Latar Belakang: Pengadaan alat medis di rumah sakit merupakan proses yang kompleks dan dipengaruhi oleh berbagai faktor, termasuk kebijakan pengadaan, efisiensi keuangan dan kebutuhan akan manajemen teknologi medis yang efektif. RSUD Oto Iskandar Di Nata mendapat tantangan efisiensi pengadaan alat medis dikarenakan rekam jejak investasi alat medis yang tidak efektif dan efisien selama 5 tahun terakhir ditambah keterbatasan anggaran akibat penurunan dana Transfer Ke Daerah.  Terbitnya kebijakan transformasi rumah sakit berbasis kompetensi yang dititikberatkan kepada ketersediaan alat kesehatan melatar belakangi perlunya mengevaluasi alur pengadaan alat medis yang berjalan saat ini dan merumuskan model transformasi sistem pengadaan alat medis di RSUD Oto Iskandar Di Nata melalui penerapan kerangka kerja Value-Based Procurement (VBP) yang diharapkan dapat mengoptimalkan proses pengambilan keputusan pengadaan sehingga mendukung efisiensi penggunaan sumber daya rumah sakit.. Metode: Penelitian ini menggunakan desain kualitatif dengan metode pengambilan data dengan wawancara mendalam sebagai teknik pengambilan data utama. 14 orang informan dipilih dengan metode purposive sampling yang berasal dari tim manajemen, tim pengadaan dan pengguna. Penelitian dilaksanakan pada bulan Maret-Mei 2026 di RSUD Oto Iskandar Di Nata Kabupaten Bandung. Data yang didapatkan dianalisis dengan metode analisis tematik guna mengidentifikasi pola nilai pengadaan Hasil: Hasil penelitian menemukan bahwa pengadaan alat medis modal belum optimal. RS masih menggunakan prinsip pengadaan tradisional yang mengedepankan harga penawaran terendah. Identifikasi pengadaan berbasis nilai menemukan bahwa selain harga penawaran terendah ada aspek lain yang yang belum terformularisasikan ke dalam instrumen penilaian pengadaan. Pada aspek nilai harga, alat dipilih berdasarkan nilai pembelian yang ditawarkan dan harga pemeliharaan pasca pembelian. Pada aspek kualitas, alat dipilih berdasarkan nilai keramahan terhadap pengguna serta tingkat keterjagaan mutu serta inovasi alat. Pada aspek dampak, alat diharapkan menimbulkan peningkatan mutu layanan, penjagaan finansial dan peningkatan daya saing rumah sakit. Kesimpulan: Pengadaan alat medis modal di RSUD Oto Iskandar Di Nata belum berjalan dengan optimal. Tidak adanya regulasi internal terkait pengadaan membuat tidak terstandarisasinya proses pengadaan. Dalam upaya optimalisasi pengadaan dengan penerapan Value-Based Procurement (VBP), matriks penilaian pengambilan keputusan pengadaan dibuat dengan mempertimbangkan keseimbangan antara kualitas, manfaat klinis, efisiensi biaya, keberlanjutan operasional, dan dampak terhadap rumah sakit, alih-alih hanya berpatokan pada harga beli termurah

Background: Medical device procurement in hospitals is a complex process influenced by various factors, including procurement policies, financial efficiency, and the need for effective medical technology management. RSUD Oto Iskandar Di Nata faces challenges in achieving procurement efficiency due to a history of ineffective and inefficient medical device investments over the past five years, compounded by budget constraints resulting from reductions in intergovernmental transfer funds. Furthermore, the implementation of hospital transformation policies based on service competencies, which emphasize the availability of medical devices and equipment, has underscored the need to evaluate the existing procurement process and formulate a transformative medical device procurement model at RSUD Oto Iskandar Di Nata. This transformation is proposed through the adoption of a Value-Based Procurement (VBP) framework, which is expected to optimize procurement decision-making processes and enhance the efficient utilization of hospital resources. Methods: This study employed a qualitative research design, with in-depth interviews serving as the primary data collection method. Fourteen informants were selected using purposive sampling and consisted of members of the management team, procurement team, and end users. The study was conducted between March and May 2026 at RSUD Oto Iskandar Di Nata, Bandung Regency, Indonesia. The collected data were analyzed using thematic analysis to identify procurement value patterns Results: The findings revealed that the current capital medical device procurement process has not been optimized. The hospital continues to rely on a traditional procurement approach that prioritizes the lowest bid price. The assessment of value-based procurement identified additional dimensions beyond the lowest acquisition cost that have not yet been formally incorporated into the procurement evaluation framework. Regarding the cost dimension, procurement decisions are influenced by both the purchase price and post-purchase maintenance costs. In terms of quality, devices are selected based on user-friendliness, quality assurance, and technological innovation. Concerning impact, medical devices are expected to contribute to improvements in service quality, financial sustainability, and the hospital’s competitive advantage. Conclusion: Capital medical device procurement at RSUD Oto Iskandar Di Nata has not been functioning optimally. The absence of internal regulations governing procurement has resulted in a lack of standardization in the procurement process. In an effort to optimize procurement through the application of Value-Based Procurement (VBP), a procurement decision-making assessment matrix was developed that considers the balance between quality, clinical benefit, cost efficiency, operational sustainability, and impact on the hospital, rather than relying solely on the lowest purchase price.