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. Kesimpulan 1. Even though a leak occurred in BPJS scheme for the poor and near-poor (PBI), but this social security scheme is still largely enjoyed by poor and near poor. BPJS Health and The Government need to address the card usage leakage of BPJS for PIB. This is really important to aim the target for 40% of the population with the lowest expenses. This result recommend for further research to investigate the most appropriate implementation management strategies to health security system to minimize program leakage. 2. In general, the implementation of PBI BPJS Health is able to increase the poor and near-poor tendency to use public and private health facilities than others facilities that are not covered in the program. Some of the examples are the practices of health workers/ traditional treatment/ other. a) Public health facilities utilization (public hospitals/ community health centers) The implementation of BPJS Health PBI in the first year succeeded in increasing the likelihood of poor and near poor population for outpatient care in public health facilities than other facilities. Compared to Jamkesmas program, the trend of public health facilities utilization is greater in BPJS program. In case of outpatient, urban populations tend to prefer government hospital/ community health center/ sub health centre compared to other health facilities. BPJS Health PBI program was able to increase the tendency of the specific population for inpatient to use public health facilities compared to other facilities which are not covered by BPJS scheme programs such as the practice of health workers/traditional treatment/ other. Compare to Jamkesmas period, this trend is found to be greater. b) The use of private health facilities (private hospital/ doctor/ clinic) The implementation of BPJS Health PBI in the first year successfully raised the poor and near poor to choose an outpatient facility at the private hospital/ doctor/ clinic compared to other facilities. This result is in the contrary with Jamkesmas implementation. Study shows that uninsured population has higher tendency of choosing private health facilities among other facilities compare to outpatient care covered by Jamkesmas. The tendency to utilize private hospitals for inpatient than other facilities for the population covered by BPJS health PBI is greater than uninsured population. BPJS Health program has been able to increase the elderly tendency to choose inpatient facility in private hospitals compared to other facilities.
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