Responsiveness and Satisfaction with Providers and Carriers in a Safety Net Insurance Program : Evidence from Georgia's Medical Insurance for the Poor

Objective: To evaluate provider responsiveness and beneficiary satisfaction with insurance carriers participating in the Republic of Georgia’s Medical Insurance for the Poor. Study setting: A dedicated survey of approximately 3,500 households in two types of regions – with different eligibility thresholds – in November and December 2008. Study design: Regression-based estimation of responsiveness ratings by beneficiaries and non-beneficiaries of the insurance program and estimation of mean satisfaction scores for beneficiaries. Principal findings: In the high-threshold regions, provider responsiveness toward beneficiaries and non-beneficiaries is comparable. In the low-threshold regions, beneficiary status is associated with lower responsiveness of outpatient providers. Inpatient providers may have become less responsive toward beneficiaries during the program’s transition from public to private administration. While satisfaction of beneficiaries with carriers is above average, there are reports of difficulties obtaining reimbursement and information about benefits. Conclusions: The results suggest that relying on private insurance companies to deliver public programs in middle-income settings may impact provider responsiveness and indicates the need for continuous monitoring and regulation