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Georgian Government introduces co-payments into its UHC scheme - P4H Network

Georgian Government introduces co-payments into its UHC scheme

The Georgian government is introducing co-payments in the universal health coverage system to allow patient choice and flexibly. Prime Minister Irakli Kobakhidze said patients who could not choose a preferred provider or certain comfort level during medical care would no longer refuse universal health coverage altogether.

 

As reported by @NGnewsgeorgia, the Georgian government announced changes to the state health insurance system. A co-payment mechanism is planned to be introduced, which will allow patients to receive medical services more flexibly, Prime Minister Irakli Kobakhidze said after a government meeting on October 24, 2024. It is assumed that citizens will be able to continue to use free services, but will also be able to pay extra for additional options, such as choosing a doctor, nurse or room.

“Thousands of people will no longer have to refuse universal health care simply because they want to receive various medical services, which was impossible under the current regulations,” Kobakhidze said. The Minister of Health has been instructed to develop specific co-payment conditions by the end of the year (2024). He must determine the limits for different types of services and co-payment conditions.

Since January 1, 2023, health care organizations reimbursed under the universal health care program switched to the DRGs (Diagnosis-Related Groups) financing model. In Georgia, this mechanism means provider of medical services receive fixed funding from the state for treating patients depending on their diagnosis. Many health care organizations have protested the established tariffs. The Ministry of Health has reacted by increasing tariffs (reimbursement rates) and funding for expensive resuscitation services (intensive care). Health system managers say the DRG system has areas for improvement. In some instances, the state refused to reimburse certain services for patients, citing incorrect diagnoses, which made health care providers dissatisfied. The universal health coverage in Georgia is being continuously improved and reformed.

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