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Organizational commitment is essential for maintaining hospital performance, service quality, and healthcare continuity. Preliminary data from Brebes Regional General Hospital shows that 35% of medical doctors face issues with low organizational commitment, which may negatively impact the institution's effectiveness. This study examines how meritocracy strengthens the effects of transformational leadership and work motivation on medical personnel's organizational commitment. A quantitative approach with causal research design was used to analyze the relationships among these variables. The sample included 72 doctors, selected through purposive sampling. Data were collected via structured questionnaires and analyzed using Moderated Regression Analysis (MRA) to assess both direct and moderating effects. The findings show that transformational leadership, work motivation, and meritocracy together significantly influence organizational commitment. Transformational leadership and work motivation each have a positive impact on organizational commitment. Additionally, meritocracy serves as a moderating factor, enhancing the connection between leadership and commitment, as well as work motivation and commitment. These results suggest that meritocratic systems based on competence, performance, and achievement improve leadership effectiveness and motivation, fostering greater commitment among medical staff. The study suggests that hospital management should implement meritocratic principles consistently in leadership and human resource practices, alongside developing transformational leadership and motivation strategies, to maintain high levels of organizational commitment among medical personnel.

This study investigates the optimization of claims under the Indonesian Case-Based Groups (INA-CBGs) payment mechanism within the National Health Insurance Program (Jaminan Kesehatan Nasional) at Hospital X in Serang. The research aims to analyze the influence of managerial competence, digital adoption, and organizational behavior on claim effectiveness, with policy implementation serving as a moderating variable. Employing a quantitative explanatory approach, data were collected from 144 respondents comprising management staff, casemix teams, and medical record officers through questionnaires and structured interviews. Structural Equation Modeling–Partial Least Square (SEM-PLS) was applied to examine the relationships among variables. Findings reveal that managerial competence, digital adoption, and organizational behavior significantly and positively affect the optimization of INA-CBGs claims. Furthermore, the implementation of the National Health Insurance Program policy strengthens these relationships, enhancing claim efficiency and equity. The results align with the Resource-Based View theory, highlighting the strategic role of internal resources in achieving organizational performance. Managerial implications include capacity building for managers, integration of hospital information systems (SIMRS) with e-Claim platforms, and fostering collaborative organizational culture. Overall, the study underscores the importance of managerial, technological, and behavioral factors, moderated by policy implementation, in improving hospital claim optimization under the INA-CBGs system.