One form of quality management is cost-efficiency. In term of cost-efficiency,  BPJS Kesehatan is developing a referral system. Fasilitas Kesehatan Tingkat Pertama (FKTP) acts as a gate keeper for the selection of cases that can treated at the first or second level of health care. Of course this is very important for the aspect of financing, because the cases handled by the second level of health care cost more. The fact is that 144 diagnoses that should be completed in FKTP were still referred to second level health care facilities. Seeing the potential for a decrease in the quality of service both in second level health care and FKTP because patients are not appropriately referenced, in 2015 the Makassar Branch Office decided that some efforts should be made to minimize the above problems. One of the efforts is to conduct supervision of FKTP to get an overview of the barriers that are found on the first level of service that causes the less than optimal quality of service in FKTP.