Background: Hospital must be able to keep up with the times that are getting faster, both in terms of technology, science and information. Hospital must have a component of hospital service quality and healthy financial, so that hospital will be able to become of good service and financial performance will not get losses. Method: This study was a case study. The informants in the study were the head of the finance department, health workers and BPJS patients. Data collection techniques used interview guidelines, questionnaires and documentation. Data analysis used as quantitative and qualitative descriptive analysis. Results: Research shows that 1) service performance in the era of National Health Insurance as many as 5 (50.0%) respondents stated in good category. Services that need to be improved are the duration of waiting time and timeliness in implementing the schedule, as well as the readiness of doctors to serve patients. 2) Financial performance in the era of National Health Insurance was quite good in 2016, but in 2017 had a decrease in financial ratios. This condition is due to claims/payments of BPJS patients being disbursed in the following month so that financial performance becomes disrupted, the hospital’s tariff is sometimes not in accordance with the tariffs determined by BPJS Conclusion: Service performance is good at Yogyakarta's At-Turots Al-Islamy Hospital, but the duration of waiting time and timeliness in implementing the schedule, as well as the readiness of doctors to serve patients still need to be improved. Financial performance in 2016 was quite good, but there was a decrease in 2017 due to the prescription of drugs not in accordance with the JKN tariff maximum. Keywords: service performance, financial performance, era of national health insurance