cita Sehat Foundation)