Harnessing Digital Innovation for Fair and Efficient Health Financing in Indonesia and Korea

The ADB–IQVIA study showcases how Indonesia’s Mobile JKN and Korea’s HIRA ICT systems revolutionized health financing through digital innovation, boosting efficiency, transparency, and universal access. It concludes that strategic digitalization, backed by strong governance and public trust, can transform health systems into more equitable and sustainable models.

The Asian Development Bank’s Sustainable Development Working Paper No. 111, developed jointly by researchers from IQVIA and the Asian Development Bank (ADB), explores how digital technologies have reshaped health financing in Indonesia and the Republic of Korea. Authored by Parul Goela, Kanishak Gautam, Santosh Moses, and Saro Tsaturyan from IQVIA, together with ADB health specialists Jae Kyoun Kim, Akihito Watabe, and Eduardo P. Banzon, the report shows how both nations used automation, artificial intelligence, and mobile innovations to enhance efficiency, transparency, and equity in their healthcare systems. These models, the study argues, provide valuable lessons for developing countries seeking to achieve Universal Health Coverage (UHC) through digital transformation.

Indonesia’s Digital Leap Toward Universal Health Coverage

Indonesia’s health financing reform began with the launch of Jaminan Kesehatan Nasional (JKN) in 2014, which consolidated over 300 fragmented insurance schemes into a single program managed by the Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS Kesehatan). The system rapidly expanded coverage to more than 235 million citizens, reducing out-of-pocket (OOP) health expenses from nearly half of all expenditures to about 30 percent. Yet the massive participation led to long queues and administrative delays, with around 300,000 people visiting BPJS offices daily. To address this, Indonesia introduced the Mobile JKN app in 2017, providing citizens with a digital one-stop solution for registration, payments, membership updates, and access to healthcare services.

The app, available on Android and iOS, includes features such as digital ID cards, payment tracking, and medical history access. It also offers health screening tools and a chatbot powered by artificial intelligence. Within three years, it was downloaded over 10 million times, reducing office visits by 68 percent and improving user satisfaction. Complaints were resolved faster, with nearly 99 percent handled within five days. Mobile JKN has since evolved into a critical platform for Indonesia’s march toward inclusive, citizen-centered healthcare.

Smart Innovations Behind Indonesia’s JKN-Mobile

The digital transformation of JKN deepened through continuous innovation. The online queue management system, launched in 2022, allowed patients to obtain queue numbers before arriving at hospitals, cutting waiting times from six hours to under one. The app also integrates with hospital systems for seamless referrals. Another addition, i-Care JKN, connects doctors with hospitals and primary care centers, enabling them to view patient histories and coordinate treatment in real time. Meanwhile, the REHAB 2.0 feature helps informal workers pay overdue premiums in installments, automatically reactivating their insurance cards once payments are completed. Together, these advancements have strengthened financial sustainability and boosted accessibility across Indonesia’s health network, marking a turning point in how digital tools can humanize health financing.

Korea’s Digital Discipline: The HIRA Advantage

While Indonesia focused on access, the Republic of Korea mastered precision and efficiency through the Health Insurance Review and Assessment Service (HIRA). Established in 2000 under the Ministry of Health and Welfare (MoHW), HIRA supports Korea’s National Health Insurance (NHI) system, which achieved universal coverage in just 12 years. The HIRA’s Information and Communication Technology (ICT) framework digitally connects all hospitals, clinics, and pharmacies, processing more than 1.5 billion claims annually, 99 percent of them electronically. Its six main components form the backbone of Korea’s digital health financing model: the Healthcare Data Acquisition System (HDAS) for data collection, Health Data Review and Assessment System (HRAS) for AI-powered claims checks, Korea Pharmaceutical Information Service (KPIS) for drug tracking, Drug Utilization Review (DUR) for real-time alerts on drug safety, Provider Integrated Profiling System (PIPS) for provider evaluation, and the Healthcare Big Data System (HBiG) for analytics and policy development.

This integrated network has saved Korea more than USD 1.25 billion annually by preventing fraud and overbilling. During the COVID-19 pandemic, its real-time data exchange capabilities enabled rapid public health response and efficient medical resource allocation.

Global Leadership Through Digital Governance

HIRA’s success extends beyond Korea’s borders. Its systems, certified under ISO 9001 and ISO 20000, employ big data, artificial intelligence, and Internet of Things (IoT) technologies such as RFID tags for tracking medical supplies. The Drug Utilization Review and International Traveler Information System (ITS) played a vital role in managing infectious diseases like MERS and COVID-19. Korea has also exported its digital health expertise to over 20 countries through the K-Health International Cooperation Strategy and is recognized as a World Health Organization Collaborating Center for digital health policy. These achievements underline how a strong digital backbone can ensure financial transparency, patient safety, and innovation simultaneously.

A Blueprint for the Future of Health Financing

The ADB report concludes that Indonesia and Korea represent two complementary approaches to digital health reform. Indonesia’s Mobile JKN demonstrates how inclusive, mobile-based innovation can expand access and trust, while Korea’s HIRA shows how sophisticated data management can optimize resources and policy. Both models highlight the importance of strong governance, skilled digital workforces, and institutional coordination. For developing nations, ADB recommends starting with mobile and claims automation, then gradually integrating interoperable systems for long-term sustainability.

Ultimately, the study argues that digital transformation in health financing is not just a technical upgrade but a redefinition of governance and equity. By combining innovation with accountability, Indonesia and Korea prove that technology can bridge the gap between healthcare systems and the citizens they serve. In doing so, they offer a powerful message for the future: digitalization, when people-centered, is the foundation of fair, resilient, and sustainable healthcare for all.