Health_Financing.pdf

U.S. Agency for International Development American Embassy, Jl. Budi Kemuliaan I/1, Jakarta 10110 – Indonesia Tel: (62 21) 3435-9000 http://www.usaid.gov/indonesia

Subject: Sources Sought Notice Program Name: Health Financing Activity Issuance Date: November 13th, 2017 Response Due: November 27th, 2017 (OOB 08:00 a.m., Jakarta time) Response To: proposals-indo@usaid.gov

USAID/Indonesia is designing a Health Financing Activity to help the Government Of Indonesia (GOI) improve the performance of Indonesia’s financing system, including JKN (Jaminan Kesehatan Nasional = universal health coverage program). The purpose of this Sources Sought Notice is to identify qualified small business concerns that are interested in and capable of performing the work described herein. Your responses to the information requested will assist USAID to plan the acquisition strategy, including whether a set-aside is possible. This is not a Request for Proposal and in no way obligates the Government to award a contract. USAID/Indonesia will not entertain questions regarding this market research.

Background:

As part of the implementation of the National Social Security Law (SJSN), the GOI has a target to cover all Indonesians under their universal health coverage program (JKN) by 2019. Currently, with over 180 million people covered under JKN, Indonesia has the largest national health insurance system in the world. However, at this time, only 15% of total health expenditures (THE) and 30% of government health spending flows through JKN. Given the complex decentralized structure of the Indonesian health system, a significant percentage of government funds for the health sector continue to flow through a variety of intergovernmental fiscal transfers that lie outside the JKN program. Despite recent increases in health sector budget allocations, overall government health spending is one of the lowest in the ASEAN region (approximately 1.6% of Gross Domestic Product) and out of pocket payments remain high (approximately 45% of THE). However, the implementation of recent health financing reforms is promising and has led to significant opportunities for improving health outcomes across the board and specifically for USAID priority health areas of HIV, tuberculosis (TB) and maternal and newborn health (MNH) (the Priority Health Areas).

Better health financing makes healthcare more accessible, especially for poor and vulnerable populations. Efficient, predictable and transparent financing helps increase the supply of quality health services. Improving financial access and availability of quality health care in turn leads to better health outcomes and over time to increased productivity and reduced poverty. Finally, thoughtfully structured health care purchasing arrangements can improve the quality of care that will also contribute to better outcomes and health system responsiveness. These principles are consistent with the Indonesian priorities for health, Indonesia’s commitment to the Sustainable Development Goals, USAID’s mission to reduce poverty, and the USAID/Indonesia Country Development Cooperation Strategy (CDCS).

Activity Synopsis:

The purpose of this activity is to contribute toward the improvement of the efficiency, equity, predictability and sustainability of GOI financing for health across the board, and especially for USAID Priority Health Areas, by building the capacity of Indonesian institutions to conceptualize, conduct and apply the necessary health financing analyses and tools needed to drive health sector reform.

Sources Sought Notice – Health Financing Activity

Activity objectives include:

1) Improved sustainability and allocative and technical efficiency of GOI financing for health.

USAID seeks technical assistance to support the GOI in producing and applying high quality health finance performance indicators to health sector reform decision making. Specific activities include, but are not limited to, institutionalization of a health expenditure tracking systems, fiscal space analysis, financial viability analysis of the health insurance fund, effectiveness of supply versus demand side financing, annual monitoring and reporting of out of pocket spending, equity in access to and utilization of health services and other relevant research to guide policy.

2) Improved health financing efficiency and greater impact on health outcomes. USAID seeks technical assistance to support the GOI in designing, implementing, monitoring and improving health care provider payment mechanisms with the aim of contributing toward the achievement of better health outcomes and stabilizing cost per member enrolled in JKN. Specific activities include, but are not limited to, working with the GOI to create data-driven recommendations on how to improve the government’s approach to purchasing health services through the JKN system, which might lead to refinements to current methods or alternative purchasing approaches entirely. How to improve GOI purchasing of health services for USAID Priority Health Areas must be considered and will include working, in the areas of HIV, TB and MNH to understand patient flows and identify financing-related bottlenecks and levers to improve patient outcomes; design, test and scale new/alternative provider payment mechanism models with appropriate monitoring and evaluation methods; and provide technical direction for strategic health purchasing. We envision this work applying to private and public sector providers.

3) Improved capacity of the Indonesian system (government and other institutions / centers of excellence) to produce and apply key health financing related analyses for policy decision making. USAID seeks support in building the capacity of the relevant government agencies, Ministry of Health (MOH), Ministry of Finance (MOF), National Social Security Council (DJSN), National Health Insurance Agency (BPJS-K), National Planning Board (Bappenas) and the National Taskforce for Poverty Reduction (TNP2K) and other bodies such as the Center for Health Policy (CHPM) in the University of Gajah Mada, the Indonesian Health Economics Association (CHEPS) in the University of Indonesia and/or other relevant institutions, in producing and applying high quality health finance performance indicators to health sector reform decision making. In addition to the skills transfer that takes place when people work side-by-side (global and local talent), other approaches to capacity building could include specific trainings and workshops, academic and professional exchanges between Indonesian experts and global consultants, study tours, regular progress reviews with key stakeholders and innovative approaches to organizational and leadership development.

Submission Instructions:

Interested qualified US small businesses should submit a tailored capability statement for this objectives in Microsoft Word or Adobe PDF format to proposals-indo@usaid.gov with the subject title “Sources Sought Notice: USAID/Indonesia Health Financing Activity”, no later than the date/time stated above.

In the cover page, please provide business information of DUNS, Organization Name, Organization Address and the Contact Information.

Responses should not exceed 8 single-sided pages (12-point Times New Roman font, single-spaced with one inch margins on the electronic equivalent of 8.5 x 11 inch paper). Responses should include a minimum of two pages demonstrating past experience in achieving similar objectives over the past two years. All proprietary information should be marked as such. Statements should also include an mailto:proposals-indo@usaid.gov

Sources Sought Notice – Health Financing Activity indication of current certified US small business status1; this indication should be clearly marked on the first page of your capability statement. Those working on domestic health financing issues are welcome to respond. Teaming arrangements are encouraged. Responses will be reviewed only by USAID personnel and will be held in a confidential manner.

Responses to this notice are NOT considered offers and CANNOT be accepted by the Government to form a binding contract. Responses are strictly voluntary and USAID will NOT reimburse respondents for the preparation of information submitted in response to this notice.

By responding to this notice, there will be no advantage to any entity in any subsequent procurement.

This notice does NOT restrict the Government's acquisition approach on a future solicitation.

USAID appreciates any feedback provided. Thank you for your time and interest in USAID’s activities.

Sincerely, /s/ Albert E. Carrera Contracting Officer USAID/Indonesia

1 8(a), Historically Underutilized Business (HUB) Zone, Women Owned Small Business (WOSB), Economically Disadvantaged Women Owned Small Business (EDWOSB), Service Disabled Veteran Owned Small Business (SDVOSB), Veteran Owned Small Business (VOSB), Small Disadvantaged Business (SDB), Small Business (SB)