BPJS Claim Receivables, Working Capital, and Operating Cash Flow at PKU Muhammadiyah Wonosobo

Abstract

BPJS Kesehatan claim receivables represent a significant source of liquidity pressure for hospitals, as delays in reimbursement collection may constrain working capital and operating cash flow. This study examined the performance of BPJS Kesehatan claim receivables and their statistical associations with working capital and operating cash flow at PKU Muhammadiyah Wonosobo Hospital. A quantitative descriptive-associative research design was employed using 36 consecutive monthly financial statements covering January 2023 through December 2025. Receivables management performance was measured using receivables turnover (RTO) and days sales outstanding (DSO), while financial performance was assessed using working capital, the current ratio, and the operating cash flow ratio. Data were analyzed using descriptive trend analysis, Pearson correlation analysis, and separate simple linear regression models with IBM SPSS Statistics. RTO decreased from 6.35 times in 2023 to 5.89 times in 2025, while DSO increased from 57.52 to 61.96 days. Working capital declined from IDR 4.17 billion to IDR 4.00 billion, the current ratio decreased from 1.73 to 1.57, and the operating cash flow ratio fell from 0.38 to 0.22. RTO exhibited positive associations, whereas DSO demonstrated negative associations, with all three financial indicators. However, because DSO is mathematically related to RTO, the reported strong statistical associations should be interpreted cautiously and should not be considered evidence of independent causal effects. The findings indicated that declining receivables collection efficiency coincided with reduced liquidity flexibility and operating cash flow capacity during the study period.