p–ISSN: 2723 - 6609 e-ISSN: 2745-5254
Vol. 4, No. 8, August 2023 http://jist.publikasiindonesia.id/
Doi : 10.59141/jist.v4i8.658 949
ANALYZING THE EFFECTS OF THE HEALTH BPJS REGULATION ON
THE INSURANCE COMPANIES PERFORMANCE AND EFFICIENCY
Syefiki Amalia Army
1*
, Katiya Nahda
Islamic University of Indonesia Sleman, Indonesia
Email: [email protected]
*Correspondence
ARTICLE INFO
ABSTRACT
Accepted
: 05-08-2023
Revised
: 09-08-2023
Approved
: 09-08-2023
The purpose of this study was to determine the effect of the presence of
BPJS Health regulations on the level of efficiency of insurance
companies and to determine the effect of the level of efficiency of
insurance companies on company performance in the period 2009
(before the implementation of the BPJS Health regulations) to 2019
(after the implementation of the BPJS Health regulations). The method
used in this study is the analysis of Data Envelopment Analysis (DEA),
calculation of Return on Assets (ROA), and calculation of Return on
Equity (ROE) by testing 12 insurance company samples. The results
showed that the company's efficiency had a significant positive change
in the period before compared to after implementing the BPJS Health
regulation. The tests of ROA and ROE showed that the company's
performance did not significantly differ before and after implementing
the BPJS Health regulation.
Keywords: DEA; Efficiency;
Performance; Insurance.
Attribution-ShareAlike 4.0 International
Introduction
Efficient companies actively use their best assets. For this reason, (Yuniastuti &
Nasyaroeka, 2017), measuring efficiency is an essential concern for insurance
companies to support companies in measuring and evaluating performance. To what
extent can insurance companies survive and solve problems on an ongoing basis, seeing
how BPJS users have experienced an increase? (Viverita, 2019) found no significant
difference between the company's efficiency before and after the implementation of
BPJS Health. Based on previous findings, insurance-related research is still tiny, so
research can be carried out regarding the impact of the BPJS Health program on the
efficiency and performance of insurance companies (Muhamad & Kusumastuti, 2022).
The concept of efficiency begins with the microeconomic theory developed by
Adam Smith et al. in the 18th and 19th centuries, consisting of producer and consumer
theories. Producers maximize profits and minimize costs; in consumer theory, they
maximize utility or satisfaction. For this reason, efficiency must represent the maximum
output level from each use of a company's technological input to reach the frontier line
(Gusmiarni & Sudrajat, 2023).
Efficiency is a method related to how well a company manages available
resources to obtain yield productivity by measuring the ratio between output and input
and optimizing output without excessive input (Prakoso, 2018). The concept of
performance is based on the agency theory developed by Jensen & Meckling (1976), in
which the ownership and company management functions are separated. Therefore
Syefiki Amalia Army, Katiya Nahda
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, August 2023 950
companies are very vulnerable to agency conflicts because shareholders and
management often conflict in achieving their respective welfare. Thus, obtaining
benefits for both parties is highly dependent on the results of the company's
performance. Signaling Theory developed by (Nugrahaningsih, 2021) states that there
are signals of success or failure that occur in companies that need to be conveyed by
management as company managers to shareholders as company owners to reduce
asymmetric information (Munir, Arief, Abdinagoro, & Furinto, 2022).
Performance is a portrait of the company's finances in a certain period to show
good and bad financial performance concerning the collection or distribution of funds
and is measured by financial analysis through financial ratios, so that performance in a
certain period or last year with the following period can be compared, including
comparing financial statements with other companies, especially in the same industry.
Thus, companies can evaluate, plan, and control the company's performance growth.
(Yulianti, Djatmika, & Santoso, 2017) said that efficiency and company
performance are interconnected where the primary goal of a company is to maximize
shareholder profits by carrying out optimal performance productivity through an
efficient system, which can be achieved by managing and evaluating the use of costs
and resources to minimize the occurrence of cost reduction. This is also supported by
Duston et al. (2014) that companies that are efficient in building development and
investment actively use the best assets.
(Viverita, 2019) argues that increasingly fierce competition encourages companies
to try to be more optimal in providing services and efficiency. This is reinforced by the
opinion of (Eling & Schaper, 2017), where the results of their research illustrate that life
insurance companies in Europe from 2002-2013 experienced increased efficiency due to
increasingly competitive business conditions. Thus, environmental changes affect
productivity and efficiency. Then, the hypothesis can be determined as follows:
H1: BPJS's policies positively affect insurance companies' efficiency levels.
(Jang & Ahn, 2021) analyzed Korean outbound shipping companies' financial
performance ratio before and after the 2008 financial crisis. Korean outbound shipping
companies relatively increased their stability, profitability, productivity, development,
and performance before the financial crisis compared to transportation companies and
other industries. However, these parameters tended to decrease after the financial crisis.
(Zhang et al., 2020) in (Jang & Ahn, 2021) based on his research using financial panel
data from 29 medium-sized shipping companies within the ten years from 2009 to 2018
and independent variables derived from financial data regarding strategy. The analysis
results related to the growth strategy show that the components of assets, turnover,
equity, and debt affect performance. The hypotheses can be determined as follows:
H2: There are differences in the performance of insurance companies before and
after implementing the BPJS regulations.
Method
Analyzing The Effects Of The Health Bpjs Regulation On The Insurance Companies
Performance And Efficiency
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, Agustus 2023 951
The population used in this study is all insurance companies registered with the
Financial Services Authority (OJK). The sampling technique uses a purposive sampling
technique with the criteria: national life insurance companies consistently published
their annual report during the 2009-2019 period so that the sample used in the study can
be determined from as many as 12 insurance companies. Quantitative data collection
techniques use secondary data through insurance statistical, financial reports sourced
from OJK.
Data Envelopment Analysis (DEA)
According to (Subardi, Sukmadilaga, & Yuliafitri, 2020), efficiency measurement
techniques through a non-parametric approach carry out mathematical designs using
output and input, which are applied to evaluate company efficiency. DEA has a relative
value, not an absolute one, where the Decision Making Unit (DMU) with the best
performance gets a score of 100 and a lower DMU of 0-100, depending on comparing
the best DMU. According to (Aldo, 2022), efficiency measurement models based on the
DEA approach are divided into two types, namely:
a. Constant Return to Scale (CRS): a change of x times in the input will also increase
the output of x times. Rusyidiana (2013) states that CRS represents technical
efficiency and scale.
b. Variable Return to Scale (VRS): a change of x times in the input is not matched by
an increase in output x times. We go higher or lower. Rusyidiana (2013) stated that
VRS only represents technical efficiency.
Relative scale efficiency is the ratio of the efficiency of the CRS and VRS models.
If the scale value equals one, then the DMU operates at the best scale efficiency
standard. The DEA method used in this study uses DEAP 2.1 software with the
following equation:
Es =




Information:
Es = insurance efficiency
m = observed insurance output
n = observed insurance input
Ys = total output produced by insurance
Xs = number of inputs produced by insurance
Ui = output weight generated by the insurance
Vj = input weight provided by insurance
Financial Performance Ratios
According to (ROHIM, 2017), financial ratios are metrics applied as analytical
techniques in financial management to interpret and analyze financial reports or
company performance over a certain period through one of the ratios, namely the
profitability ratio. (Noordiatmoko, 2020) states that the profitability ratio measures a
company's profit-seeking ability and provides an overview of the value related to the
Syefiki Amalia Army, Katiya Nahda
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, August 2023 952
effectiveness of a company's governance during a specific period through the company's
asset or capital components.
Return on Assets
Prastowo and Juliaty (2002) in Astuti (2009) argue that ROA is an assessment
tool for a company's ability to use its assets to generate profits. ROA measures the
return on investment that a company has generated using all of its asset holdings. The
higher the yield ratio, the better the use of assets by the company in earning profits.
ROA ratio calculation formula:
Return on Aset =


Return on Equity
Prastowo and Juliaty (2002) in Astuti (2009) argue that ROE is a measure of net
profit after tax or the level of investment that comes from the financial funds of the
company owner only. This becomes necessary because one of the most important
reasons a company operates is to maximize profits for shareholders.
Hypothesis testing
The t-test is applied to the same sample in two different observation periods to
evaluate specific characteristics in one sample (Pramana, 2012). Observations in this
study examined whether there were differences in efficiency and performance before
and after the BPJS Health regulation implementation in insurance companies and
whether the two objects are significantly related.
Results And Discussion
12 samples of insurance companies registered with OJK with the following
criteria: local life insurance companies and consistent financial reports during the 2009-
2019 period.
Data Envelopment Analysis
The efficiency measurement component uses input consisting of assets, claims
expenses, and other expenses. While the output used consists of premiums and
investment returns.
Table 1
The difference in Average Total Input of Insurance Companies
INSURANCE
COMPANY
TOTAL
INPUT
2009-2013
AVERAG
E
AVERAG
E
DIFFERENC
E
Adisarana
Wanaartha
20.023.965
4.004.793
16.417.883
12.413.090
Jiwa Bersama
Bumiputra
125.865.54
7
25.173.109
22.815.598
-2.357.511
Central Asia Raya
20.644.151
4.128.830
6.658.492
2.529.662
Equity Life
10.949.829
2.189.966
9.810.883
7.620.918
Analyzing The Effects Of The Health Bpjs Regulation On The Insurance Companies
Performance And Efficiency
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, Agustus 2023 953
Indolife
70.917.084
14.183.417
25.891.541
11.708.124
Heksa Eka
1.988.533
397.707
4.228.581
3.830.874
Inhealth
15.126.138
3.025.228
16.627.295
13.602.067
Jiwasraya
69.030.975
13.806.195
35.702.091
21.895.896
Jiwa Kresna
1.099.840
219.968
4.584.620
4.364.652
Pasaraya
415.959
83.192
220.175
136.983
Sequis Financial
3.856.639
771.328
738.405
-32.923
Tugu Mandiri
2.736.262
547.252
1.351.782
804.530
Based on the classification above, it can be seen that in the description of
insurance company inputs for the period 2009-2013 (before the implementation of the
BPJS Health regulation) to 2015-2019 (after the implementation of the BPJS Health
regulation), the average ratio of company inputs has increased and decreased. The
increase occurred in 10 companies with an increase in inputs between 136 billion
rupiahs (Pasaraya Company) and 21 trillion rupiahs (Jiwasraya Company). In
comparison, for two insurance companies, it decreased by 32 billion (Sequis Financial
Company) up to 2 trillion rupiahs (Jiwa Bersama Bumiputera Company).
Table 2
The Difference in Average Output of Insurance Companies
INSURANCE
COMPANY
TOTAL
OUTPUT
2009-2013
AVERAGE
TOTAL
OUTPUT
2015-2019
AVERAGE
DIFFERENCE
Adisarana
Wana.
-538,231
-107,646.20
2,214,736
442,947.20
335,301.00
Jiwa Bersama
Bumiputra
5,390,131
1,078,026.12
2,100,525
420,105.00
-657,921.12
Central Asia
Raya
2,237,739
447,547.70
2,277,063
455,412.60
7,864.90
Equity Life
993,834
198,766.80
918,451
183,690.20
-15,076.60
Indolife
3,396,964
679,392.70
9,996,814
1,999,362.80
1,319,970.10
Heksa Eka
141,592
28,318.36
191,043
38,208.60
9,890.24
Inhealth
1,704,929
340,985.84
1,250,587
250,117.40
-90,868.44
Jiwasraya
6,816,797
1,363,359.46
5,351,974
1,070,394.80
-292,964.66
Jiwa Kresna
143,274.00
28,654.80
2,196,406
439,281.20
410,626.40
Pasaraya
21,076
4,215.18
23,752
4,750.40
535.22
Sequis
Financial
177,258.10
35,451.62
223,679
44,735.80
9,284.18
Tugu Mandiri
251,818.20
50,363.64
1,337,360
267,472.00
217,108.36
Based on the classification above, it can be seen that the input description of
insurance companies for the period 2009-2013 (before the implementation of the BPJS
Health regulation) to 2015-2019 (after the implementation of the BPJS Health
Syefiki Amalia Army, Katiya Nahda
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, August 2023 954
regulation), the ratio of the average output of companies has increased and decreased.
The increase occurred in 8 companies with an output increase of 532 million rupiahs
(Pasaraya Company) to 1 trillion rupiahs (Indolife Company). In comparison, for four
insurance companies, it decreased by 15 billion (Equity Life Company) to 657 billion
rupiahs (Jiwa Bersama Bumiputera Company).
Table 3
Results of the Mean Comparison of Analysis of Insurance Companies Before
and After the Implementation of the Health BPJS Regulations
Period
Mean
CRS
VRS
SCALE
2009
0,869
0,942
0,922
2010
0,865
0,918
0,938
2011
0,847
0,883
0,950
2012
0,673
0,738
0,905
2013
0,168
0,443
0,258
AVERAGE
0,684
0,784
2015
0,788
0,801
0
2016
0,697
0,732
0,922
2017
0,581
0,724
0,816
2018
0,580
0,594
0,955
2019
0,947
0,955
0,990
AVERAGE
0,719
0,761
Based on the results of the mean analysis of insurance companies expressed by the
description of t-0 as the basis, the year represents the year of the object under study. The
average CRS for 2009-2013 has a value of 0.684, while the CRS for 2015-2019 has
increased with a value of 0.719. Thus, based on the CRS benchmark, insurance
companies, after implementing the BPJS Health regulation, are said to be more efficient
after implementing the BPJS Health regulation. On the other hand, the average VRS for
2009-2013 was 0.784, while the 2015-2019 VRS was 0.761. Thus, the insurance
company is said to be more efficient in the period before the implementation of the
BPJS Health regulation compared to after the implementation of the BPJS Health
regulation when measured using the VRS perspective. Based on this, H1 is supported,
and H0 is rejected because the CRS results show that after the implementation of
government policies, there has been a positive change in the efficiency of insurance
companies.
Financial Performance Ratios
Analyzing The Effects Of The Health Bpjs Regulation On The Insurance Companies
Performance And Efficiency
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, Agustus 2023 955
Table 4
Results of Comparative Analysis of ROA and ROE in the Period Before and After
the Implementation of BPJS Health in Insurance Companies
ROA
INSURANCE
COMPANY
AVERAGE
BEFORE BPJS
AVERAGE
AFTER BPJS
DIFFERENCE
Adisarana
Wanaartha
-0,114
0,026
0,088
Jiwa Bersama
Bumiputra
-0,012
-0,051
-0,039
Central Asia Raya
0,059
0,029
0,030
Equity Life
0,015
0,016
0,001
Indolife
0,006
0,007
0,001
Heksa Eka
0,034
0,013
-0,021
Inhealth
0,086
0,088
0,002
Jiwasraya
0,040
-0,111
-0,071
Jiwa Kresna
0,058
0,000
-0,058
Pasaraya
-0,059
-0,014
0,045
Sequis Financial
0,048
0,002
-0,046
Tugu Mandiri
0,039
0,021
-0,018
RATA-RATA
0,017
0,002
Decrease
0,015
ROE
INSURANCE
COMPANY
AVERAGE
BEFORE BPJS
AVERAGE
AFTER BPJS
DIFFERENCE
Adisarana
Wanaartha
-0,331
0,208
0,203
Jiwa Bersama
Bumiputra
-0,462
0,161
-0,300
Central Asia Raya
0,161
0,113
-0,048
Equity Life
0,129
0,078
-0,065
Indolife
0,018
0,032
0,014
Heksa Eka
0,093
0,050
-0,043
Inhealth
0,104
0,110
0,006
Jiwasraya
0,270
0,476
0,206
Jiwa Kresna
0,088
0,000
-0,088
Pasaraya
-0,260
-0,018
0,242
Sequis Financial
0,099
-0,002
-0,097
Tugu Mandiri
-24,231
0,126
24,138
RATA-RATA
-2,027
0,111
Increase
1,916
Based on the table above, the results of calculating the ROA of insurance
companies for the period 2009-2013 (before implementing BPJS Health regulations)
and 2015-2019 (after implementing BPJS Health regulations) show a decrease in ROA
of 0.015, which means that insurance companies use assets to earn profits better or
experienced an increase in the period before the implementation of the BPJS Health
regulations compared to after the implementation of the regulations.
Syefiki Amalia Army, Katiya Nahda
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, August 2023 956
On the other hand, there was an increase in the average ROE comparison of
insurance companies between 2009-2013 and 2015-2019, namely 1.916, which means
that the ability of insurance companies to use owner's equity to earn profits for
shareholders and increase company value is better in the period after the implementation
of BPJS Health regulations compared to before the implementation of regulations.
The results of DEA analysis comparing the efficiency of the period before and
after the implementation of BPJS Health regulations show that there are differences in
results between the CRS and VRS models because the CRS model represents more
technical efficiency and scale efficiency. In contrast, the VRS model only represents
technical efficiency. The results of the CRS model efficiency show an increase, offset
by an increase in ROE, even though the value of ROA has decreased. The decrease in
ROA was due to an increase in total assets. Thus, researchers are more inclined to the
CRS model than the VRS. Based on this, H2 is supported, and H0 is rejected because
the performance results show differences in insurance companies before and after the
BPJS Health regulation.
Hypothesis Testing
Table 5
Paired Samples Test (Firm’s Efficiency)
Paired Differences
t
Df
Sig.
(2-
tailed)
Mean
Std.
Deviati
on
Std.
Error
Mean
95% Confidence
Interval of the
Difference
Lower
Upper
P
a
ir
1
Before
- After
-
.129433
.42276
4
.05457
9
-
.23864
5
-
.02022
2
-
2.3
72
59
.021
Based on the table above, it can be seen that the significance value is 0.021 where
<0.05 with an increase that occurs at a mean efficiency of 0.129 so that H1 is supported
and H0 is rejected because there is a positive change in the efficiency of insurance
companies between the period before and after the implementation of the BPJS Health
regulation, which was supported by an increase in the output of insurance companies.
Table 6
Paired Samples Test (Firm Performance-ROA)
Paired Differences
T
Df
Sig.
(2-
tailed
)
Mean
Std.
Deviat
ion
Std.
Error
Mean
95% Confidence
Interval of the
Difference
Lower
Upper
Analyzing The Effects Of The Health Bpjs Regulation On The Insurance Companies
Performance And Efficiency
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, Agustus 2023 957
P
ai
r
1
Before
2014
After 2014
.0114
33
.1216
67
.01570
7
-
.01999
7
.04286
3
.72
8
59
.470
Based on the table above, it can be seen that the significance value is 0.470 where
> 0.05 with a decrease that occurs in the mean ROA of 0.011, meaning that H0 is
supported and H2 is rejected because there is no difference in the ROA of insurance
companies between the period before and after the implementation of the BPJS Health
regulation.
Table 7
Paired Samples Test (Firm Performance-ROE)
Paired Differences
t
D
f
Sig.
(2-
tailed
)
Mean
Std.
Deviati
on
Std.
Error
Mean
95% Confidence
Interval of the
Difference
Lower
Upper
Pa
ir
1
Before
2014 -
After
2014
-
2.1588
50
15.694
158
2.0261
07
-
6.2130
81
1.8953
81
-
1.0
66
5
9
.291
Based on the table above, it can be seen that the significance value is 0.291 where
> 0.05 with an increase in the mean ROE of 2.159, meaning that H0 is supported and
H2 is rejected because there is no significant difference in insurance company ROE
between the period before and after the implementation of the BPJS Health regulation.
Conclusion
Based on the elaboration above regarding the results of the study, it can be
concluded that. With the CRS model, the existence of BPJS Health regulations has a
positive impact on the efficiency of insurance companies, which is indicated by the
results of the hypothesis where H0 is rejected. The existence of BPJS Health regulations
does not have an impact on the ROA performance of insurance companies due to an
increase in assets. Meanwhile, ROE has an impact on performance.
ACKNOWLEDGEMENTS
We want to thank the Center for Management Development, Department of
Management, Faculty of Business and Economics, Universitas Islam Indonesia, for
providing grants for this research.
Syefiki Amalia Army, Katiya Nahda
Jurnal Indonesia Sosial Teknologi, Vol. 4, No. 8, August 2023 958
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